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Purpose <p>To investigate the clinical potential of <i>O</i>-(2-[<sup>18</sup>F]fluoroethyl)-L-tyrosine ([<sup>18</sup>F]FET) PET imaging in the management of circumscribed astrocytic gliomas (CAG), a rare glioma subtype with limited imaging data.</p> Methods <p>We retrospectively identified adult CAG patients who underwent [<sup>18</sup>F]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 (TBR<sub>max</sub>, TBR<sub>mean</sub>) 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.</p> Results <p>We evaluated 79 [<sup>18</sup>F]FET PET scans of 42 patients, including nine (21%) with actionable molecular targets. Measurable [<sup>18</sup>F]FET uptake was observed in 65% of WHO grade 1 and 100% of WHO grade 2 and 3 CAG. TBR values were significantly higher in WHO grade 2 and 3 CAG than in pilocytic astrocytomas (<i>P</i> &lt; 0.01), but showed no difference based on molecular target status (<i>P</i> &gt; 0.05). In 5 of 11 patients (45%), treatment response assessment by PET RANO 1.0 differed from MRI. Treatment-related changes were confirmed in 12 patients (43%). In CAG WHO grades 2 or 3, the accuracy of [<sup>18</sup>F]FET PET to identify treatment-related changes was 82% using single PET scans and 100% using serial PET imaging (<i>P</i> &lt; 0.05).</p> Conclusions <p>[<sup>18</sup>F]FET PET can contribute to clinical management of patients with CAG by detecting measurable disease, differentiating treatment-related changes from tumor progression, and showing potential in treatment response assessment through longitudinal imaging.</p>

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Clinical potential of [18F]FET PET in patients with circumscribed astrocytic glioma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月18日

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

摘要

Purpose

To investigate the clinical potential of O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET) PET imaging in the management of circumscribed astrocytic gliomas (CAG), a rare glioma subtype with limited imaging data.

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. Measurable [18F]FET uptake was observed in 65% of WHO grade 1 and 100% of WHO grade 2 and 3 CAG. TBR values were significantly higher in WHO grade 2 and 3 CAG than in pilocytic astrocytomas (P < 0.01), but showed no difference based on molecular target status (P > 0.05). In 5 of 11 patients (45%), treatment response assessment by PET RANO 1.0 differed from MRI. Treatment-related changes were confirmed 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).

Conclusions

[18F]FET PET can contribute to clinical management of patients with CAG by detecting measurable disease, differentiating treatment-related changes from tumor progression, and showing potential in treatment response assessment through longitudinal imaging.