(18)F-FET-PET guided surgical biopsy and resection in children and adolescence with brain tumors

Childs Nerv Syst. 2015 Feb;31(2):261-7. doi: 10.1007/s00381-014-2552-y. Epub 2014 Sep 18.


Purpose: MRI alone has its limitations for target selection in biopsy or resection in newly diagnosed and pretreated pediatric brain tumor patients. (18)F-FET-PET imaging is considered to identify metabolically active tumor tissue and to differentiate it from therapy-associated changes. We retrospectively analyzed our experience with (18)F-FET-PET in targeted surgical interventions for pediatric brain tumors.

Methods: In 26 cases with lesions suspicious of a growing brain tumor on MRI, either newly diagnosed or after antitumoral treatment led to (18)F-FET-PET imaging for target selection prior to stereotactic biopsy, navigated open biopsy or navigated microsurgical tumor resection. Indications for (18)F-FET-PET imaging were visualization of metabolic active tumor tissue within diffuse tumors or pretreated lesions as well as depicting their extent.

Results: (18)F-FET-PET integration in surgery was feasible in all patients using stereotaxy or neuronavigation. Sensitivity for tumor detection was 20/24. (18)F-FET-PET was false positive in two pretreated patients.

Conclusion: (18)F-FET-PET imaging is helpful for target selection and can be integrated in surgical guidance. (18)F-FET-PET image-guided surgical targeting yielded histological diagnosis with decent specificity and high sensitivity in our cohort of pediatric brain tumor patients. Our results warrant further evaluation of (18)F-FET-PET imaging for surgical guidance.

MeSH terms

  • Adolescent
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / surgery*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Neuronavigation / methods*
  • Positron-Emission Tomography
  • Radiopharmaceuticals*
  • Sensitivity and Specificity
  • Tyrosine / analogs & derivatives*


  • O-(2-fluoroethyl)tyrosine
  • Radiopharmaceuticals
  • Tyrosine