Skip to main content
SpringerLink
Log in

PET Imaging of Brain Tumors

  • Chapter
Brain Tumor Imaging

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Routine diagnostics and treatment monitoring of brain tumors is usually based on magnetic resonance imaging (MRI), but the capacity of conventional MRI to differentiate tumor tissue from nonspecific tissue changes may be limited especially after therapeutic interventions such as neurosurgical resection, radiotherapy, and chemotherapy. Molecular imaging using positron-emission tomography (PET) may provide relevant additional information on tumor metabolism, which allows for more accurate diagnostics especially in clinically equivocal situations. In the last decades, a variety of molecular targets have been addressed by specific PET tracers, but only a few have achieved relevance in routine clinical practice. This book chapter is focussed on PET tracers that appear to be especially helpful in clinical decision-making with regard to a better delineation of brain tumors, prognosis, and grading, improved differentiation of tumor recurrence from nonspecific posttherapeutic changes, and treatment monitoring.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

PET:

Positron-emission tomography

MRI:

Magnetic resonance imaging

MET:

11C-methionine

FET:

18F-fluoroethyltyrosine

FDOPA:

3,4-Dihydroxy-6-18F-fluoro-l-phenylalanine

BBB:

Blood-brain barrier

FLT:

18F-3′-deoxy-3′-fluorothymidine

FMISO:

18F-fluoromisonidazole

HGG:

High-grade gliomas

LGG:

Low-grade gliomas

References

  • Afshar-Oromieh A, Giesel FL, Linhart HG, Haberkorn U, Haufe S, Combs SE, Podlesek D, Eisenhut M, Kratochwil C (2012) Detection of cranial meningiomas: comparison of (6)(8)Ga-DOTATOC PET/CT and contrast-enhanced MRI. Eur J Nucl Med Mol Imaging 39:1409–1415

    Article  PubMed  Google Scholar 

  • Arbizu J, Tejada S, Marti-Climent JM, Diez-Valle R, Prieto E, Quincoces G, Vigil C, Idoate MA, Zubieta JL, Penuelas I, Richter JA (2012) Quantitative volumetric analysis of gliomas with sequential MRI and (11)C-methionine PET assessment: patterns of integration in therapy planning. Eur J Nucl Med Mol Imaging 5:771–781

    Article  Google Scholar 

  • Bading JR, Shields AF (2008) Imaging of cell proliferation: status and prospects. J Nucl Med (official publication) 49(Suppl 2):64S–80S

    Google Scholar 

  • Basu S, Alavi A (2009) Molecular imaging (PET) of brain tumors. Neuroimaging Clin N Am 19:625–646

    Article  PubMed  Google Scholar 

  • Becherer A, Karanikas G, Szabo M, Zettinig G, Asenbaum S, Marosi C, Henk C, Wunderbaldinger P, Czech T, Wadsak W, Kletter K (2003) Brain tumour imaging with PET: a comparison between [18F]fluorodopa and [11C]methionine. Eur J Nucl Med Mol Imaging 30:1561–1567

    Article  PubMed  CAS  Google Scholar 

  • Belohlavek O, Simonova G, Kantorova I, Novotny J Jr, Liscak R (2003) Brain metastases after stereotactic radiosurgery using the Leksell gamma knife: can FDG PET help to differentiate radionecrosis from tumour progression? Eur J Nucl Med Mol Imaging 30:96–100

    Article  PubMed  CAS  Google Scholar 

  • Bergmann R, Pietzsch J, Fuechtner F, Pawelke B, Beuthien-Baumann B, Johannsen B, Kotzerke J (2004) 3-O–methyl-6-18F-fluoro-Ldopa, a new tumor imaging agent: investigation of transport mechanism in vitro. J Nucl Med (official publication) 45:2116–2122

    CAS  Google Scholar 

  • Borbely K, Nyary I, Toth M, Ericson K, Gulyas B (2006) Optimization of semi-quantification in metabolic PET studies with 18F-fluorodeoxyglucose and 11C-methionine in the determination of malignancy of gliomas. J Neurol Sci 246:85–94

    Article  PubMed  CAS  Google Scholar 

  • Brandsma D, Stalpers L, Taal W, Sminia P, van den Bent MJ (2008) Clinical features, mechanisms, and management of pseudoprogression in malignant gliomas. Lancet Oncol 9:453–461

    Article  PubMed  Google Scholar 

  • Calcagni ML, Galli G, Giordano A, Taralli S, Anile C, Niesen A, Baum RP (2011) Dynamic O–(2-[18F]fluoroethyl)-L-tyrosine (F-18 FET) PET for glioma grading: assessment of individual probability of malignancy. Clin Nucl Med 36:841–847

    Article  PubMed  Google Scholar 

  • Ceyssens S, Van Laere K, de Groot T, Goffin J, Bormans G, Mortelmans L (2006) [11C]methionine PET, histopathology, and survival in primary brain tumors and recurrence. AJNR Am J Neuroradiology 27:1432–1437

    CAS  Google Scholar 

  • Chen W (2007) Clinical applications of PET in brain tumors. J Nucl Med (official publication) 48:1468–1481

    Google Scholar 

  • Chen W, Geist C, Czernin J, Silverman D, Satyamurthy N, Delaloye S, Lai A, Phelps M, Cloughesy T (2008) Assess treatment response using FDOPA PET in patients with recurrent malignant gliomas treated with bevacizumab and irinotecan. J Nucl Med (official publication) 49(Supplement):78

    Google Scholar 

  • Chen W, Cloughesy T, Kamdar N, Satyamurthy N, Bergsneider M, Liau L, Mischel P, Czernin J, Phelps ME, Silverman DH (2005) Imaging proliferation in brain tumors with 18F-FLT PET: comparison with 18F-FDG. J Nucl Med (official publication) 46:945–952

