Utility of FET-PET in detecting high-grade gliomas presenting with equivocal MR imaging features

Ameya D. Puranik; Mathew Boon; Nilendu Purandare; Venkatesh Rangarajan; Tejpal Gupta; Aliasgar Moiyadi; Prakash Shetty; Epari Sridhar; Archi Agrawal; Indraja Dev; Sneha Shah

doi:10.4103/wjnm.WJNM_89_18

World Journal of Nuclear Medicine, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · World J Nucl Med 2019; 18(03): 266-272
DOI: 10.4103/wjnm.WJNM_89_18

Original Article

Utility of FET-PET in detecting high-grade gliomas presenting with equivocal MR imaging features

Ameya D. Puranik

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Mathew Boon

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Nilendu Purandare

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Venkatesh Rangarajan

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Tejpal Gupta

¹Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Aliasgar Moiyadi

²Department of Neurosurgery, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Prakash Shetty

²Department of Neurosurgery, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Epari Sridhar

³Department of Pathology, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Archi Agrawal

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Indraja Dev

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

,

Sneha Shah

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India

› Institutsangaben

Abstract

High-grade gliomas, metastases, and primary central nervous system lymphoma (PCNSL) are common high-grade brain lesions, which may have overlapping features on magnetic resonance (MR) imaging. Our objective was to assess the utility of 18-fluoride-fluoro-ethyl-tyrosine positron emission tomography (FET-PET) in reliably differentiating between these lesions, by studying their metabolic characteristics. Patients with high-grade brain lesions suspicious for glioma, with overlapping features for metastases and PCNSL were referred for FET-PET by Neuroradiologists from Multidisciplinary Neuro-Oncology Joint Clinic. Tumor-to-contralateral white mater ratio (T/Wm) at 5 and 20 min was derived and compared to histopathology. Receiver operating characteristic curve analysis was used to find the optimal T/Wm cutoff to differentiate between the tumor types. T/Wm was higher for glial tumors compared to nonglial tumors (metastases, PCNSL, tuberculoma, and anaplastic meningioma). A cutoff of 1.9 was derived to reliably diagnose a tumor of glial origin with a sensitivity and specificity of 93.8% and 91%, respectively. FET-PET can be used to diagnose glial tumors presenting as high-grade brain lesions when MR findings show overlapping features for other common high-grade lesions.

Keywords

Brain lesions - fluoroethyl-tyrosine-positron-emission tomography - high-grage glioma - magnetic resonance imaging

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Referenzen

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