Learning objectives
Summarize the recent developments and the current role of 18F-FET PET in brain tumours according to recent literature data.
Describe the current limitations of 18F-FET PET and the need for expertise in the interpretation of PET data
Background
Positron emission tomography (PET) is gaining widespread use in the evaluation of brain tumours. PET-tracers currently used for imaging glial tumours in Australia are largely radiolabelled amino acid tracers. These tracers are preferentially taken up by tumour cells due to an overexpression of amino acid transporters on their cell surface, while their uptake in background normal brain tissue is relatively low. Numerous studies related to [18F]FluoroEthyl-L-Tyrosine (18F-FET-PET) in gliomas have been published by our group and in the literature1, 2. Our clinical experience and findings...
Imaging findings OR Procedure details
18F-FET is a fluorinated amino acid used in imaging CNS glial tumours. 18F-FET is taken up into neoplastic cells due to their increased amino acid uptake through an L-type amino acid transport system. Unlike GBCAs on MRI, uptake of amino acid tracers is independent of blood-brain-barrier integrity. FET PET has utility in the differential diagnosis between malignant and non-neoplastic lesions10 and to stratify between low-grade and high-grade gliomas. FET PET for surgical planning offers potential to undertake supramarginal resections of non-enhancing disease on MRI, assessment...
Conclusion
Based on the increasing imaging role of FET-PET in our group and published in the recent literature, FET-PET provides additional non-invasive imaging information compared to standard MRI in neuro-oncology. This is particularly true for IDH-Wildtype and higher grade IDH-Mutant gliomas. Amino Acid PET has become an important imaging technique to improve delineation of the extent of tumour including non-enhancing disease, surgical biopsy/resection planning and for definition of the target volume for radiation therapy. It also offers an avenue for improved RT field morphometry and dose...
Personal information
J. Gajera:
Nothing to disclose
H. Ireland:
Nothing to disclose
J. Drummond:
Nothing to disclose
E. Hsiao:
Nothing to disclose
G. Schembri:
Nothing to disclose
M. Back:
Nothing to disclose
References
de Zwart PL, van Dijken BRJ, Holtman GA, et al. Diagnostic Accuracy of PET Tracers for the Differentiation of Tumor Progression from Treatment-Related Changes in High-Grade Glioma: A Systematic Review and Metaanalysis. Journal of Nuclear Medicine. 2020;61:498-504.
Katsanos AH, Alexiou GA, Fotopoulos AD, Jabbour P, Kyritsis AP, Sioka C. Performance of 18F-FDG, 11C-Methionine, and 18F-FET PET for Glioma Grading: A Meta-analysis. Clinical Nuclear Medicine. 2019;44:864-869.
Decazes P, Hinault P, Veresezan O, Thureau S, Gouel P, Vera P. Trimodality PET/CT/MRI and Radiotherapy: A Mini-Review. Frontiers in...