    Google Scholar 

  • Chen W, Delaloye S, Silverman DH, Geist C, Czernin J, Sayre J, Satyamurthy N, Pope W, Lai A, Phelps ME, Cloughesy T (2007) Predicting treatment response of malignant gliomas to bevacizumab and irinotecan by imaging proliferation with [18F] fluorothymidine positron emission tomography: a pilot study. J Clin Oncol 25:4714–4721

    Article  PubMed  CAS  Google Scholar 

  • Choi SJ, Kim JS, Kim JH, Oh SJ, Lee JG, Kim CJ, Ra YS, Yeo JS, Ryu JS, Moon DH (2005) [18F]30-deoxy-30-fluorothymidine PET for the diagnosis and grading of brain tumors. Eur J Nucl Med Mol Imaging 32:653–659

    Article  PubMed  Google Scholar 

  • Crippa F, Alessi A, Serafini GL (2012) PET with radiolabeled aminoacid. Q J Nucl Med Mol Imaging 56:151–162

    PubMed  CAS  Google Scholar 

  • Delbeke D, Meyerowitz C, Lapidus RL, Maciunas RJ, Jennings MT, Moots PL, Kessler RM (1995) Optimal cutoff levels of F-18 fluorodeoxyglucose uptake in the differentiation of low-grade from high-grade brain tumors with PET. Radiology 195:47–52

    Article  PubMed  CAS  Google Scholar 

  • Di Chiro G, DeLaPaz RL, Brooks RA, Sokoloff L, Kornblith PL, Smith BH, Patronas NJ, Kufta CV, Kessler RM, Johnston GS, Manning RG, Wolf AP (1982) Glucose utilization of cerebral gliomas measured by [18F] fluorodeoxyglucose and positron emission tomography. Neurology 32:1323–1329

    Article  PubMed  Google Scholar 

  • Dooms GC, Hecht S, Brant-Zawadzki M, Berthiaume Y, Norman D, Newton TH (1986) Brain radiation lesions: MR imaging. Radiology 158:149–155

    Article  PubMed  CAS  Google Scholar 

  • Dunet V, Rossier C, Buck A, Stupp R, Prior JO (2012) Performance of 18F-fluoro-ethyL-tyrosine (18F-FET) PET for the differential diagnosis of primary brain tumor: a systematic review and Metaanalysis. J Nucl Med (official publication) 53:207–214

    Article  CAS  Google Scholar 

  • Floeth FW, Pauleit D, Sabel M, Reifenberger G, Stoffels G, Stummer W, Rommel F, Hamacher K, Langen KJ (2006) 18F-FET PET differentiation of ring-enhancing brain lesions. J Nucl Med (official publication) 47:776–782

    Google Scholar 

  • Floeth FW, Pauleit D, Sabel M, Stoffels G, Reifenberger G, Riemenschneider MJ, Jansen P, Coenen HH, Steiger HJ, Langen KJ (2007) Prognostic value of O–(2-18F-fluoroethyl)-L-tyrosine PET and MRI in low-grade glioma. J Nucl Med (official publication) 48:519–527

    Google Scholar 

  • Galldiks N, Kracht LW, Burghaus L, Thomas A, Jacobs AH, Heiss WD, Herholz K (2006) Use of 11C-methionine PET to monitor the effects of temozolomide chemotherapy in malignant gliomas. Eur J Nucl Med Mol Imaging 33:516–524

    Article  PubMed  CAS  Google Scholar 

  • Galldiks N, Kracht LW, Burghaus L, Ullrich RT, Backes H, Brunn A, Heiss WD, Jacobs AH (2010a) Patient-tailored, imaging-guided, long-term temozolomide chemotherapy in patients with glioblastoma. Mol Imaging 9:40–46

    PubMed  CAS  Google Scholar 

  • Galldiks N, Kracht LW, Berthold F, Miletic H, Klein JC, Herholz K, Jacobs AH, Heiss WD (2010b) [11C]-L-methionine positron emission tomography in the management of children and young adults with brain tumors. J Neurooncol 96:231–239

    Article  PubMed  PubMed Central  Google Scholar 

  • Galldiks N, Rapp M, Stoffels G, Fink GR, Shah NJ, Coenen HH, Sabel M, Langen KJ (2013) Response assessment of bevacizumab in patients with recurrent malignant glioma using [18F]Fluoroethyl-Ltyrosine PET in comparison to MRI. Eur J Nucl Med Mol Imaging 40:22–33

    Article  PubMed  CAS  Google Scholar 

  • Galldiks N, von Tempelhoff W, Kahraman D, Kracht LW, Vollmar S, Fink GR, Schroeter M, Goldbrunner R, Schmidt M, Maarouf M (2012a) 11C-methionine positron emission tomographic imaging of biologic activity of a recurrent glioblastoma treated with stereotaxy-guided laser-induced interstitial thermotherapy. Mol Imaging 11:265–271

    PubMed  CAS  Google Scholar 

  • Galldiks N, Stoffels G, Filss CP, Piroth MD, Sabel M, Ruge MI, Herzog H, Shah NJ, Fink GR, Coenen HH, Langen KJ (2012b) Role of O–(2-(18)F-fluoroethyl)-L-tyrosine PET for differentiation of local recurrent brain metastasis from radiation necrosis. J Nucl Med (official publication) 53:1367–1374

    Google Scholar 

  • Galldiks N, Langen K, Holy R, Pinkawa M, Stoffels G, Nolte K, Kaiser H, Filss C, Fink G, Coenen H, Eble M, Piroth M (2012c) Assessment of treatment response in patients with glioblastoma using [18F]Fluoroethyl-L-Tyrosine PET in comparison to MRI. J Nucl Med (official publication) 53:1048–1057

    Article  CAS  Google Scholar 

  • Gehler B, Paulsen F, Oksuz MO, Hauser TK, Eschmann SM, Bares R, Pfannenberg C, Bamberg M, Bartenstein P, Belka C, Ganswindt U (2009) [68 Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planning. Radiat Oncol 4:56

