Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND O-(2-[18F]fluoroethyl)-L-tyrosine ([¹⁸F]FET) PET is predominantly applied for molecular imaging of diffuse gliomas. In contrast, data on the clinical utility of [¹⁸F]FET PET in circumscribed astrocytic gliomas (CAG) remain scarce. MATERIAL AND METHODS We retrospectively identified adult CAG patients who underwent [¹⁸F]FET PET imaging (i) before diagnosis, (ii) at suspected relapse, or (iii) for response assessment at three institutions. Maximum and mean tumor-to-brain ratios (TBRmax, TBRmean) and metabolic tumor volumes were assessed according to the PET RANO 1.0 criteria. Diagnostic performance in differentiating treatment-related changes from tumor relapse was evaluated using ROC analysis and Fisher’s exact test. RESULTS We evaluated 79 [¹⁸F]FET PET scans of 42 patients, including nine (21%) with actionable molecular targets. 65% of CAG WHO grade 1 and 100% of CAG WHO grades 2 or 3 had measurable [¹⁸F]FET uptake according to the PET RANO 1.0 criteria. In these patients, TBR values of CAG WHO grades 2 or 3 were significantly higher than in pilocytic astrocytomas (P<0.01). There was no significant difference in TBR between CAG with or without actionable targets (P>0.05). Following various treatments, response assessment according to the PET RANO 1.0 criteria differed from changes in MRI in 5 of 11 patients (45%). Treatment-related changes were confirmed neuropathologically or clinicoradiologically in 12 patients (43%). In CAG WHO grades 2 or 3, the accuracy of [¹⁸F]FET PET to identify treatment-related changes was 82% using single PET scans and 100% using serial PET imaging (P<0.05). CONCLUSION [¹⁸F]FET PET can add valuable information for the clinical management of patients with CAG.
Source: Neuro-Oncology
Authors: J Werner, M J Mair, M M Wollring, E Barci, I Stetter, H C Puhr, C Tscherpel, G Stoffels, J A Hainfellner, A S Berghoff, V Sunder-Plassmann, G Widhalm, F Eckert, G Kasprian, T S Nakuz, A Beck, P N Harter, L von Baumgarten, N Thon, S Schönecker, R Forbrig, F M Mottaghy, P Lohmann, G R Fink, K Langen, N Galldiks, N L Albert, M Preusser
Institutions: University of Cologne, University Hospital Cologne, Medical University of Vienna, LMU Klinikum, Ludwig-Maximilians-Universität München, Goethe University Frankfurt, Forschungszentrum Jülich, University Hospital Frankfurt, Comprehensive Cancer Center Vienna, Institut für Neuropathologie, Universitätsklinikum Knappschaftskrankenhaus Bochum, Institut für Diagnostische und Interventionelle Neuroradiologie, Maastricht University Medical Centre, Maastricht University, Universitätsklinikum Aachen, RWTH Aachen University
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4414792497
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