Two Decades of Brain Tumour Imaging with O-(2-[18F]fluoroethyl)-L-tyrosine PET: The Forschungszentrum Jülich Experience

Author:

Heinzel Alexander,Dedic Daniela,Galldiks Norbert,Lohmann PhilippORCID,Stoffels Gabriele,Filss Christian P.,Kocher Martin,Migliorini FilippoORCID,Dillen Kim N. H.,Geisler StefanieORCID,Stegmayr Carina,Willuweit AntjeORCID,Sabel Michael,Rapp Marion,Eble Michael J.,Piroth Marc,Clusmann Hans,Delev Daniel,Bauer Elena K.,Ceccon Garry,Dunkl Veronika,Rosen Jurij,Tscherpel Caroline,Werner Jan-MichaelORCID,Ruge Maximilian I.,Goldbrunner Roland,Hampl Jürgen,Weiss Lucas Carolin,Herrlinger Ulrich,Maurer Gabriele D.,Steinbach Joachim P.,Mauler JörgORCID,Worthoff Wieland A.ORCID,Neumaier Bernd N.ORCID,Lerche ChristophORCID,Fink Gereon R.ORCID,Shah Nadim JonORCID,Mottaghy Felix M.ORCID,Langen Karl-JosefORCID

Abstract

O-(2-[18F]fluoroethyl)-L-tyrosine (FET) is a widely used amino acid tracer for positron emission tomography (PET) imaging of brain tumours. This retrospective study and survey aimed to analyse our extensive database regarding the development of FET PET investigations, indications, and the referring physicians’ rating concerning the role of FET PET in the clinical decision-making process. Between 2006 and 2019, we performed 6534 FET PET scans on 3928 different patients against a backdrop of growing demand for FET PET. In 2019, indications for the use of FET PET were as follows: suspected recurrent glioma (46%), unclear brain lesions (20%), treatment monitoring (19%), and suspected recurrent brain metastasis (13%). The referring physicians were neurosurgeons (60%), neurologists (19%), radiation oncologists (11%), general oncologists (3%), and other physicians (7%). Most patients travelled 50 to 75 km, but 9% travelled more than 200 km. The role of FET PET in decision-making in clinical practice was evaluated by a questionnaire consisting of 30 questions, which was filled out by 23 referring physicians with long experience in FET PET. Fifty to seventy per cent rated FET PET as being important for different aspects of the assessment of newly diagnosed gliomas, including differential diagnosis, delineation of tumour extent for biopsy guidance, and treatment planning such as surgery or radiotherapy, 95% for the diagnosis of recurrent glioma, and 68% for the diagnosis of recurrent brain metastases. Approximately 50% of the referring physicians rated FET PET as necessary for treatment monitoring in patients with glioma or brain metastases. All referring physicians stated that the availability of FET PET is essential and that it should be approved for routine use. Although the present analysis is limited by the fact that only physicians who frequently referred patients for FET PET participated in the survey, the results confirm the high relevance of FET PET in the clinical diagnosis of brain tumours and support the need for its approval for routine use.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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