P03.25.B CLINICAL UTILITY OF [18F]FET PET IN PATIENTS WITH CIRCUMSCRIBED ASTROCYTIC GLIOMA

Abstract BACKGROUND O-(2-[18F]fluoroethyl)-L-tyrosine ([¹⁸F]FET) PET is predominantly applied for molecular imaging of diffuse gliomas. In contrast, data on the clinical utility of [¹⁸F]FET PET in circumscribed astrocytic gliomas (CAG) remain scarce. MATERIAL AND METHODS We retrospectively identified adult CAG patients who underwent [¹⁸F]FET PET imaging (i) before diagnosis, (ii) at suspected relapse, or (iii) for response assessment at three institutions. Maximum and mean tumor-to-brain ratios (TBRmax, TBRmean) and metabolic tumor volumes were assessed according to the PET RANO 1.0 criteria. Diagnostic performance in differentiating treatment-related changes from tumor relapse was evaluated using ROC analysis and Fisher’s exact test. RESULTS We evaluated 79 [¹⁸F]FET PET scans of 42 patients, including nine (21%) with actionable molecular targets. 65% of CAG WHO grade 1 and 100% of CAG WHO grades 2 or 3 had measurable [¹⁸F]FET uptake according to the PET RANO 1.0 criteria. In these patients, TBR values of CAG WHO grades 2 or 3 were significantly higher than in pilocytic astrocytomas (P<0.01). There was no significant difference in TBR between CAG with or without actionable targets (P>0.05). Following various treatments, response assessment according to the PET RANO 1.0 criteria differed from changes in MRI in 5 of 11 patients (45%). Treatment-related changes were confirmed neuropathologically or clinicoradiologically in 12 patients (43%). In CAG WHO grades 2 or 3, the accuracy of [¹⁸F]FET PET to identify treatment-related changes was 82% using single PET scans and 100% using serial PET imaging (P<0.05). CONCLUSION [¹⁸F]FET PET can add valuable information for the clinical management of patients with CAG.

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Publication Details

Journal
Neuro-Oncology
Published
2025-10-01
DOI
https://doi.org/10.1093/neuonc/noaf193.184
Primary Topic
Glioma Diagnosis and Treatment
Type
article
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article

P03.25.B CLINICAL UTILITY OF [18F]FET PET IN PATIENTS WITH CIRCUMSCRIBED ASTROCYTIC GLIOMA

Gereon R. Fink, Isabelle Stetter, Robert Forbrig, Enio Barci et al.
Neuro-Oncology
Glioma Diagnosis and Treatment
article

P03.25.B CLINICAL UTILITY OF [18F]FET PET IN PATIENTS WITH CIRCUMSCRIBED ASTROCYTIC GLIOMA

Gereon R. Fink, Isabelle Stetter, Robert Forbrig, Enio Barci, Patrick N. Harter, Michael Wollring, Felix Manuel Mottaghy, Louisa von Baumgarten, Franziska Eckert, Alexander Beck, Nathalie L. Albert, Johannes A. Hainfellner, Thomas Nakuz, Gregor J. Kasprian, Sonja Schönecker, Norbert Galldiks, Matthias Preusser, Karl‐Josef Langen, Georg Widhalm, Gabriele Stoffels, Jan‐Michael Werner, Niklas Thon, Caroline Tscherpel, Maximilian J. Mair, V. Sunder-Plassmann, Hannah Christina Puhr, Philipp Lohmann
article en

Abstract

Abstract BACKGROUND O-(2-[18F]fluoroethyl)-L-tyrosine ([¹⁸F]FET) PET is predominantly applied for molecular imaging of diffuse gliomas. In contrast, data on the clinical utility of [¹⁸F]FET PET in circumscribed astrocytic gliomas (CAG) remain scarce. MATERIAL AND METHODS We retrospectively identified adult CAG patients who underwent [¹⁸F]FET PET imaging (i) before diagnosis, (ii) at suspected relapse, or (iii) for response assessment at three institutions. Maximum and mean tumor-to-brain ratios (TBRmax, TBRmean) and metabolic tumor volumes were assessed according to the PET RANO 1.0 criteria. Diagnostic performance in differentiating treatment-related changes from tumor relapse was evaluated using ROC analysis and Fisher’s exact test. RESULTS We evaluated 79 [¹⁸F]FET PET scans of 42 patients, including nine (21%) with actionable molecular targets. 65% of CAG WHO grade 1 and 100% of CAG WHO grades 2 or 3 had measurable [¹⁸F]FET uptake according to the PET RANO 1.0 criteria. In these patients, TBR values of CAG WHO grades 2 or 3 were significantly higher than in pilocytic astrocytomas (P<0.01). There was no significant difference in TBR between CAG with or without actionable targets (P>0.05). Following various treatments, response assessment according to the PET RANO 1.0 criteria differed from changes in MRI in 5 of 11 patients (45%). Treatment-related changes were confirmed neuropathologically or clinicoradiologically in 12 patients (43%). In CAG WHO grades 2 or 3, the accuracy of [¹⁸F]FET PET to identify treatment-related changes was 82% using single PET scans and 100% using serial PET imaging (P<0.05). CONCLUSION [¹⁸F]FET PET can add valuable information for the clinical management of patients with CAG.

Neuro-OncologyVol. 27(Supplement_3)
Goethe University Frankfurt (DE), Forschungszentrum Jülich (DE), University of Cologne (DE), Maastricht University Medical Centre (NL), LMU Klinikum (DE), Maastricht University (NL), Comprehensive Cancer Center Vienna (AT), Christian Doppler Laboratory for Thermoelectricity (AT), Universitätsklinikum Knappschaftskrankenhaus Bochum (DE), University Hospital Frankfurt (DE), University Hospital Cologne (DE), Medical University of Vienna (AT), Ludwig-Maximilians-Universität München (DE), RWTH Aachen University (DE)
Openalex Percentile: Top 62%
Glioma Diagnosis and Treatment
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