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62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

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Predictive value of 18F-FET PET in 169 newly diagnosed glioma suspective cerebral lesions

Meeting Abstract

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  • M. Rapp - Neurochirurgische Klinik, Heinrich-Heine Universität, Düsseldorf
  • K.J. Langen - Institut für Neurowissenschaften und Medizin 4, Forschungszentrum Jülich, Jülich
  • H.J. Steiger - Neurochirurgische Klinik, Heinrich-Heine Universität, Düsseldorf
  • F.W. Floeth - Neurochirurgische Klinik, Heinrich-Heine Universität, Düsseldorf; Klinik Wirbelsäule und Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf
  • M. Sabel - Neurochirurgische Klinik, Heinrich-Heine Universität, Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMO.04.10

doi: 10.3205/11dgnc018, urn:nbn:de:0183-11dgnc0181

Published: April 28, 2011

© 2011 Rapp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: The study aimed to investigate the clinical value of preoperative O-(2-[18F] fluoroethyl)-L-tyrosine (18F-FET) positron emission tomography (PET) in patients with untreated intracerebral lesions suspicious for glioma.

Methods: We retrospectively evaluated the biological, clinical, radiological and neuropathological data of 169 patients (91 men, 78 women, median age 44.6 years) admitted to the department of neurosurgery for assessment of histological diagnosis of a cerebral mass or lesion detected by MRI between 2001 and 2010. Special attention was given to suspected grade II and III glioma. FET PET and Gd enhanced MRI was obtained in all patients within 6 weeks before surgery (n=79) or biopsy (n=90) was performed. In reference to the literature a FETmax uptake with a lesion to brain ratio of 1.6 or higher was considered positive in PET.

Results: Histology revealed a tumorous lesion in 150 and a non-tumorous lesion in 19 patients. FET PET was positive in 134 patients (sensitivity 84%, positive predictive value 0.9) and negative in 35 patients (specificity 43%, negative predictive value 0.3). Depending on the tumor entity the sensitivity was as follows: Gliomas WHO grade I (n=4) 50%, diffuse gliomas WHO grade II (n=73) 78%, anaplastic gliomas WHO grade III (n=47) 89%, glioblastomas WHO grade IV (n=20) 100% and lymphomas (n=2) 100%. Four patients with an initially unspecific histology developed a glioma WHO grade III or IV later and initial FET PET was positive in three. Depending on the non-tumorous entity the specificity was as follows: Unspecific gliotic lesions (n=9) 55%, demyelinating-inflammatory lesions (n=4) 25%, abscesses (n=2) 0%, vascular lesions (n=4) 75%.

Conclusions: The sensitivity of FET PET for detection of tumor tissue in glioma is high and increases with the WHO grade: While a subset of grade II gliomas shows low or absent FET-uptake nearly all grade III and IV gliomas are FET-positive. In contrast the specificity of FET-PET for tumor detection is moderate, because especially acute inflammatory or infectious lesions show moderate to high FET-uptake.