Abstract
Simple SummaryPositron emission tomography (PET) is a functional imaging technique which plays an increasingly important role in the management of brain tumors. Owing different radiotracers, PET allows to image different metabolic aspects of the brain tumors. This review outlines currently available PET radiotracers and their respective indications in neuro-oncology. It specifically focuses on the investigation of gliomas, meningiomas, primary central nervous system lymphomas as well as brain metastases. Recent advances in the production of PET radiotracers, image analyses and translational applications to peptide radionuclide receptor therapy, which allow to treat brain tumors with radiotracers, are also discussed. The objective of this review is to provide a comprehensive overview of PET imaging’s potential in neuro-oncology as an adjunct to brain magnetic resonance imaging (MRI).PET plays an increasingly important role in the management of brain tumors. This review outlines currently available PET radiotracers and their respective indications. It specifically focuses on 18F-FDG, amino acid and somatostatin receptor radiotracers, for imaging gliomas, meningiomas, primary central nervous system lymphomas as well as brain metastases. Recent advances in radiopharmaceuticals, image analyses and translational applications to therapy are also discussed. The objective of this review is to provide a comprehensive overview of PET imaging’s potential in neuro-oncology as an adjunct to brain MRI for all medical professionals implicated in brain tumor diagnosis and care.
Highlights
With an incidence rate of 12.0/105 per 100,000 person-years, primary central nervous system (CNS) tumors are rare tumors but represent a major public health issue as they are associated with high morbidity and mortality [1]
An up-to-date summary of the different available Positron Emission Tomography (PET) radiotracers and their current indications for different types of brain tumors in this fast-evolving field would appear informative. This current review outlines the different indications that PET radiotracers can be used for in the management of gliomas, meningiomas, primary CNS lymphomas, and brain metastases, in current practice, and their advantages over MRI-based applications
Even though significant uptake can be observed in chronic inflammatory tissues, gliomas and brain metastases [15], even higher uptake is observed in meningiomas when using somatostatin receptors (SSTR) ligands, with detection sensitivities superior to contrast-enhanced MRI [14,15]
Summary
With an incidence rate of 12.0/105 per 100,000 person-years, primary central nervous system (CNS) tumors are rare tumors but represent a major public health issue as they are associated with high morbidity and mortality [1]. Amino acid PET tracers are characterized by their relatively low uptake in normal grey matter, and can detect gliomas with greater sensitivity than 18 F-FDG in primary and recurrent tumors which is informative for differentiating recurrent tumors from treatmentinduced changes [7]. Targeting SSTR subtype 2 and 5 receptors, are the most used radiotracers in the clinical management of meningiomas These tracers provide an excellent lesion-to-background contrast, which is due to their low uptake in healthy brain parenchyma [14,15]. An up-to-date summary of the different available PET radiotracers and their current indications for different types of brain tumors in this fast-evolving field would appear informative This current review outlines the different indications that PET radiotracers can be used for in the management of gliomas, meningiomas, primary CNS lymphomas, and brain metastases, in current practice, and their advantages over MRI-based applications. Image analyses and translational applications in peptide receptor radionuclide therapy (PRRT) are discussed
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