Initial Experience of 18 F-FET PET-MR Image Fusion for Evaluation of Recurrent Primary Brain Tumors

Habibollah Dadgar; Manouchehr Seyedi Vafaee; Amirreza Khorasanchi; Parastoo Kordestani Moghadam; Reza Nemati; Hossein Shooli; Esmail Jafari; Majid Assadi

doi:10.1055/s-0043-1771282

Initial Experience of ¹⁸ F-FET PET-MR Image Fusion for Evaluation of Recurrent Primary Brain Tumors

World J Nucl Med. 2023 Sep 6;22(3):183-190. doi: 10.1055/s-0043-1771282. eCollection 2023 Sep.

Authors

Habibollah Dadgar¹, Manouchehr Seyedi Vafaee^{2

3

4}, Amirreza Khorasanchi¹, Parastoo Kordestani Moghadam⁵, Reza Nemati⁶, Hossein Shooli⁷, Esmail Jafari⁷, Majid Assadi⁷

Affiliations

¹ Cancer Research Center, RAZAVI Hospital, Imam Reza International University, Mashhad, Iran.
² Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
³ Translational Neuroscience, BRIDGE, University of Southern Denmark, Odense, Denmark.
⁴ Department of Psychiatry, Odense University Hospital, Odense, Denmark.
⁵ Social Determinants of Health Research Center (Division of Cognitive Neuroscience), Lorestan University of Medical Sciences, Khorramabad, Iran.
⁶ Department of Neurology, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
⁷ The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.

Abstract

Background An accurate monitoring technique is crucial in brain tumors to choose the best treatment approach after surgery and/or chemoradiation. Radiological assessment of brain tumors is widely based on the magnetic resonance imaging (MRI) modality in this regard; however, MRI criteria are unable to precisely differentiate tumoral tissue from treatment-related changes. This study was conducted to evaluate whether fused MRI and O-(2- ¹⁸ F-fluoroethyl)-L-tyrosine ( ¹⁸ F-FET) positron emission tomography (PET) can improve the diagnostic accuracy of the practitioners to discriminate treatment-related changes from true recurrence of brain tumor. Methods We retrospectively analyzed ¹⁸ F-FET PET/computed tomography (CT) of 11 patients with histopathologically proven brain tumors that were suspicious for recurrence changes after 3 to 4 months of surgery. All the patients underwent MRI and ¹⁸ F-FET PET/CT. As a third assessment, fused ¹⁸ F-FET PET/MRI was also acquired. Finally, the diagnostic accuracy of the applied modalities was compared. Results Eleven patients aged 27 to 73 years with a mean age of 47 ± 13 years were enrolled. According to the results, 9/11 cases (82%) showed positive MRI and 6 cases (55%) showed positive PET/CT and PET/MRI. Tumoral recurrence was observed in six patients (55%) in the follow-up period. Based on the follow-up results, accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 64, 85, 25, 67, and 50%, respectively, for MRI alone and 91, 85, 100, 100, and 80%, respectively, for both PET/CT and PET/MRI. Conclusion This study found that ¹⁸ F-FET PET-MR image fusion in the management of brain tumors might improve recurrence detection; however, further well-designed studies are needed to verify these preliminary data.

Keywords: 18 F-FET PET/CT; amino acid PET; brain tumor; magnetic resonance imaging; positron emission tomography.

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Grants and funding

Funding None.