Abstract
Metabolic imaging techniques such as positron emission tomography (PET) can characterize specific metabolic and cellular features of gliomas which may provide clinically relevant information beyond structural magnetic resonance imaging (MRI). In contrast to the widely used PET tracer 2-[18F]fluoro-2-deoxy-D-glucose (FDG), the uptake of radiolabeled amino acids such as O-(2-[18F]fluoroethyl)-L-tyrosine (FET) or 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine (FDOPA) is low in normal brain tissue, and brain tumors can be depicted with high contrast. Like FDG, these amino acid tracers are able to cross the intact blood-brain barrier, which allows the depiction of the tumor extent beyond the contrast-enhancing region of conventional MRI. Recently, the Response Assessment in Neuro-Oncology (RANO) working group – an international effort to develop new standardized response criteria for clinical trials in brain tumors – has recommended the additional use of amino acid PET imaging for brain tumor management, especially for the delineation of the tumor extent, differentiation of treatment-related changes from tumor progression, and the assessment of treatment response.
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