PET in neuro-oncology

Roelcke, Ulrich; Leenders, Klaus L.

doi:10.1007/s004320000158

Cited by 28 publications

(8 citation statements)

References 26 publications

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“…The most prominent example is the use of 18 F-fluorodeoxyglucose (FDG), a radiotracer derived from 2-deoxy-d-glucose, to study the first steps of glucose metabolism. FDG PET is used to stage cancer and to differentiate between malignant and benign lesions [27]. In neuro-oncology, the largest experience has been acquired with FDG PET.…”

Section: Positron Emission Tomography (Pet)mentioning

confidence: 99%

The Clinical Value of PET with Amino Acid Tracers for Gliomas WHO Grade II

Smits

Baumert

2011

International Journal of Molecular Imaging

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The clinical management of adults with low-grade gliomas (LGGs) remains a challenge. There is no curative treatment, and management of individual patients is a matter of deciding optimal timing as well as right treatment modality. In addition to conventional imaging techniques, positron emission tomography (PET) with amino acid tracers can facilitate diagnostic and therapeutic procedures. In this paper, the clinical applications of PET with amino acid tracers 11C-methyl-L-methionine (MET) and 18F-fluoro-ethyl-L-tyrosine (FET) for patients with LGG are summarized. We also discuss the value of PET for the long-term followup of this patient group. Monitoring metabolic activity by PET in individual patients during course of disease will provide insight in the biological behavior and evolution of these tumors. As such, spatial changes in tumor activity over time, including shifts of hot-spot regions within the tumor, may reflect intratumoral heterogeneity and correlate to clinical parameters.

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Section: Positron Emission Tomography (Pet)mentioning

confidence: 99%

The Clinical Value of PET with Amino Acid Tracers for Gliomas WHO Grade II

Smits

Baumert

2011

International Journal of Molecular Imaging

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“…In some patients who present with encephalopathy, positron emission tomography may demonstrate diffusely diminished glucose use in otherwise normal-appearing brain. This situation may be reversible after treatment with cranial irradiation [20].…”

Section: Opinion Statementmentioning

confidence: 99%

Neoplastic meningitis

Kim

Glantz

2001

Curr. Treat. Options in Oncol.

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Neoplastic meningitis is recognized clinically in 4% to 7% of patients with extraneural cancer, but it remains dramatically under-diagnosed. The frequency of neoplastic meningitis is increasing because of heightened clinical suspicion, improved neuroimaging techniques, and longer survival in patients with extraneural cancer Longer survival allows residual tumor cells within central nervous system sanctuary sites time to become symptomatic. Affected patients may present with cerebral, cranial nerve, or spinal signs and symptoms, depending on the specific sites of central nervous system (CNS) involvement. Magnetic Resonance Imaging (MRI) seems to be sensitive for detecting metastatic deposits along the neuraxis. However, metastases at a microscopic level are below the resolution of MRI scanning. As a result, the standard diagnostic test for neoplastic meningitis remains the cytologic identification of malignant cells in cerebrospinal fluid (CSF). Although CSF cytology is useful, malignant cells are not detected in as many as one third of patients who have compelling clinical or radiographic evidence of neoplastic meningitis. Novel assays are being tested that may enhance the early identification of malignant cells in CSF. Currently, the diagnosis occurs generally after the onset of neurologic manifestations and heralds a rapidly fatal course for most patients. By the time symptoms appear, most tumors have disseminated widely within the CNS, due to cortical irritation, compression of nervous system structures, or obstruction of CSF flow. At this stage surgery, cranial irradiation, and chemotherapy are rarely, if ever, curative. The goals of treatment are to improve or to stabilize the neurologic status of patients and to prolong survival. A major problem in treating neoplastic meningitis is that the entire neuraxis must be treated. If only symptomatic areas are treated, reseeding of the neuraxis with tumor cells will occur. Therefore, intrathecal chemotherapy remains a mainstay of therapy. Currently, four therapeutic agents are available for intrathecal treatment: methotrexate, ara-C, sustained-release ara-C (DepoCyt; Chiron Therapeutics, San Francisco, CA), and thiotepa. Unfortunately, intrathecal chemotherapy does not treat bulky disease in the subarachnoid space, and often is slow to stabilize progressive neurologic deficits. For these reasons, radiation therapy to sites of symptomatic disease and sites of bulky disease on imaging studies is recommended. High dose intravenous methotrexate may be as effective as intrathecal methotrexate. Alternative approaches (which offer less toxicity, enhanced therapeutic effect, and prolonged survival) are being investigated.

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“…Les particules émettant des positrons sont accouplées à des molécules vectrices participant aux processus métaboliques physiologiques, plus intenses dans les tumeurs, ce qui permet de les visualiser en trois dimensions [7]. C'est surtout le métabolisme du glucose qui ressort bien, avec le 18 F-fluordésoxyglucose (FDG), celui des acides aminés ou la synthèse des protéines ( 11 C-méthionine, 18 F-thymidine, 18 F-tyrosine) et la perfusion (H2 15 O) [7,9,10]. Le traceur le plus répandu est le 18 F-FDG, qui convient particulièrement bien pour les tumeurs denses, hautement prolifératives et peu différenciées.…”

Section: Tomographie Par éMission De Positrons (Pet)unclassified

“…Les tumeurs de degré III (astrocytome anaplasique, oligodendrogliome anaplasique, épendymome anaplasique) ont en général une glycolyse nettement plus marquée et peuvent donc être examinées avec le 18 F-FDG, mais aussi avec les conjugués des acides aminés ci-dessus, du fait de leur activité proliférative marquée. Les tumeurs de degré IV (glioblastome polymorphe) font preuve d'un métabolisme du glucose très nettement accéléré, et d'une tendance proliférative marquée: ils peuvent donc être parfaitement examinés par 18 F-FDG et acides aminés marqués [9,10]. Pour visualiser une tumeur, l'important n'est pas seulement son volume, mais aussi son activité métabolique ou sa tendance proliférative: aucune tumeur anaplasique ne peut être nettement mieux différenciée du parenchyme cérébral environnant que les tumeurs à faible degré de malignité.…”

Section: Représentation De Certains Types De Tumeur Par La Petunclassified

Tumeurs cérébrales gliales de l'adulte Imagerie diagnostique et contrôle du traitement

Freitag¹,

Schumacher²

2002

Forum Med Suisse

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PET in neuro-oncology

Cited by 28 publications

References 26 publications

The Clinical Value of PET with Amino Acid Tracers for Gliomas WHO Grade II

The Clinical Value of PET with Amino Acid Tracers for Gliomas WHO Grade II

Neoplastic meningitis

Tumeurs cérébrales gliales de l'adulte Imagerie diagnostique et contrôle du traitement

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