    Google Scholar 

  • Goldman S, Levivier M, Pirotte B, Brucher JM, Wikler D, Damhaut P, Dethy S, Brotchi J, Hildebrand J (1997) Regional methionine and glucose uptake in high-grade gliomas: a comparative study on PET-guided stereotactic biopsy. J Nucl Med (official publication) 38:1459–1462

    Google Scholar 

  • Graf R, Nyuyki F, Steffen IG, Michel R, Fahdt D, Wust P, Brenner W, Budach V, Wurm R, Plotkin M (2013) Contribution of 68 Ga-DOTATOC PET/CT to target volume delineation of skull base meningiomas treated with stereotactic radiation therapy. Int J Radiat Oncol Biol Phys 85:68–73

    Article  PubMed  Google Scholar 

  • Grosu AL, Weber WA (2010) PET for radiation treatment planning of brain tumours. Radiother Oncol J Eur Soc Ther Radiol Oncol 96:325–327

    Article  Google Scholar 

  • Grosu AL, Weber WA, Franz M, Stark S, Piert M, Thamm R, Gumprecht H, Schwaiger M, Molls M, Nieder C (2005) 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 63:511–519

    Article  PubMed  CAS  Google Scholar 

  • Grosu AL, Astner ST, Riedel E, Nieder C, Wiedenmann N, Heinemann F, Schwaiger M, Molls M, Wester HJ, Weber WA (2011) An Interindividual Comparison of O–(2- [(18)F]Fluoroethyl)-L-Tyrosine (FET)- and L-[Methyl-(11)C]Methionine (MET)-PET in Patients With Brain Gliomas and Metastases. Int J Radiat Oncol Biol Phys 81:1049–1058

    Article  PubMed  CAS  Google Scholar 

  • Gulyas B, Halldin C (2012) New PET radiopharmaceuticals beyond FDG for brain tumor imaging. Q J Nucl Med Mol Imaging 56:173–190

    PubMed  CAS  Google Scholar 

  • Gulyas B, Nyary I, Borbely K (2008) FDG, MET or CHO? The quest for the optimal PET tracer for glioma imaging continues. Nat clin pract Neurol 4:470–471

    Article  PubMed  CAS  Google Scholar 

  • Harris RJ, Cloughesy TF, Pope WB, Nghiemphu PL, Lai A, Zaw T, Czernin J, Phelps ME, Chen W, Ellingson BM (2012) 18F-FDOPA and 18F-FLT positron emission tomography parametric response maps predict response in recurrent malignant gliomas treated with bevacizumab. Neurooncol 14:1079–1089

    CAS  Google Scholar 

  • Haubner R, Beer AJ, Wang H, Chen X (2010) Positron emission tomography tracers for imaging angiogenesis. Eur J Nucl Med Mol Imaging 37(Suppl 1):S86–S103

    Article  PubMed  PubMed Central  Google Scholar 

  • Heinzel A, Stock S, Langen KJ, Muller D (2012a) Cost-effectiveness analysis of FET PET-guided target selection for the diagnosis of gliomas. Eur J Nucl Med Mol Imaging 39:1089–1096

    Article  PubMed  Google Scholar 

  • Heinzel A, Stock S, Langen KJ, Muller D (2012b) Cost-effectiveness analysis of amino acid PET-guided surgery for supratentorial highgrade gliomas. J Nucl Med (official publication) 53:552–558

    Google Scholar 

  • Heinzel A, Muller D, Langen KJ, Blaum M, Verburg FA, Mottaghy FM, Galldiks N (2013) The use of O–(2-18F-Fluoroethyl)-Ltyrosine PET for treatment management of bevacizumab and irinotecan in patients with recurrent high-grade glioma: a costeffectiveness analysis. J Nucl Med (official publication) 54:1217–1222

    Google Scholar 

  • Henze M, Dimitrakopoulou-Strauss A, Milker-Zabel S, Schuhmacher J, Strauss LG, Doll J, Macke HR, Eisenhut M, Debus J, Haberkorn U (2005) Characterization of 68 Ga-DOTA-D-Phe1-Tyr3-octreotide kinetics in patients with meningiomas. J Nucl Med (official publication) 46:763–769

    Google Scholar 

  • Herholz K, Langen KJ, Schiepers C, Mountz JM (2012) Brain tumors. Semin Nucl Med 42:356–370

    Article  PubMed  PubMed Central  Google Scholar 

  • Herholz K, Holzer T, Bauer B, Schroder R, Voges J, Ernestus RI, Mendoza G, Weber-Luxenburger G, Lottgen J, Thiel A, Wienhard K, Heiss WD (1998) 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 50:1316–1322

    Article  PubMed  CAS  Google Scholar 

  • Horky LL, Hsiao EM, Weiss SE, Drappatz J, Gerbaudo VH (2011) Dual phase FDG-PET imaging of brain metastases provides superior assessment of recurrence versus post-treatment necrosis. J Neurooncol 103:137–146

    Article  PubMed  Google Scholar 

  • Huang C, McConathy J (2013) Radiolabeled amino acids for oncologic imaging. J Nucl Med (official publication) 54:1007–1010

    Google Scholar 

  • Hutterer M, Nowosielski M, Putzer D, Waitz D, Tinkhauser G, Kostron H, Muigg A, Virgolini IJ, Staffen W, Trinka E, Gotwald T, Jacobs AH, Stockhammer G (2011) O–(2-18F-fluoroethyl)-L-tyrosine PET predicts failure of antiangiogenic treatment in patients with recurrent high-grade glioma. J Nucl Med (official publication) 52:856–864

    Google Scholar 

  • Hutterer M, Nowosielski M, Putzer D, Jansen NL, Seiz M, Schocke M, McCoy M, Gobel G, la Fougere C, Virgolini IJ, Trinka E, Jacobs AH, Stockhammer G (2013) [18F]-fluoro-ethyl-L-tyrosine PET: a valuable diagnostic tool in neuro-oncology, but not all that glitters is glioma. Neurooncol 15:341–351

