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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 12/2007

01-12-2007 | Original article

FET PET for the evaluation of untreated gliomas: correlation of FET uptake and uptake kinetics with tumour grading

Authors: Gabriele Pöpperl, Friedrich W. Kreth, Jan H. Mehrkens, Jochen Herms, Klaus Seelos, Walter Koch, Franz J. Gildehaus, Hans A. Kretzschmar, Jörg C. Tonn, Klaus Tatsch

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2007

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Abstract

Purpose

Treatment and prognosis of gliomas depend on their histological tumour grade. The aim of the study was to evaluate the potential of [18F]fluoroethyltyrosine (FET) PET for non-invasive tumour grading in untreated patients.

Methods

Dynamic FET PET studies were performed in 54 patients who, based on MRI, were estimated to have low grade (LG; n = 20), intermediate (WHO II–III; n = 4) or high grade (HG; n = 30) tumours. For standard evaluation, tumour SUVmax and the ratio to background (SUVmax/BG) were calculated (sum image: 20–40 min). For dynamic evaluation, mean SUV values within a 90% isocontour ROI (SUV90) and the SUV90/BG ratios were determined for each time frame to evaluate the course of FET uptake. Results were correlated with histopathological findings from PET-guided stereotactic biopsies.

Results

Histology revealed gliomas in all patients. Using the standard method a statistically significant difference (p = 0.001) was found between LG (n = 20; SUVmax/BG: 2.16 ± 0.98) and HG (n = 34; SUVmax/BG: 3.29 ± 1.06) gliomas (opt. threshold 2.58: SN71%/SP85%/area under ROC curve [AUC]:0.798), however, with a marked overlap between WHO II to IV tumours. Time activity curves showed slight increase in LG, whereas HG tumours presented with an early peak (10–20 min) followed by a decrease. Dynamic evaluation successfully separated LG from HG gliomas with higher diagnostic accuracy (SN94%/SP100%/AUC:0.967).

Conclusions

Based on the ratio-based method, a statistically significant difference was found between LG and HG gliomas. Due to the interindividual variability, however, no reliable individual grading was possible. In contrast, dynamic evaluation allowed LG and HG gliomas to be differentiated with high diagnostic power and, thus, should supplement the conventional method.
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Metadata
Title
FET PET for the evaluation of untreated gliomas: correlation of FET uptake and uptake kinetics with tumour grading
Authors
Gabriele Pöpperl
Friedrich W. Kreth
Jan H. Mehrkens
Jochen Herms
Klaus Seelos
Walter Koch
Franz J. Gildehaus
Hans A. Kretzschmar
Jörg C. Tonn
Klaus Tatsch
Publication date
01-12-2007
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2007
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-007-0534-y

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