Abstract
BackgroundThe precise definition of the post-operative resection status in high-grade gliomas (HGG) is crucial for further management. We aimed to assess the feasibility of assessment of the resection status with early post-operative positron emission tomography (PET) using [18F]O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET).Methods25 patients with the suspicion of primary HGG were enrolled. All patients underwent pre-operative [18F]FET-PET and magnetic resonance imaging (MRI). Intra-operatively, resection status was assessed using 5-aminolevulinic acid (5-ALA). Imaging was repeated within 72h after neurosurgery. Post-operative [18F]FET-PET was compared with MRI, intra-operative assessment and clinical follow-up.Results[18F]FET-PET, MRI and intra-operative assessment consistently revealed complete resection in 12/25 (48%) patients and incomplete resection in 6/25 cases (24%). In 7 patients, PET revealed discordant findings. One patient was re-resected. 3/7 experienced tumor recurrence, 3/7 died shortly after brain surgery.ConclusionEarly assessment of the resection status in HGG with [18F]FET-PET seems to be feasible.
Highlights
The importance of complete resection of contrast-enhancing tumor in patients with malignant gliomas has been highlighted by several studies [1, 2]
We aimed to assess the feasibility of assessment of the resection status with early post-operative positron emission tomography (PET) using [18F] O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET)
In this study we investigated the value of early post-operative [18F]FET-PET to assess the resection status in comparison to intra-operative findings as well as Magnetic resonance imaging (MRI)
Summary
The importance of complete resection of contrast-enhancing tumor in patients with malignant gliomas has been highlighted by several studies [1, 2]. The precise definition of the early postoperative resection status in high-grade gliomas (HGG) is crucial for further treatment planning, e.g. delineation of the radiation field in radiotherapy or surgical re-evaluation if larger residual tumor is present. Magnetic resonance imaging (MRI) represents the state-of-the-art technique for brain tumor imaging. In the early postoperative setting after brain tumor surgery, MRI is the imaging modality of choice to verify the resection status. The precise definition of the post-operative resection status in high-grade gliomas (HGG) is crucial for further management. We aimed to assess the feasibility of assessment of the resection status with early post-operative positron emission tomography (PET) using [18F] O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET)
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