    CAS  Google Scholar 

  • Jacobs AH, Thomas A, Kracht LW, Li H, Dittmar C, Garlip G, Galldiks N, Klein JC, Sobesky J, Hilker R, Vollmar S, Herholz K, Wienhard K, Heiss WD (2005) 18F-fluoro-L-thymidine and 11C-methylmethionine as markers of increased transport and proliferation in brain tumors. J Nucl Med (official publication) 46:1948–1958

    Google Scholar 

  • Jager PL, Vaalburg W, Pruim J, de Vries EG, Langen KJ, Piers DA (2001) Radiolabeled amino acids: basic aspects and clinical applications in oncology. J Nucl Med (official publication) 42:432–445

    Google Scholar 

  • Jansen NL, Graute V, Armbruster L, Suchorska B, Lutz J, Eigenbrod S, Cumming P, Bartenstein P, Tonn JC, Kreth FW, la Fougere C (2012) MRI-suspected low-grade glioma: is there a need to perform dynamic FET PET? Eur J Nucl Med Mol Imaging 39:1021–1029

    Article  PubMed  CAS  Google Scholar 

  • Kaschten B, Stevenaert A, Sadzot B, Deprez M, Degueldre C, Del Fiore G, Luxen A, Reznik M (1998) Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med (official publication) 39:778–785

    Google Scholar 

  • Kato T, Shinoda J, Nakayama N, Miwa K, Okumura A, Yano H, Yoshimura S, Maruyama T, Muragaki Y, Iwama T (2008) Metabolic assessment of gliomas using 11C-methionine, [18F] fluorodeoxyglucose, and 11C-choline positron-emission tomography. AJNR Am J Neuroradiology 29:1176–1182

    Article  CAS  Google Scholar 

  • Kim S, Chung JK, Im SH, Jeong JM, Lee DS, Kim DG, Jung HW, Lee MC (2005) 11C-methionine PET as a prognostic marker in patients with glioma: comparison with 18F-FDG PET. Eur J Nucl Med Mol Imaging 32:52–59

    Article  PubMed  CAS  Google Scholar 

  • Kracht LW, Miletic H, Busch S, Jacobs AH, Voges J, Hoevels M, Klein JC, Herholz K, Heiss WD (2004) Delineation of brain tumor extent with [11C]L-methionine positron emission tomography: local comparison with stereotactic histopathology. Clin Cancer Res J Am Assoc Cancer Res (official) 10:7163–7170

    Google Scholar 

  • Kunz M, Thon N, Eigenbrod S, Hartmann C, Egensperger R, Herms J, Geisler J, la Fougere C, Lutz J, Linn J, Kreth S, von Deimling A, Tonn JC, Kretzschmar HA, Pöpperl G, Kreth FW (2011a) Hot spots in dynamic (18)FET-PET delineate malignant tumor parts within suspected WHO grade II gliomas. Neurooncol 13:307–316

    CAS  Google Scholar 

  • Kunz M, Thon N, Eigenbrod S, Hartmann C, Egensperger R, Herms J, Geisler J, la Fougere C, Lutz J, Linn J, Kreth S, von Deimling A, Tonn JC, Kretzschmar HA, Pöpperl G, Kreth FW (2011b) Hot spots in dynamic (18)FET-PET delineate malignant tumor parts within suspected WHO grade II gliomas. Neurooncol 13:307–316

    CAS  Google Scholar 

  • Kwee SA, Ko JP, Jiang CS, Watters MR, Coel MN (2007) Solitary brain lesions enhancing at MR imaging: evaluation with fluorine 18 fluorocholine PET. Radiology 244:557–565

    Article  PubMed  Google Scholar 

  • Langen KJ, Broer S (2004) Molecular transport mechanisms of radiolabeled amino acids for PET and SPECT. J Nucl Med (official publication) 45:1435–1436

    Google Scholar 

  • Langen KJ, Eschmann SM (2008) Correlative imaging of hypoxia and angiogenesis in oncology. J Nucl Med (official publication) 49:515–516

    Google Scholar 

  • Langen KJ, Tatsch K, Grosu AL, Jacobs AH, Weckesser M, Sabri O (2008) Diagnostics of cerebral gliomas with radiolabeled amino acids. Dtsch Arztebl Int 105:55–61

    PubMed  PubMed Central  Google Scholar 

  • Langen KJ, Jarosch M, Muhlensiepen H, Hamacher K, Broer S, Jansen P, Zilles K, Coenen HH (2003) Comparison of fluorotyrosines and methionine uptake in F98 rat gliomas. Nucl Med Biol 30:501–508

    Article  PubMed  CAS  Google Scholar 

  • Langen KJ, Hamacher K, Weckesser M, Floeth F, Stoffels G, Bauer D, Coenen HH, Pauleit D (2006) O–(2-[18F]fluoroethyl)-L-tyrosine: uptake mechanisms and clinical applications. Nucl Med Biol 33:287–294

    Article  PubMed  CAS  Google Scholar 

  • Lee HY, Chung JK, Jeong JM, Lee DS, Kim DG, Jung HW, Lee MC (2008) Comparison of FDG-PET findings of brain metastasis from non-small-cell lung cancer and small-cell lung cancer. Ann Nucl Med 22:281–286

    Article  PubMed  Google Scholar 

  • Lee IH, Piert M, Gomez-Hassan D, Junck L, Rogers L, Hayman J, Ten Haken RK, Lawrence TS, Cao Y, Tsien C (2009) Association of 11C-methionine PET uptake with site of failure after concurrent temozolomide and radiation for primary glioblastoma multiforme. Int J Radiat Oncol Biol Phys 73:479–485

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Lee ST, Scott AM (2007) Hypoxia positron emission tomography imaging with 18f-fluoromisonidazole. Semin Nucl Med 37:451–461

