Abstract
The number of positron-emission tomography (PET) tracers used to evaluate patients with brain tumors has increased substantially over the last years. For the management of patients with brain tumors, the most important indications are the delineation of tumor extent (e.g., for planning of resection or radiotherapy), the assessment of treatment response to systemic treatment options such as alkylating chemotherapy, and the differentiation of treatment-related changes (e.g., pseudoprogression or radiation necrosis) from tumor progression. Furthermore, newer PET imaging approaches aim to address the need for noninvasive assessment of tumoral immune cell infiltration and response to immunotherapies (e.g., T-cell imaging). This review summarizes the clinical value of the landscape of tracers that have been used in recent years for the above-mentioned indications and also provides an overview of promising newer tracers for this group of patients.
Highlights
For the management of patients with brain tumors, clinicians frequently need to rely on imaging information obtained from anatomical magnetic resonance imaging (MRI) before, during, and after the treatment
This review summarizes the value of positron-emission tomography (PET) tracers that have been used in brain tumors in recent years for the most relevant clinical indications
A PubMed search using the terms “PET”, “positron”, “tracer”, “glioma”, “brain metastases”, “FDG”, “amino acid”, “methionine”, “FET”, “FDOPA”, “FACBC”, “AMT”, “translocator protein (TSPO)”, “GE-180”, “FLT”, “FAZA”, “epidermal growth factor receptor (EGFR)”, “vascular endothelial growth factor (VEGF)”, “immunoPET”, “isocitrate dehydrogenase”, “radiotherapy”, “T-cell imaging”, “reporter gene”, “radiation necrosis”, “pseudoprogression”, “tumor extent”, “response assessment”, “treatment-related changes”, and combinations thereof was performed until January
Summary
For the management of patients with brain tumors, clinicians frequently need to rely on imaging information obtained from anatomical magnetic resonance imaging (MRI) before, during, and after the treatment. With the advent of newer treatment options in neuro-oncology, in particular, targeted therapy and various immunotherapy options, the needs for additional information derived from neuroimaging in terms of characterization of the tumor environment, the evaluation of tumoral drug accumulation, immune cell infiltration, and the diagnosis of treatment-related changes following these newer treatment options are steadily increasing. Some of these requirements may be met by the existing landscape of well-established PET tracers, while others can be addressed by newer ones [22,23]. More unique but promising PET tracers are summarized and discussed
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