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CC BY 4.0 · World J Nucl Med 2023; 22(03): 183-190
DOI: 10.1055/s-0043-1771282
Original Article

Initial Experience of 18F-FET PET-MR Image Fusion for Evaluation of Recurrent Primary Brain Tumors

Habibollah Dadgar
1   Cancer Research Center, RAZAVI Hospital, Imam Reza International University, Mashhad, Iran
,
Manouchehr Seyedi Vafaee
2   Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
3   Translational Neuroscience, BRIDGE, University of Southern Denmark, Odense, Denmark
4   Department of Psychiatry, Odense University Hospital, Odense, Denmark
,
Amirreza Khorasanchi
1   Cancer Research Center, RAZAVI Hospital, Imam Reza International University, Mashhad, Iran
,
Parastoo Kordestani Moghadam
5   Social Determinants of Health Research Center (Division of Cognitive Neuroscience), Lorestan University of Medical Sciences, Khorramabad, Iran
,
Reza Nemati
6   Department of Neurology, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
,
Hossein Shooli
7   The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
,
Esmail Jafari 
7   The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
,
Majid Assadi 
7   The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
› Author Affiliations Funding None.
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Abstract

Background An accurate monitoring technique is crucial in brain tumors to choose the best treatment approach after surgery and/or chemoradiation. Radiological assessment of brain tumors is widely based on the magnetic resonance imaging (MRI) modality in this regard; however, MRI criteria are unable to precisely differentiate tumoral tissue from treatment-related changes. This study was conducted to evaluate whether fused MRI and O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) positron emission tomography (PET) can improve the diagnostic accuracy of the practitioners to discriminate treatment-related changes from true recurrence of brain tumor.

Methods We retrospectively analyzed 18F-FET PET/computed tomography (CT) of 11 patients with histopathologically proven brain tumors that were suspicious for recurrence changes after 3 to 4 months of surgery. All the patients underwent MRI and 18F-FET PET/CT. As a third assessment, fused 18F-FET PET/MRI was also acquired. Finally, the diagnostic accuracy of the applied modalities was compared.

Results Eleven patients aged 27 to 73 years with a mean age of 47 ± 13 years were enrolled. According to the results, 9/11 cases (82%) showed positive MRI and 6 cases (55%) showed positive PET/CT and PET/MRI. Tumoral recurrence was observed in six patients (55%) in the follow-up period. Based on the follow-up results, accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 64, 85, 25, 67, and 50%, respectively, for MRI alone and 91, 85, 100, 100, and 80%, respectively, for both PET/CT and PET/MRI.

Conclusion This study found that 18F-FET PET-MR image fusion in the management of brain tumors might improve recurrence detection; however, further well-designed studies are needed to verify these preliminary data.

Keywords

magnetic resonance imaging - positron emission tomography - amino acid PET - brain tumor - 18F-FET PET/CT


Publication History

Article published online:
06 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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