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Nucl Med Biol. 2015 Jan;42(1):38-45. doi: 10.1016/j.nucmedbio.2014.07.006. Epub 2014 Aug 15.

(18)F-fluoromethylcholine (FCho), (18)F-fluoroethyltyrosine (FET), and (18)F-fluorodeoxyglucose (FDG) for the discrimination between high-grade glioma and radiation necrosis in rats: a PET study.

Author information

1
Department of Nuclear Medicine, Ghent University Hospital, Ghent, Belgium.
2
iMinds Medical IT - MEDISIP - Infinity lab, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium.
3
Department of Radiology, Ghent University Hospital, Ghent, Belgium.
4
Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium.
5
Department of Radiopharmacy, Ghent University, Ghent, Belgium.
6
Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
7
Department of Pathology, Ghent University Hospital, Ghent, Belgium.
8
Department of Basic Medical Sciences-Physiology group, Ghent University, Ghent, Belgium.
9
Department of Nuclear Medicine, Ghent University Hospital, Ghent, Belgium. Electronic address: ingeborg.goethals@ugent.be.

Abstract

INTRODUCTION:

Discrimination between (high-grade) brain tumor recurrence and radiation necrosis (RN) remains a diagnostic challenge because both entities have similar imaging characteristics on conventional magnetic resonance imaging (MRI). Metabolic imaging, such as positron emission tomography (PET) could overcome this diagnostic dilemma. In this study, we investigated the potential of 2-[(18)F]-fluoro-2-deoxy-D-glucose ((18)F-FDG), O-(2-[(18)F]-fluoroethyl)-L-tyrosine ((18)F-FET), and [(18)F]-Fluoromethyl-dimethyl-2-hydroxyethylammonium ((18)F-fluoromethylcholine, (18)F-FCho) PET in discriminating high-grade tumor from RN.

METHODS:

We developed a glioblastoma (GB) rat model by inoculating F98 GB cells into the right frontal region. Induction of RN was achieved by irradiating the right frontal region with 60 Gy using three arcs with a beam aperture of 3×3 mm (n=3). Dynamic PET imaging with (18)F-FDG, (18)F-FET, and (18)F-FCho, as well as (18)F-FDG PET at a delayed time interval (240 min postinjection), was acquired.

RESULTS:

MRI revealed contrast-enhancing tumors at 15 days after inoculation (n=4) and contrast-enhancing RN lesions 5-6 months postirradiation (n=3). On (18)F-FDG PET, the mean lesion-to-normal ratio (LNRmean) was significantly higher in GB than in RN (p=0.034). The difference in the LNRmean between tumors and RN was higher on the late (18)F-FDG PET images than on the PET images reconstructed from the last time frame of the dynamic acquisition (this is at a conventional time interval). LNRs obtained from (18)F-FCho PET were not significantly different between GB and RN (p=1.000). On (18)F-FET PET, the LNRmean was significantly higher in GB compared to RN (p=0.034).

CONCLUSIONS:

Unlike (18)F-FCho, (18)F-FDG and (18)F-FET PET were effective in discriminating GB from RN. Interestingly, in the case of (18)F-FDG, delayed PET seems particularly useful.

ADVANCES IN KNOWLEDGE AND IMPLICATIONS FOR PATIENT CARE:

Our results suggest that (delayed) (18)F-FDG and (18)F-FET PET can be used to discriminate GB (recurrence) from RN. Confirmation of these results in clinical studies is needed.

KEYWORDS:

(18)F-FCho; (18)F-FDG; (18)F-FET; Glioblastoma; PET; Radiation necrosis

PMID:
25218024
DOI:
10.1016/j.nucmedbio.2014.07.006
[Indexed for MEDLINE]

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