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European Journal of Nuclear Medicine and Molecular Imaging

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01-04-2005 | Original Article

O-(2-[¹⁸F]fluorethyl)-L-tyrosine PET in the clinical evaluation of primary brain tumours

Authors: M. Weckesser, K.J. Langen, C.H. Rickert, S. Kloska, R. Straeter, K. Hamacher, G. Kurlemann, H. Wassmann, H.H. Coenen, O. Schober

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2005

Abstract

Purpose

The aim of this study was to evaluate the differential uptake of O-(2-[¹⁸F]fluorethyl)-L-tyrosine (FET) in suspected primary brain tumours.

Methods

Positron emission tomography (PET) was performed in 44 patients referred for the evaluation of a suspected brain tumour. Acquisition consisted of four 10-min frames starting upon i.v. injection of FET. Tumour uptake was calculated as the ratio of maximal tumour intensity to mean activity within a reference region (FET_max).

Results

FET uptake above the cortical level was observed in 35/44 lesions. All histologically confirmed gliomas and many other lesions showed FET uptake to a variable extent. No uptake was observed in nine lesions (one inflammatory lesion, one dysembryoplastic neuroepithelial tumour, one mature teratoma, six lesions without histological confirmation). An analysis of uptake dynamics was done in the patients with increased FET uptake (22 gliomas, three lymphomas, three non-neoplastic lesions, three lesions with unknown histology and four other primaries). Upon classification of tumours into low (i.e. WHO I and II) and high grade (i.e. WHO III and IV), a significant difference in FET_max between the two categories was observed only in the first image frame (0–10 min p.i.), with FET_max=2.0 in low-grade and 3.2 in high-grade tumours (p<0.05); no significant differences were found in frame 4 (30–40 min p.i.), with FET_max=2.4 vs 2.7. Similar results were obtained when the analysis was applied only to astrocytic tumours (2.0 vs 3.1 in the first frame; 2.4 vs 2.6 in the fourth frame).

Conclusion

These initial results indicate that FET PET is a useful method to identify malignant brain lesions. It appears that high- and low-grade brain tumours exhibit a different uptake kinetics of FET. A kinetic analysis of FET PET may provide additional information in the differentiation of suspected brain lesions.

Jager PL, Vaalburg W, Pruim J, de Vries EG, Langen KJ, Piers DA. Radiolabeled amino acids: basic aspects and clinical applications in oncology. J Nucl Med 2001;42:432–45.PubMed

Bergström M, Collins VP, Ehrin E, Ericson K, Eriksson L, Greitz T, et al. Discrepancies in brain tumor extent as shown by computed tomography and positron emission tomography using [⁶⁸Ga]EDTA, [¹¹C]glucose, and [¹¹C]methionine. J Comput Assist Tomogr 1983;7:1062–66.PubMed

Mosskin M, Ericson K, Hindmarsh T, von Holst H, Collins VP, Bergstrom M, et al. Positron emission tomography compared with magnetic resonance imaging and computed tomography in supratentorial gliomas using multiple stereotactic biopsies as reference. Acta Radiol 1989;30:225–32.PubMed

Ogawa T, Shishido F, Kanno I, Inugami A, Fujita H, Murakami M, et al. Cerebral glioma: evaluation with methionine PET. Radiology 1993;186:45–53.PubMed

Pirotte B, Goldman S, Massager N, David P, Wikler D, Vandesteene A, et al. Comparison of¹⁸F-FDG and¹¹C-methionine for PET-guided stereotactic brain biopsy of gliomas. J Nucl Med 2004;45(8):1293–98.PubMed

Kaschten B, Stevenaert A, Sadzot B, Deprez M, Degueldre C, Del Fiore G, et al. Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med 1998;39:778–85.PubMed

Herholz K, Hölzer T, Bauer B, Schröder R, Voges J, Ernestus RI, et al. ¹¹C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 1998;50:1316–22.PubMed

Würker M, Herholz K, Voges J, Pietrzyk U, Treuer H, Bauer B, et al. Glucose consumption and methionine uptake in low-grade gliomas after iodine-125 brachytherapy. Eur J Nucl Med 1996;23:583–86.PubMed

Langen KJ, Ziemons K, Kiwit JCW, Herzog H, Kuwert T, Bock WJ, et al. [¹²³I]-Iodo-α-methyltyrosine SPECT and [¹¹C]-L-methionine uptake in cerebral gliomas: a comparative study using SPECT and PET. J Nucl Med 1997;38:517–22.PubMed

10.

Matheja P, Rickert CH, Weckesser M, Palkovic S, Löttgen J, Riemann B, et al. Sequential scintigraphic strategy for the differentiation of brain tumours. Eur J Nucl Med 2000;27:550–58.CrossRefPubMed

11.

Schmidt D, Gottwald U, Langen KJ, Weber F, Hertel A, Floeth F, et al. 3-[¹²³I]Iodo-α-methyl-L-tyrosine uptake in cerebral gliomas: relationship to histological grading and prognosis. Eur J Nucl Med 2001;28:855–61.CrossRefPubMed

12.

