Article
FET-PET for postoperative control of resection of malignant gliomas
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Authors
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Niels Buchmann
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
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Jens Gempt
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
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Benjamin Kläsner
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
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Haiko Pape
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
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Annette Förschler
- Abteilung für Neuroradiologie, Institut für Röntgendiagnostik, Klinikum rechts der Isar der TU München, Deutschland
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Friederike Schmidt
- Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
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Bernhard Meyer
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
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Florian Ringel
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
| Published: | September 16, 2010 |
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Outline
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Objective: Complete resection is an important prognostic factor in the therapy of gliomas. Hence the postoperative control of the extent of resection is important for the estimation of a patient's prognosis and for the planning of further adjuvant therapies. Postoperative control of resection is carried out by MRI, currently. However, there can be a discrepancy between MRI and the biological imaging by FET-PET concerning exact localization and extent of the tumor. The aim of the present study was the evaluation of the role of FET-PET in the postoperative resection control in comparison to MRI.
Methods: A series of 31 patients harboring FET-positive (prior to surgery) gliomas (21 glioblastomas, 4 anaplastic astrocytomas, 5 diffuse astrocytomas, 1 pilocytic astrocytoma) were examined after surgical resection by MRI ± contrast agent and FET-PET. Imaging data were analyzed for presence and extent and localization of residual tumor tissue. MRI and PET results were compared.
Results: Concordant results were found for 21 patients in both imaging modalities concerning presence, extent and localisation of residual tumor. In 5 cases (16%) PET revealed residual tumor despite a tumor free MRI, in 1 case (3%) the suspicion of residual tumor in MRI could be excluded by PET. In 2 cases (6%) both imaging modalities showed residual tumor in contrary to the intraoperative estimation of a complete resection. In 2 cases, FET-PET was done in an interval of several days after surgery, therefore a reliable differentiation of residual tumor from unspecific changes was not possible.
Conclusions: We found a very good correlation of postoperative FET-PET and MRI in 81% of the evaluated cases. However, in 19% MRI and FET-PET showed discordant results. Due to the biological mechanism underlying FET-PET we suspect a higher sensitivity for detection of residual tumor than for MRI. However, to verify this hypothesis a higher number of patients has to be examined.
It is conceivable, that FET-PET might help predicting localization of recurring tumor already in the postoperative control and so might help in planning a customized therapy for each patient.
