UNLABELLED: The aim of this study was to explore the differential diagnostic value of PET using the amino acid O-(2-(18)F-fluoroethyl)-L-tyrosine ((18)F-FET) in patients with newly diagnosed solitary intracerebral lesions showing ring enhancement on contrast-enhanced MRI. METHODS: (18)F-FET PET analyses were performed on 14 consecutive patients with intracerebral ring-enhancing lesions. Eleven of the patients were additionally studied with (18)F-FDG PET. In all patients, the main differential diagnosis after MRI was a malignant lesion, in particular glioblastoma multiforme, versus a benign lesion, in particular brain abscess. A malignant tumor was suspected for lesions showing increased (18)F-FET uptake on PET images with a mean lesion-to-brain ratio of at least 1.6 ((18)F-FET PET positive). A nonneoplastic lesion was suspected in cases of minimal or absent (18)F-FET uptake, with a mean lesion-to-brain ratio of less than 1.6 ((18)F-FET PET negative). Histologic diagnosis was obtained by serial biopsies in 13 of the 14 patients. One patient refused the biopsy, but follow-up indicated an abscess because his lesion regressed under antibiotic therapy. RESULTS: Histology and clinical follow-up showed high-grade malignant gliomas in 5 patients and nonneoplastic lesions in 9 patients. The findings of (18)F-FET PET were positive in all 5 glioma patients and in 3 of 9 patients with nonneoplastic lesions, including 2 patients with brain abscesses and 1 patient with a demyelinating lesion. The findings of (18)F-FDG PET were positive (mean lesion-to-gray matter ratio > or = 0.7) in 4 of 4 glioma patients and 3 of 7 patients with nonneoplastic lesions. CONCLUSION: Although (18)F-FET PET has been shown to be valuable for the diagnostic evaluation of brain tumors, our data indicate that, like (18)F-FDG PET, (18)F-FET PET has limited specificity in distinguishing between neoplastic and nonneoplastic ring-enhancing intracerebral lesions. Thus, histologic investigation of biopsy specimens remains mandatory to make this important differential diagnosis.
UNLABELLED: The aim of this study was to explore the differential diagnostic value of PET using the amino acid O-(2-(18)F-fluoroethyl)-L-tyrosine ((18)F-FET) in patients with newly diagnosed solitary intracerebral lesions showing ring enhancement on contrast-enhanced MRI. METHODS: (18)F-FET PET analyses were performed on 14 consecutive patients with intracerebral ring-enhancing lesions. Eleven of the patients were additionally studied with (18)F-FDG PET. In all patients, the main differential diagnosis after MRI was a malignant lesion, in particular glioblastoma multiforme, versus a benign lesion, in particular brain abscess. A malignant tumor was suspected for lesions showing increased (18)F-FET uptake on PET images with a mean lesion-to-brain ratio of at least 1.6 ((18)F-FET PET positive). A nonneoplastic lesion was suspected in cases of minimal or absent (18)F-FET uptake, with a mean lesion-to-brain ratio of less than 1.6 ((18)F-FET PET negative). Histologic diagnosis was obtained by serial biopsies in 13 of the 14 patients. One patient refused the biopsy, but follow-up indicated an abscess because his lesion regressed under antibiotic therapy. RESULTS: Histology and clinical follow-up showed high-grade malignant gliomas in 5 patients and nonneoplastic lesions in 9 patients. The findings of (18)F-FET PET were positive in all 5 gliomapatients and in 3 of 9 patients with nonneoplastic lesions, including 2 patients with brain abscesses and 1 patient with a demyelinating lesion. The findings of (18)F-FDG PET were positive (mean lesion-to-gray matter ratio > or = 0.7) in 4 of 4 gliomapatients and 3 of 7 patients with nonneoplastic lesions. CONCLUSION: Although (18)F-FET PET has been shown to be valuable for the diagnostic evaluation of brain tumors, our data indicate that, like (18)F-FDG PET, (18)F-FET PET has limited specificity in distinguishing between neoplastic and nonneoplastic ring-enhancing intracerebral lesions. Thus, histologic investigation of biopsy specimens remains mandatory to make this important differential diagnosis.
Authors: Nathalie L Jansen; Vera Graute; Lena Armbruster; Bogdana Suchorska; Juergen Lutz; Sabina Eigenbrod; Paul Cumming; Peter Bartenstein; Jörg-Christian Tonn; Friedrich Wilhelm Kreth; Christian la Fougère Journal: Eur J Nucl Med Mol Imaging Date: 2012-04-11 Impact factor: 9.236
Authors: Nathalie L Albert; Michael Weller; Bogdana Suchorska; Norbert Galldiks; Riccardo Soffietti; Michelle M Kim; Christian la Fougère; Whitney Pope; Ian Law; Javier Arbizu; Marc C Chamberlain; Michael Vogelbaum; Ben M Ellingson; Joerg C Tonn Journal: Neuro Oncol Date: 2016-04-21 Impact factor: 12.300
Authors: Markus Hutterer; Martha Nowosielski; Daniel Putzer; Nathalie L Jansen; Marcel Seiz; Michael Schocke; Mark McCoy; Georg Göbel; Christian la Fougère; Irene J Virgolini; Eugen Trinka; Andreas H Jacobs; Günther Stockhammer Journal: Neuro Oncol Date: 2013-01-17 Impact factor: 12.300