Abstract
Background: Several meta-analyses reporting data on the diagnostic performance or prognostic value of positron emission tomography (PET) with different tracers in detecting brain tumors have been published so far. This review article was written to summarize the evidence-based data in these settings. Methods: We have performed a comprehensive literature search of meta-analyses published in the Cochrane library and PubMed/Medline databases (from inception through July 2019) about the diagnostic performance or prognostic value of PET with different tracers in patients with brain tumors. Results: We have summarized the results of 24 retrieved meta-analyses on the use of PET or PET/computed tomography (CT) with different tracers in brain tumors. The tracers included were: fluorine-18 fluorodeoxyglucose (18F-FDG), carbon-11 methionine (11C-methionine), fluorine-18 fluoroethyltyrosine (18F-FET), fluorine-18 dihydroxyphenylalanine (18F-FDOPA), fluorine-18 fluorothymidine (18F-FLT), and carbon-11 choline (11C-choline). Evidence-based data demonstrated good diagnostic performance of PET with different tracers in detecting brain tumors, in particular, radiolabelled amino acid tracers showed the highest diagnostic performance values. All the PET tracers evaluated had significant prognostic value in patients with glioma. Conclusions: Evidence-based data showed a good diagnostic performance for some PET tracers in specific indications and significant prognostic value in brain tumors.
Highlights
Positron emission tomography (PET) is a nuclear medicine imaging technique that, using different radiotracers evaluating different metabolic patterns, is able to detect in advance pathophysiological changes in oncological patients, including those with brain tumors
magnetic resonance imaging (MRI) provides accurate morphological information on brain lesions, whereas positron emission tomography (PET)/computed tomography (CT), using tracers evaluating different metabolic pathways, provides useful information that may definitively improve the diagnostic accuracy of brain tumors if combined with MRI [20,32]
Current evidence based data suggest that radiolabelled amino acid PET or PET/CT is an accurate diagnostic method for several clinical indications including evaluation of suspicious brain tumors, glioma grading and delineation, and detection of brain tumor recurrence
Summary
Positron emission tomography (PET) is a nuclear medicine imaging technique that, using different radiotracers evaluating different metabolic patterns, is able to detect in advance pathophysiological changes in oncological patients, including those with brain tumors. These functional changes usually occur before the development of morphological changes detected by conventional radiological imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) [1]. Several meta-analyses reporting data on the diagnostic performance or prognostic value of positron emission tomography (PET) with different tracers in detecting brain tumors have been published so far. Conclusions: Evidence-based data showed a good diagnostic performance for some PET tracers in specific indications and significant prognostic value in brain tumors
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