    Article  PubMed  Google Scholar 

  • Levivier M, Massager N, Wikler D, Lorenzoni J, Ruiz S, Devriendt D, David P, Desmedt F, Simon S, Van Houtte P, Brotchi J, Goldman S (2004) Use of stereotactic PET images in dosimetry planning of radiosurgery for brain tumors: clinical experience and proposed classification. J Nucl Med (official publication) 45:1146–1154

    Google Scholar 

  • Lustig RA, Seiferheld W, Berkey B, Yung AW, Scarantino C, Movsas B, Jones CU, Simpson JR, Fishbach J, Curran WJ Jr (2007) Imaging response in malignant glioma, RTOG 90–06. Am J ClinOncol 30:32–37

    Article  Google Scholar 

  • Matsuo M, Miwa K, Tanaka O, Shinoda J, Nishibori H, Tsuge Y, Yano H, Iwama T, Hayashi S, Hoshi H, Yamada J, Kanematsu M, Aoyama H (2012) Impact of [11C]methionine positron emission tomography for target definition of glioblastoma multiforme in radiation therapy planning. Int J Radiat Oncol Biol Phys 82:83–89

    Article  PubMed  Google Scholar 

  • Meller J, Sahlmann CO, Scheel AK (2007) 18F-FDG PET and PET/CT in fever of unknown origin. J Nucl Med (official publication) 48:35–45

    Google Scholar 

  • Miyake K, Shinomiya A, Okada M, Hatakeyama T, Kawai N, Tamiya T (2012) Usefulness of FDG, MET and FLT-PET studies for the management of human gliomas. J Biomed Biotechnol 2012:205818

    Article  PubMed  PubMed Central  Google Scholar 

  • Mosskin M, Ericson K, Hindmarsh T, von Holst H, Collins VP, Bergstrom M, Eriksson L, Johnstrom P (1989) Positron emission tomography compared with magnetic resonance imaging and computed tomography in supratentorial gliomas using multiple stereotactic biopsies as reference. Acta Radiol 30:225–232

    Article  PubMed  CAS  Google Scholar 

  • Narita T, Aoyama H, Hirata K, Onodera S, Shiga T, Kobayashi H, Murata J, Terasaka S, Tanaka S, Houkin K (2012) Reoxygenation of glioblastoma multiforme treated with fractionated radiotherapy concomitant with temozolomide: changes defined by 18F-fluoromisonidazole positron emission tomography: two case reports. Jpn J Clin Oncol 42:120–123

    Article  PubMed  Google Scholar 

  • Nyuyki F, Plotkin M, Graf R, Michel R, Steffen I, Denecke T, Geworski L, Fahdt D, Brenner W, Wurm R (2010) Potential impact of (68)Ga-DOTATOC PET/CT on stereotactic radiotherapy planning of meningiomas. Eur J Nucl Med Mol Imaging 37:310–318

    Article  PubMed  Google Scholar 

  • Padma MV, Said S, Jacobs M, Hwang DR, Dunigan K, Satter M, Christian B, Ruppert J, Bernstein T, Kraus G, Mantil JC (2003) Prediction of pathology and survival by FDG PET in gliomas. J Neurooncol 64:227–237

    Article  PubMed  CAS  Google Scholar 

  • Pauleit D, Floeth F, Hamacher K, Riemenschneider MJ, Reifenberger G, Muller HW, Zilles K, Coenen HH, Langen KJ (2005) O–(2-[18F]fluoroethyl)-L-tyrosine PET combined with MRI improves the diagnostic assessment of cerebral gliomas. Brain J Neurol 128:678–687

    Article  Google Scholar 

  • Pauleit D, Stoffels G, Bachofner A, Floeth FW, Sabel M, Herzog H, Tellmann L, Jansen P, Reifenberger G, Hamacher K, Coenen HH, Langen KJ (2009) Comparison of (18)F-FET and (18)F-FDG PET in brain tumors. Nucl Med Biol 36:779–787

    Article  PubMed  CAS  Google Scholar 

  • Pichler R, Dunzinger A, Wurm G, Pichler J, Weis S, Nussbaumer K, Topakian R, Aigner RM (2010) Is there a place for FET PET in the initial evaluation of brain lesions with unknown significance? Eur J Nucl Med Mol Imaging 37:1521–1528

    Article  PubMed  Google Scholar 

  • Piroth MD, Pinkawa M, Holy R, Stoffels G, Demirel C, Attieh C, Kaiser HJ, Langen KJ, Eble MJ (2009) Integrated-boost IMRT or 3-D-CRT using FET-PET based auto-contoured target volume delineation for glioblastoma multiforme–a dosimetric comparison. Radiat Oncol 4:57

    Article  PubMed  PubMed Central  Google Scholar 

  • Piroth MD, Holy R, Pinkawa M, Stoffels G, Kaiser HJ, Galldiks N, Herzog H, Coenen HH, Eble MJ, Langen KJ (2011a) Prognostic impact of postoperative, pre-irradiation (18)F-fluoroethyl-L-tyrosine uptake in glioblastoma patients treated with radiochemotherapy. Radiother Oncol J Eur Soc Ther Radiol Oncol 99:218–224

    Article  CAS  Google Scholar 

  • Piroth MD, Pinkawa M, Holy R, Klotz J, Nussen S, Stoffels G, Coenen HH, Kaiser HJ, Langen KJ, Eble MJ (2011b) Prognostic value of early [18F]fluoroethyltyrosine positron emission tomography after radiochemotherapy in glioblastoma multiforme. Int J Radiat Oncol Biol Phys 80:176–184

    Article  PubMed  Google Scholar 

  • Piroth MD, Pinkawa M, Holy R, Klotz J, Schaar S, Stoffels G, Galldiks N, Coenen HH, Kaiser HJ, Langen KJ, Eble MJ (2012) Integrated boost IMRT with FET-PET-adapted local dose escalation in glioblastomas. results of a prospective phase II study. Strahlentherapie und Onkologie: Organ der Deutschen Rontgengesellschaft [et al] 188:334–339

