Department of Neurology, University Hospital Cologne, Josef-Stelzmann St. 9, 50937, Cologne, Germany.
Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Eur J Nucl Med Mol Imaging. 2018 Jul;45(9):1626-1635. doi: 10.1007/s00259-018-3992-5. Epub 2018 Mar 21.
We present our first clinical experience with O-(2-F-fluoroethyl)-L-tyrosine (FET) PET in patients with high-grade glioma treated with various neurooncological therapies including tumour-treating fields (TTFields) for the differentiation of tumour progression from treatment-related changes.
We retrospectively assessed 12 patients (mean age 51 ± 12 years, range 33-72 years) with high-grade glioma (11 glioblastomas, 1 gliosarcoma) in whom the treatment regimen included TTFields and who had undergone FET PET scans for differentiation of tumour progression from treatment-related changes. Mean and maximum tumour-to-brain ratios (TBR, TBR) were calculated. The definitive diagnosis (tumour progression or posttherapeutic changes) was confirmed either by histopathology (4 of 12 patients) or on clinical follow-up.
In all nine patients with confirmed tumour progression, the corresponding FET PET showed increased uptake (TBR 3.5 ± 0.6, TBR 2.7 ± 0.7). In one of these nine patients, FET PET was consistent with treatment-related changes, whereas standard MRI showed a newly diagnosed contrast-enhancing lesion. In two patients treated solely with TTFields without any other concurrent neurooncological therapy, serial FET PET revealed a decrease in metabolic activity over a follow-up of 6 months or no FET uptake without any signs of tumour progression or residual tumour on conventional MRI.
FET PET may add valuable information in monitoring therapy in individual patients with high-grade glioma undergoing neurooncological treatment including TTFields.
我们介绍了我们在接受包括肿瘤治疗电场（TTFields）在内的各种神经肿瘤学治疗的高级别神经胶质瘤患者中使用 O-(2-氟乙基)-L-酪氨酸（FET）PET 的首次临床经验，以区分肿瘤进展与治疗相关变化。
我们回顾性评估了 12 名接受 TTFields 治疗且接受 FET PET 扫描以区分肿瘤进展与治疗相关变化的高级别神经胶质瘤患者（11 例胶质母细胞瘤，1 例胶质肉瘤）的临床资料（平均年龄 51±12 岁，范围 33-72 岁）。计算平均和最大肿瘤与脑比值（TBR、TBR）。通过组织病理学（12 例患者中的 4 例）或临床随访确定明确诊断（肿瘤进展或治疗后改变）。
在所有 9 例经证实肿瘤进展的患者中，相应的 FET PET 显示摄取增加（TBR 3.5±0.6，TBR 2.7±0.7）。在这 9 例患者中的 1 例，FET PET 与治疗相关变化一致，而标准 MRI 显示新诊断的对比增强病变。在仅接受 TTFields 治疗而无其他同时进行的神经肿瘤学治疗的 2 例患者中，连续 FET PET 在 6 个月的随访中显示代谢活性降低，或无 FET 摄取且无常规 MRI 上肿瘤进展或残留肿瘤的迹象。
FET PET 可能为接受包括 TTFields 在内的神经肿瘤学治疗的高级别神经胶质瘤患者的治疗监测提供有价值的信息。
