PET in der Strahlentherapie von Hirntumoren

Zusammenfassung

Die Integration von biologischer Bildgebung wie PET und SPECT bei Patienten mit Hirntumoren erhält in der Strahlentherapie einen zunehmend größeren Stellenwert, sowohl in der Bestrahlungsplanung als auch in der Verlaufskontrolle. Der vorliegende Artikel soll einen kurzen Überblick über die Rationale, die verwendeten Tracer und die klinische Bedeutung bei dem Einsatz dieser Verfahren bei Patienten mit Hirntumoren liefern.

Abstract

The integration of biological imaging, as PET and SPECT, in patients with brain tumors is of growing importance in radiotherapy - for treatment planning as well as for monitoring. The aim of this article is to give a brief overview of the rationale, the applied tracers, and the clinical impact of these methods in patients with brain tumors.

Schlüsselwörter

PET / CT - FDG - Bestrahlung - Hirntumoren

Key words

PET / CT - FDG - irradiation treatment - brain tumors

Literatur

• 1 Bergström M, Collins V P, Ehrin E. et al . Discrepancies in brain tumor extent as shown by computed tomography an positron emission tomography using [⁶⁸Ga]EDTA, [¹¹C]glucose, and [¹¹C]methionine.  J Comput Assist Tomogr. 1983;  7 1062-1066
• 2 Beuthien-Baumann B, Bredow J, Burchert W, Füchtner F, Bergmann R, Alheit H D, Reiss G, Hliscs R, Steinmeier R, Franke W G, Johannsen B, Kotzerke J. 3-0-Methyl-6-[(¹⁸)F]fluoro-L-DOPA and its evaluation in brain tumor imaging.  Eur J Nucl Med Mol Imaging. 2003;  30 1004-1008
• 3 Braun V, Dempf S, Weller R, Reske S N, Schachenmayr W, Richter H P. Cranial neuronavigation with direct integration of (¹¹)C methionine positron emission tomography (PET) data - results of a pilot study in 32 surgical cases.  Acta Neurochir. 2002;  144 777-782
• 4 Ericson K, Lilja A, Bergström M, Collins V P, Eriksson L, Ehrin E, Holst H von, Lundqvist H, Långsrom B B, Mosskin M. Positron emission tomography with ([¹¹C]methyl)-L-methionine, [¹¹C]D-glucose, and [⁶⁸Ga]EDTA in supratentorial tumors.  J Comput Assist Tomogr. 1985;  9 683-689
• 5 Grosu A L, Feldmann H J, Albrecht C, Kneschaurek P, Wehrmann R, Gross M W, Zimmermann F B, Molls M. Three-dimensional treatment planning of brain tumors: Advantages of the method and clinical results.  Strahlenther Onkol. 1998;  174 7-13
• 6 Grosu A L, Feldmann H, Dick S, Dzewas B, Nieder C, Gumprecht H, Frank A, Schwaiger M, Molls M, Weber W A. Implications of IMT-SPECT for postoperative radiotherapy planning in patients with gliomas.  Int J Radiat Oncol Biol Phys. 2002;  54 842-854
• 7 Grosu A L, Lachner R, Wiedenmann N, Stärk S, Thamm R, Kneschaurek P, Schwaiger M, Molls M, Weber W A. Validation of a method for automatic image fusion (BrainLAB System) of CT data and ¹¹C-methionine-PET data for stereotactic radiotherapy using a LINAC: first clinical experience.  Int J Radiat Oncol Biol Phys. 2003;  56 1450-1463
• 8 Grosu A L, Weber W A, Astner S T, Adam M, Krause B J, Schwaiger M, Molls M, Nieder C. ¹¹C-methionine PET improves the target volume delineation of meningiomas treated with stereotactic fractionated radiotherapy.  Int J Radiat Oncol Biol Phys. 2006;  66 339-344
• 9 Grosu A L, Weber W A, Feldmann H J, Wuttke B, Bartenstein P, Gross M W, Lumenta C, Schwaiger M, Molls M. First experience with I-123-alpha-methyl-tyrosine spect in the 3-D radiation treatment planning of brain gliomas.  Int J Radiat Oncol Biol Phys. 2000;  47 517-526
• 10 Grosu A L, Weber W A, Franz M, Stärk S, Piert M, Thamm R, Gumprecht H, Schwaiger M, Molls M, Nieder C. Reirradiation of recurrent high-grade gliomas using amino acid PET (SPECT) / CT / MRI image fusion to determine gross tumor volume for stereotactic fractionated radiotherapy.  Int J Radiat Oncol Biol Phys. 2005;  63 511-519
• 11 Grosu A L, Weber W A, Riedel E, Jeremic B, Nieder C, Franz M, Gumprecht H, Jaeger R, Schwaiger M, Molls M. L-(methyl-11C) methionine positron emission tomography for target delineation in resected high-grade gliomas before radiotherapy.  Int J Radiat Oncol Biol Phys. 2005;  63 64-74
• 12 Henze M, Schuhmacher J, Hipp P, Kowalski J, Becker D W, Doll J, Mäcke H R, Hofmann M, Debus J, Haberkorn U. PET imaging of somatostatin receptors using [⁶⁸GA]DOTA-D-Phe1-Tyr3-octreotide: first results in patients with meningiomas.  J Nucl Med. 2001;  42 1053-1056