    Google Scholar 

  • Pirotte B, Goldman S, Massager N, David P, Wikler D, Lipszyc M, Salmon I, Brotchi J, Levivier M (2004) Combined use of 18Ffluorodeoxyglucose and 11C-methionine in 45 positron emission tomography-guided stereotactic brain biopsies. J Neurosurg 101:476–483

    Article  PubMed  CAS  Google Scholar 

  • Pirotte B, Goldman S, Salzberg S, Wikler D, David P, Vandesteene A, Van Bogaert P, Salmon I, Brotchi J, Levivier M (2003) Combined positron emission tomography and magnetic resonance imaging for the planning of stereotactic brain biopsies in children: experience in 9 cases. Pediatr Neurosurg 38:146–155

    Article  PubMed  Google Scholar 

  • Pirotte BJ, Lubansu A, Massager N, Wikler D, Goldman S, Levivier M (2007) Results of positron emission tomography guidance and reassessment of the utility of and indications for stereotactic biopsy in children with infiltrative brainstem tumors. J Neurosurg 107:392–399

    Article  PubMed  Google Scholar 

  • Pirotte BJ, Levivier M, Goldman S, Massager N, Wikler D, Dewitte O, Bruneau M, Rorive S, David P, Brotchi J (2009) Positron emission tomography-guided volumetric resection of supratentorial highgrade gliomas: a survival analysis in 66 consecutive patients. Neurosurgery 64:471–481; discussion 481

    Google Scholar 

  • Plotkin M, Blechschmidt C, Auf G, Nyuyki F, Geworski L, Denecke T, Brenner W, Stockhammer F (2010) Comparison of F-18 FETPET with F-18 FDG-PET for biopsy planning of non-contrastenhancing gliomas. Eur Radiol 20:2496–2502

    Article  PubMed  Google Scholar 

  • Pöpperl G, Gotz C, Rachinger W, Gildehaus FJ, Tonn JC, Tatsch K (2004) Value of O–(2-[18F]fluoroethyl)- L-tyrosine PET for the diagnosis of recurrent glioma. Eur J Nucl Med Mol Imaging 31:1464–1470

    Article  PubMed  Google Scholar 

  • Pöpperl G, Gotz C, Rachinger W, Schnell O, Gildehaus FJ, Tonn JC, Tatsch K (2006a) Serial O–(2-[(18)F]fluoroethyl)-L: −tyrosine PET for monitoring the effects of intracavitary radioimmunotherapy in patients with malignant glioma. Eur J Nucl Med Mol Imaging 33:792–800

    Article  PubMed  PubMed Central  Google Scholar 

  • Pöpperl G, Goldbrunner R, Gildehaus FJ, Kreth FW, Tanner P, Holtmannspotter M, Tonn JC, Tatsch K (2005) O–(2-[18F]fluoroethyl)-L-tyrosine PET for monitoring the effects of convectionenhanced delivery of paclitaxel in patients with recurrent glioblastoma. Eur J Nucl Med Mol Imaging 32:1018–1025

    Article  PubMed  Google Scholar 

  • Pöpperl G, Kreth FW, Herms J, Koch W, Mehrkens JH, Gildehaus FJ, Kretzschmar HA, Tonn JC, Tatsch K (2006b) Analysis of 18F-FET PET for grading of recurrent gliomas: is evaluation of uptake kinetics superior to standard methods? J Nucl Med (official publication) 47:393–403

    Google Scholar 

  • Pöpperl G, Kreth FW, Herms J, Koch W, Mehrkens JH, Gildehaus FJ, Kretzschmar HA, Tonn JC, Tatsch K (2006c) Analysis of 18F-FET PET for grading of recurrent gliomas: is evaluation of uptake kinetics superior to standard methods? J Nucl Med 47:393–403

    PubMed  Google Scholar 

  • Pöpperl G, Kreth FW, Mehrkens JH, Herms J, Seelos K, Koch W, Gildehaus FJ, Kretzschmar HA, Tonn JC, Tatsch K (2007) FET PET for the evaluation of untreated gliomas: correlation of FET uptake and uptake kinetics with tumour grading. Eur J Nucl Med Mol Imaging 34:1933–1942

    Article  PubMed  Google Scholar 

  • Prieto E, Marti-Climent JM, Dominguez-Prado I, Garrastachu P, Diez-Valle R, Tejada S, Aristu JJ, Penuelas I, Arbizu J (2011) Voxelbased analysis of dual-time-point 18F-FDG PET images for brain tumor identification and delineation. J Nucl Med (official publication) 52:865–872

    Google Scholar 

  • Rachinger W, Goetz C, Pöpperl G, Gildehaus FJ, Kreth FW, Holtmannspotter M, Herms J, Koch W, Tatsch K, Tonn JC (2005) Positron emission tomography with O–(2-[18F]fluoroethyl)-L-tyrosine versus magnetic resonance imaging in the diagnosis of recurrent gliomas. Neurosurgery 57:505–511; discussion 505–511

    Google Scholar 

  • Rapp M, Floeth FW, Felsberg J, Steiger HJ, Sabel M, Langen KJ, Galldiks N (2013a) Clinical value of O–(2-[(18)F]-fluoroethyl)-Ltyrosine positron emission tomography in patients with low-grade glioma. Neurosurg Focus 34:E3

    Article  PubMed  Google Scholar 

  • Rapp M, Heinzel A, Galldiks N, Stoffels G, Felsberg J, Ewelt C, Sabel M, Steiger HJ, Reifenberger G, Beez T, Coenen HH, Floeth FW, Langen KJ (2013b) Diagnostic performance of 18F-FET PET in newly diagnosed cerebral lesions suggestive of glioma. J Nucl Med (official publication) 54:229–235

    Google Scholar 

  • Ribom D, Eriksson A, Hartman M, Engler H, Nilsson A, Langstrom B, Bolander H, Bergstrom M, Smits A (2001) Positron emission tomography (11)C-methionine and survival in patients with lowgrade gliomas. Cancer 92:1541–1549