Weber WA, Dick S, Reidl G, Dzewas B, Busch R, Feldmann HJ, et al. Correlation between postoperative 3-[(¹²³)I]iodo-L-alpha-methyltyrosine uptake and survival in patients with gliomas. J Nucl Med 2001;42:1144–50.PubMed

13.

Weckesser M, Matheja P, Schwarzrock A, Rickert CH, Strater R, Palkovic S, et al. Prognostic significance of amino acid transport imaging in patients with brain tumors. Neurosurgery 2002;50:958–64.PubMed

14.

Woesler B, Kuwert T, Morgenroth C, Matheja P, Palkovic S, Schäfers M, et al. Non-invasive grading of primary brain tumours: results of a comparative study between SPET with ¹²³I-alpha-methyl tyrosine and PET with ¹⁸F-deoxyglucose. Eur J Nucl Med 1997;24:428–34.CrossRefPubMed

15.

Riemann B, Papke K, Hoess N, Kuwert T, Weckesser M, Matheja P, et al. Noninvasive grading of untreated gliomas: a comparative study of MR imaging and 3-(iodine 123)-L-alpha-methyltyrosine SPECT. Radiology 2002;225:567–74.PubMed

16.

Bader JB, Samnick S, Moringlane JR, Feiden W, Schaefer A, Kremp S, et al. Evaluation of L-3-[¹²³I]iodo-alpha-methyltyrosine SPET and [¹⁸F]fluorodeoxyglucose PET in the detection and grading of recurrences in patients pretreated for gliomas at follow-up: a comparative study with stereotactic biopsy. Eur J Nucl Med 1999;26:144–51.CrossRefPubMed

17.

Kuwert T, Woesler B, Morgenroth C, Lerch H, Schäfers M, Palkovic S, et al. Diagnosis of recurrent glioma with SPECT and iodine-123-alpha-methyl tyrosine. J Nucl Med 1998;39:23–27.PubMed

18.

Levivier M, Wikler D, Goldman S, et al. Positron emission tomography in stereotactic conditions as a functional imaging technique for neurosurgical guidance. In: Alexander EI, Maciunas RJ, editors. Advanced neurosurgical navigation. New York: Thieme Medical; 1999. p. 85–99.

19.

Hamacher K, Coenen HH. Efficient routine production of the F-18-labelled amino acid O-(2-[F-18]fluoroethyl)-L-tyrosine. Appl Radiat Isotopes 2002;57:853–6.CrossRef

20.

Wester HJ, Herz M, Weber W, Heiss P, Senekowitsch-Schmidtke R, Schwaiger M, et al. Synthesis and radiopharmacology of O-(2-[¹⁸F]fluoroethyl)-L-tyrosine for tumor imaging. J Nucl Med 1999;40:205–12.PubMed

21.

Weber WA, Wester HJ, Grosu AL, Herz M, Dzewas B, Feldmann HJ, et al. O-(2-[¹⁸F]fluoroethyl)-L-tyrosine and L-[methyl−¹¹C]methionine uptake in brain tumours: initial results of a comparative study. Eur J Nucl Med 2000;27:542–9.CrossRefPubMed

22.

Messing-Junger AM, Floeth FW, Pauleit D, Reifenberger G, Willing R, Gartner J, et al. Multimodal target point assessment for stereotactic biopsy in children with diffuse bithalamic astrocytomas. Childs Nerv Syst 2002;18:445–9.CrossRefPubMed

23.

Pauleit D, Langen KJ, Floeth F, Sabel M, Reifenberger G, Hamacher K, et al. Improved delineation of the tumor extension using¹⁸F-FET PET compared with MRI in cerebral gliomas. J Nucl Med 2002;43(Suppl):112.

24.

Heiss P, Mayer S, Herz M, Wester HJ, Schwaiger M, Senekowitsch-Schmidtke R. Investigation of transport mechanism and uptake kinetics of O-(2-[¹⁸F]fluoroethyl)-L-tyrosine in vitro and in vivo. J Nucl Med 1999;40:1367–73.PubMed

25.

Langen KJ, Jarosch M, Muhlensiepen H, Hamacher K, Broer S, Jansen P, et al. Comparison of fluorotyrosines and methionine uptake in F98 rat gliomas. Nucl Med Biol 2003;30:501–8.CrossRefPubMed

26.

Pauleit D, Floeth F, Herzog H, Hamacher K, Tellmann L, Müller HW, et al. Whole-body distribution and dosimetry of O-(2-[(¹⁸)F]fluoroethyl)-l-tyrosine. Eur J Nucl Med Mol Imaging 2003;30:519–24.PubMed

Title: O-(2-[18F]fluorethyl)-L-tyrosine PET in the clinical evaluation of primary brain tumours
Authors: M. Weckesser
K.J. Langen
C.H. Rickert
S. Kloska
R. Straeter
K. Hamacher
G. Kurlemann
H. Wassmann
H.H. Coenen
O. Schober
Publication date: 01-04-2005
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2005
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-004-1705-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

O-(2-[¹⁸F]fluorethyl)-L-tyrosine PET in the clinical evaluation of primary brain tumours

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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