• 13 Herholz K, Hölzer T, Bauer B, Schröder R, Voges J, Ernestus R I, Mendoza G, Weber-Luxenburger G, Löttgen J, Thiel A, Wienhard K, Heiss W D. ¹¹C-methionine PET for differential diagnosis of low-grade gliomas.  Neurology. 1998;  50 1316-1322
• 14 Kracht L W, Miletic H, Busch S, Jacobs A H, Voges J, Hoevels M, Klein J C, Herholz K, Heiss W D. Delineation of brain tumor extent with [¹¹C]L-methionine positron emission tomography: local comparison with stereotactic histopathology.  Clin Cancer Res. 2004;  10 7163-7170
• 15 Langen K J, Jarosch M, Mühlensiepen H, Hamacher K, Bröer S, Jansen P, Zilles K, Coenen H H. Comparison of fluorotyrosines and methionine uptake in F 98 rat gliomas.  Nucl Med Biol. 2003;  30 501-508
• 16 Langen K J, Roosen N, Coenen H H, Kuikka J T, Kuwert T, Herzog H, Stöcklin G, Feinendegen L E. Brain and brain tumor uptake of L-3-[¹²³I]iodo-alpha-methyl tyrosine: competition with natural L-amino acids.  J Nucl Med. 1991;  32 1225-1229
• 17 Langen K J, Ziemons K, Kiwit J C, Herzog H, Kuwert T, Bock W J, Stöcklin G, Feinendegen L E, Müller-Gärtner H W. 3-[¹²³I]iodo-alpha-methyltyrosine and [methyl-¹¹C]-L-methionine uptake in cerebral gliomas: a comparative study using SPECT and PET.  J Nucl Med. 1997;  38 517-522
• 18 Massey V, Wallner K E. Patterns of second recurrence of malignant astrocytomas.  Int J Radiat Oncol Biol Phys. 1990;  18 395-398
• 19 Milker-Zabel S, Zabel-du Bois A, Henze M, Huber P, Schulz-Ertner D, Hoess A, Haberkorn U, Debus J. Improved target volume definition for fractionated stereotactic radiotherapy in patients with intracranial meningiomas by correlation of CT, MRI, and [⁶⁸Ga]-DOTATOC-PET.  Int J Radiat Oncol Biol Phys. 2006;  65 222-227
• 20 Mosskin M EK, Hindmarsh T, Holst H. et al . Positron emission tomography compared with magnetic resonance imaging and computed tomography in supratentorial gliomas using multiple stereotactic biopsies as reference.  Acta Radiol. 1989;  30 225-232
• 21 Nyberg G, Bergström M, Enblad P, Lilja A, Muhr C, Långström B. PET-methionine of skull base neuromas and meningiomas.  Acta Otolaryngol. 1997;  117 482-489
• 22 Ogawa T, Shishido F, Kanno I. et al . Cerebral glioma: evaluation with methionine PET.  Radiology. 1993;  186 45-53
• 23 Pauleit D, Floeth F, Hamacher K, Riemenschneider M J, Reifenberger G, Müller H W, Zilles K, Coenen H H, Langen K J. O-(2-[¹⁸F]fluoroethyl)-L-tyrosine PET combined with MRI improves the diagnostic assessment of cerebral gliomas.  Brain. 2005;  128 678-687
• 24 Rachinger W, Goetz C, Pöpperl G, Gildehaus F J, Kreth F W, Holtmannspötter M, Herms J, Koch W, Tatsch K, Tonn J C. Positron emission tomography with O-(2-[¹⁸F]fluoroethyl)-l-tyrosine versus magnetic resonance imaging in the diagnosis of recurrent gliomas.  Neurosurgery. 2005;  57 505-511
• 25 Thornton A F, Sandler H M, Haken R KT, McShan D L, Fraass B A, La Vigne M L, Yanke B R. The clinical utility of magnetic resonance imaging in 3-dimensional treatment planning of brain neoplasms.  Int J Radiat Oncol Biol Phys. 1992;  24 767-775
• 26 Weber W A, Dick S, Reidl G, Dzewas B, Busch R, Feldmann H J, Molls M, Lumenta C B, Schwaiger M, Grosu A L. Correlation between postoperative 3-[(¹²³)I]iodo-L-alpha-methyltyrosine uptake and survival in patients with gliomas.  J Nucl Med. 2001;  42 1144-1150
• 27 Weber W A, Wester H J, Grosu A L, Herz M, Dzewas B, Feldmann H J, Molls M, Stöcklin G, Schwaiger M. O-(2-[¹⁸F]Fluoroethyl)-L-tyrosine and L-[methyl-¹¹C]methionine uptake in brain tumours: initial results of a comparative study.  Eur J Nucl Med. 2000;  27 542-549
• 28 Weckesser M, Griessmeier M, Schmidt D, Sonnenberg F, Ziemons K, Kemna L, Holschbach M, Langen K, Müller-Gärtner H. Iodine-123 alpha-methyl tyrosine single-photon emission tomography of cerebral gliomas: standardised evaluation of tumour uptake and extent.  Eur J Nucl Med. 1998;  25 150-156
• 29 Weckesser M, Matheja P, Rickert C, Löttgen J, Palkovic S, Riemann B, Paulus W, Wassmann H, Schober O. Evaluation of the extension of cerebral gliomas by scintigraphy.  Strahlenther Onkol. 2000;  176 180-185