    Article  PubMed  CAS  Google Scholar 

  • Ricci PE, Karis JP, Heiserman JE, Fram EK, Bice AN, Drayer BP (1998) Differentiating recurrent tumor from radiation necrosis: time for re-evaluation of positron emission tomography? AJNR Am J Neuroradiol 19:407–413

    PubMed  CAS  Google Scholar 

  • Rickhey M, Koelbl O, Eilles C, Bogner L (2008) A biologically adapted dose-escalation approach, demonstrated for 18F-FET-PET in brain tumors. Strahlentherapie und Onkologie: Organ der Deutschen Rontgengesellschaft [et al] 184:536–542

    Google Scholar 

  • Roelcke U, Bruehlmeier M, Hefti M, Hundsberger T, Nitzsche EU (2012) F-18 choline PET does not detect increased metabolism in F-18 fluoroethyltyrosine-negative low-grade gliomas. Clin Nucl Med 37:e1–e3

    Article  PubMed  Google Scholar 

  • Rottenburger C, Hentschel M, Kelly T, Trippel M, Brink I, Reithmeier T, Meyer PT, Nikkhah G (2011) Comparison of C-11 methionine and C-11 choline for PET imaging of brain metastases: a prospective pilot study. Clin Nucl Med 36:639–642

    Article  PubMed  Google Scholar 

  • Saga T, Kawashima H, Araki N, Takahashi JA, Nakashima Y, Higashi T, Oya N, Mukai T, Hojo M, Hashimoto N, Manabe T, Hiraoka M, Togashi K (2006) Evaluation of primary brain tumors with FLTPET: usefulness and limitations. Clin Nucl Med 31:774–780

    Article  PubMed  Google Scholar 

  • Salber D, Stoffels G, Pauleit D, Reifenberger G, Sabel M, Shah NJ, Hamacher K, Coenen HH, Langen KJ (2006) Differential uptake of [18F]FET and [3H]L-methionine in focal cortical ischemia. Nucl Med Biol 33:1029–1035

    Article  PubMed  CAS  Google Scholar 

  • Salber D, Stoffels G, Pauleit D, Oros-Peusquens AM, Shah NJ, Klauth P, Hamacher K, Coenen HH, Langen KJ (2007) Differential uptake of O–(2-18F-fluoroethyl)-L-tyrosine, L-3H-methionine, and 3Hdeoxyglucose in brain abscesses. J Nucl Med (official publication) 48:2056–2062

    Google Scholar 

  • Saleem A, Brown GD, Brady F, Aboagye EO, Osman S, Luthra SK, Ranicar AS, Brock CS, Stevens MF, Newlands E, Jones T, Price P (2003) Metabolic activation of temozolomide measured in vivo using positron emission tomography. Cancer Res 63:2409–2415

    PubMed  CAS  Google Scholar 

  • Schiepers C, Dahlbom M, Chen W, Cloughesy T, Czernin J, Phelps ME, Huang SC (2010) Kinetics of 30-deoxy-30-18F-fluorothymidine during treatment monitoring of recurrent high-grade glioma. J Nucl Med (official publication) 51:720–727

    Google Scholar 

  • Schnell O, Krebs B, Carlsen J, Miederer I, Goetz C, Goldbrunner RH, Wester HJ, Haubner R, Pöpperl G, Holtmannspotter M, Kretzschmar HA, Kessler H, Tonn JC, Schwaiger M, Beer AJ (2009) Imaging of integrin alpha(v)beta(3) expression in patients with malignant glioma by [18F] Galacto-RGD positron emission tomography. Neurooncol 11:861–870

    Google Scholar 

  • Schwarzenberg J, Czernin J, Cloughesy TF, Ellingson BM, Pope WB, Geist C, Dahlbom M, Silverman DH, Satyamurthy N, Phelps ME, Chen W (2012) 30-deoxy-30-18F-fluorothymidine PET and MRI for early survival predictions in patients with recurrent malignant glioma treated with bevacizumab. J Nucl Med (official publication) 53:29–36

    Google Scholar 

  • Shields AF (2003) PET imaging with 18F-FLT and thymidine analogs: promise and pitfalls. J Nucl Med (official publication) 44:1432–1434

    Google Scholar 

  • Shields AF, Grierson JR, Dohmen BM, Machulla HJ, Stayanoff JC, Lawhorn-Crews JM, Obradovich JE, Muzik O, Mangner TJ (1998) Imaging proliferation in vivo with [F-18]FLT and positron emission tomography. Nat Med 4:1334–1336

    Article  PubMed  CAS  Google Scholar 

  • Singhal T, Narayanan TK, Jain V, Mukherjee J, Mantil J (2008) 11C-L-methionine positron emission tomography in the clinical management of cerebral gliomas. Mol Imaging Biol Official Publ Acad Mol Imaging 10:1–18

    Article  Google Scholar 

  • Singhal T, Narayanan TK, Jacobs MP, Bal C, Mantil JC (2012) 11C-methionine PET for grading and prognostication in gliomas: a comparison study with 18F-FDG PET and contrast enhancement on MRI. J Nucl Med (official publication) 53:1709–1715

    Google Scholar 

  • Smits A, Baumert BG (2011) The Clinical Value of PET with Amino Acid Tracers for Gliomas WHO Grade II. Int J Mol Imaging 2011:372509

    Article  PubMed  PubMed Central  Google Scholar 

  • Smits A, Westerberg E, Ribom D (2008) Adding 11C-methionine PET to the EORTC prognostic factors in grade 2 gliomas. Eur J Nucl Med Mol Imaging 35:65–71

    Article  PubMed  CAS  Google Scholar 

  • Spence AM, Muzi M, Mankoff DA, O’Sullivan SF, Link JM, Lewellen TK, Lewellen B, Pham P, Minoshima S, Swanson K, Krohn KA (2004) 18F-FDG PET of gliomas at delayed intervals: improved distinction between tumor and normal gray matter. J.Nucl Med 45:1653–1659

