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Neuro Oncol. 2019 Jan 5. doi: 10.1093/neuonc/noz003. [Epub ahead of print]

PET Imaging in Patients with Brain Metastasis - Report of the RANO/PET Group.

Author information

1
Dept. of Neurology, University Hospital Cologne, Cologne, Germany.
2
Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany.
3
Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Cologne, Germany.
4
Dept. of Nuclear Medicine, University Hospital Aachen, Aachen, Germany.
5
Dept. of Nuclear Medicine, Ludwig Maximilians-University of Munich, Munich, Germany.
6
Dept. of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
7
Depts. of Neurology and Neurological Surgery, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington.
8
Dept. of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy.
9
Dept. of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
10
Dept. of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Denmark.
11
Dept. of Neurosurgery, University Hospital Lille, Lille, France.
12
Dept. of Neurosurgery, University of California, San Francisco, California.
13
Dept. of Neurosurgery, Ludwig Maximilians-University of Munich, Munich, Germany.
14
German Cancer Consortium (DKTK), Partner Site Munich, Germany.
15
Dept. of Radiation Oncology, Technical University Munich, Munich, Germany.
16
Dept. of Medicine I and Comprehensive Cancer Centre CNS Tumours Unit, Medical University of Vienna, Vienna, Austria.
17
Moffitt Cancer Center, University of South Florida, Tampa, Florida.
18
Dept. of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California.

Abstract

Brain metastases (BM) from extracranial cancer are associated with significant morbidity and mortality. Effective local treatment options are stereotactic radiotherapy, including radiosurgery or fractionated external beam radiotherapy, and surgical resection. The use of systemic treatment for intracranial disease control also is improving. BM diagnosis, treatment planning and follow-up is most often based on contrast-enhanced magnetic resonance imaging (MRI). However, anatomic imaging modalities including standard MRI have limitations in accurately characterizing post-therapeutic reactive changes and treatment response. Molecular imaging techniques such as positron emission tomography (PET) characterize specific metabolic and cellular features of metastases, potentially providing clinically relevant information supplementing anatomic MRI. Here, the RANO working group provides recommendations for the use of PET imaging in the clinical management of patients with BM based on evidence from studies validated by histology and/or clinical outcome.

PMID:
30615138
DOI:
10.1093/neuonc/noz003

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