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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 9/2005

01-09-2005 | Original Article

O-(2-[18F]fluoroethyl)-l-tyrosine PET for monitoring the effects of convection-enhanced delivery of paclitaxel in patients with recurrent glioblastoma

Authors: G. Pöpperl, R. Goldbrunner, F. J. Gildehaus, F. W. Kreth, P. Tanner, M. Holtmannspötter, J. C. Tonn, K. Tatsch

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2005

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Abstract

Purpose

Convection-enhanced delivery (CED) of paclitaxel is a new locoregional approach for patients with recurrent glioblastoma. The aim of this study was to evaluate O-(2-[18F]fluoroethyl)-l-tyrosine (FET) positron emission tomography (PET) in monitoring the effects of this type of direct drug delivery.

Methods

Eight patients with recurrent glioblastoma underwent CED of paclitaxel, which was infused over stereotactically placed catheters into the tumour. FET PET and MRI were performed before and 4 weeks after therapy and then at 3-month intervals to document follow-up. For quantitative evaluation, SUVmax(tumour)/SUVmean(background) ratios were calculated.

Results

At baseline all tumours showed gadolinium enhancement and high FET uptake (SUVmax/BG 3.2±0.8). Four weeks after CED, a statistically significant decrease in FET uptake was seen (SUVmax/BG −17%; p<0.01). During follow-up, no recurrence was observed within the CED area. Two out of eight patients with extended tumours died 4 and 5 months after treatment, most probably from local complications. Temporarily stable disease with stable FET uptake was observed in six of eight patients; this was followed by progression and increasing FET uptake ratios (+46%) distant from the CED area in five of the six patients 3–13 months after CED. One patient still presents stable FET uptake 10 months after CED. MRI showed unchanged/increasing contrast enhancement and oedema without ability to reliably assess disease progression.

Conclusion

FET PET is a valuable tool in monitoring the effects of CED of paclitaxel. In long-term follow-up, stable or decreasing FET uptake, even in contrast-enhancing lesions, is suggestive of reactive changes, whereas increasing ratios appear always to be indicative of recurrence. Therefore, FET PET is more reliable than MRI in differentiating stable disease from tumour regrowth.
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Metadata
Title
O-(2-[18F]fluoroethyl)-l-tyrosine PET for monitoring the effects of convection-enhanced delivery of paclitaxel in patients with recurrent glioblastoma
Authors
G. Pöpperl
R. Goldbrunner
F. J. Gildehaus
F. W. Kreth
P. Tanner
M. Holtmannspötter
J. C. Tonn
K. Tatsch
Publication date
01-09-2005
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2005
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-005-1819-7

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