    Google Scholar 

  • Tan H, Chen L, Guan Y, Lin X (2011) Comparison of MRI, F-18 FDG, and 11C-choline PET/CT for their potentials in differentiating brain tumor recurrence from brain tumor necrosis following radiotherapy. Clin Nucl Med 36:978–981

    Article  PubMed  Google Scholar 

  • Terakawa Y, Tsuyuguchi N, Iwai Y, Yamanaka K, Higashiyama S, Takami T, Ohata K (2008) Diagnostic accuracy of 11C-methionine PET for differentiation of recurrent brain tumors from radiation necrosis after radiotherapy. J Nucl Med (official publication) 49:694–699

    Google Scholar 

  • Thorwarth D, Henke G, Muller AC, Reimold M, Beyer T, Boss A, Kolb A, Pichler B, Pfannenberg C (2011) Simultaneous 68 Ga-DOTATOC-PET/MRI for IMRT treatment planning for meningioma: first experience. Int J Radiat Oncol Biol Phys 81:277–283

    Article  PubMed  Google Scholar 

  • Tsuyuguchi N, Takami T, Sunada I, Iwai Y, Yamanaka K, Tanaka K, Nishikawa M, Ohata K, Torii K, Morino M, Nishio A, Hara M (2004) Methionine positron emission tomography for differentiation of recurrent brain tumor and radiation necrosis after stereotactic radiosurgery—in malignant glioma. Ann Nucl Med 18:291–296

    Article  PubMed  CAS  Google Scholar 

  • Ullrich R, Backes H, Li H, Kracht L, Miletic H, Kesper K, Neumaier B, Heiss WD, Wienhard K, Jacobs AH (2008) Glioma proliferation as assessed by 30-fluoro-30-deoxy-L-thymidine positron emission tomography in patients with newly diagnosed high-grade glioma. Clin Cancer Res Official J Am Assoc Cancer Res 14:2049–2055

    Article  CAS  Google Scholar 

  • Utriainen M, Metsahonkala L, Salmi TT, Utriainen T, Kalimo H, Pihko H, Makipernaa A, Harila-Saari A, Jyrkkio S, Laine J, Nagren K, Minn H (2002) Metabolic characterization of childhood brain tumors: comparison of 18F-fluorodeoxyglucose and 11C-methionine positron emission tomography. Cancer 95:1376–1386

    Article  PubMed  Google Scholar 

  • Van Laere K, Ceyssens S, Van Calenbergh F, de Groot T, Menten J, Flamen P, Bormans G, Mortelmans L (2005) Direct comparison of 18F-FDG and 11C-methionine PET in suspected recurrence of glioma: sensitivity, inter-observer variability and prognostic value. Eur J Nucl Med Mol Imaging 32:39–51

    Article  PubMed  CAS  Google Scholar 

  • Walter F, Cloughesy T, Walter MA, Lai A, Nghiemphu P, Wagle N, Fueger B, Satyamurthy N, Phelps ME, Czernin J (2012) Impact of 3,4-dihydroxy-6-18F-fluoro-L-phenylalanine PET/CT on managing patients with brain tumors: the referring physician’s perspective. J Nucl Med (official publication) 53:393–398

    Article  CAS  Google Scholar 

  • Weber DC, Casanova N, Zilli T, Buchegger F, Rouzaud M, Nouet P, Vees H, Ratib O, Dipasquale G, Miralbell R (2009) Recurrence pattern after [(18)F]fluoroethyltyrosine-positron emission tomography-guided radiotherapy for high-grade glioma: a prospective study. Radiother Oncol J Eur Soc Ther Radiol Oncol 93:586–592

    Article  Google Scholar 

  • Weber DC, Zilli T, Buchegger F, Casanova N, Haller G, Rouzaud M, Nouet P, Dipasquale G, Ratib O, Zaidi H, Vees H, Miralbell R (2008) [(18)F]Fluoroethyltyrosine- positron emission tomographyguided radiotherapy for high-grade glioma. Radiat Oncol 3:44

    Google Scholar 

  • Weber WA, Wester HJ, Grosu AL, Herz M, Dzewas B, Feldmann HJ, Molls M, Stocklin G, Schwaiger M (2000) 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 27:542–549

    Article  PubMed  CAS  Google Scholar 

  • Weckesser M, Matheja P, Rickert CH, Strater R, Palkovic S, Lottgen J, Kurlemann G, Paulus W, Wassmann H, Schober O (2001) High uptake of L-3-[123I]iodo-alpha-methyl tyrosine in pilocytic astrocytomas. Eur J Nucl Med 28:273–281

    Article  PubMed  CAS  Google Scholar 

  • Weckesser M, Langen KJ, Rickert CH, Kloska S, Straeter R, Hamacher K, Kurlemann G, Wassmann H, Coenen HH, Schober O (2005) O-(2-[18F]fluorethyl)-L-tyrosine PET in the clinical evaluation of primary brain tumours. Eur J Nucl Med Mol Imaging 32:422–429

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Neuroscience and Medicine, Forschungszentrum Jülich, D-52425, Jülich, Germany

    Karl-Josef Langen & Norbert Galldiks

  2. Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany

    Karl-Josef Langen

  3. Department of Neurology, University of Cologne, Cologne, Germany

    Norbert Galldiks

Authors
  1. Karl-Josef Langen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Norbert Galldiks
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karl-Josef Langen .

Editor information

Editors and Affiliations

  1. Neuroradiology, Dept. of Radiol., University Hospital Bonn, Bonn, Germany

    Elke Hattingen

  2. Neuroradiology, Goethe University, Hospital Frankfurt, Frankfurt/Main, Germany

    Ulrich Pilatus

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Langen, KJ., Galldiks, N. (2013). PET Imaging of Brain Tumors. In: Hattingen, E., Pilatus, U. (eds) Brain Tumor Imaging. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2013_937

Download citation

  • DOI: https://doi.org/10.1007/174_2013_937

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45039-6

  • Online ISBN: 978-3-642-45040-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation