Two Decades of Brain Tumour Imaging with O-(2-[¹⁸F]fluoroethyl)-L-tyrosine PET: The Forschungszentrum Jülich Experience

Alexander Heinzel^{1

2

3}, Daniela Dedic¹, Norbert Galldiks^{2

3

4}, Philipp Lohmann^{2

5}, Gabriele Stoffels², Christian P Filss^{1

2

3}, Martin Kocher^{2

3

5}, Filippo Migliorini⁶, Kim N H Dillen⁷, Stefanie Geisler², Carina Stegmayr², Antje Willuweit², Michael Sabel^{3

8}, Marion Rapp^{3

8}, Michael J Eble^{3

9}, Marc Piroth¹⁰, Hans Clusmann^{3

11}, Daniel Delev^{3

11}, Elena K Bauer^{3

4}, Garry Ceccon^{3

4}, Veronika Dunkl^{3

4}, Jurij Rosen^{3

4}, Caroline Tscherpel^{3

4}, Jan-Michael Werner^{3

4}, Maximilian I Ruge^{3

5}, Roland Goldbrunner^{3

12}, Jürgen Hampl^{3

12}, Carolin Weiss Lucas^{3

12}, Ulrich Herrlinger^{3

13}, Gabriele D Maurer¹⁴, Joachim P Steinbach¹⁴, Jörg Mauler², Wieland A Worthoff², Bernd N Neumaier^{2

15}, Christoph Lerche², Gereon R Fink^{2

3

4}, Nadim Jon Shah^{2

16

17}, Felix M Mottaghy^{1

3

18}, Karl-Josef Langen^{1

2

3

16}

Affiliations

¹ Department of Nuclear Medicine, RWTH University Hospital, D-52074 Aachen, Germany.
² Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5, INM-11), Forschungszentrum Jülich, D-52425 Jülich, Germany.
³ Center of Integrated Oncology (CIO), University of Aachen, D-52074 Aachen, D-53127 Bonn, D-50937 Cologne, D-40225 Düsseldorf, Germany.
⁴ Department of Neurology, University Hospital Cologne, D-50937 Cologne, Germany.
⁵ Center for Neurosurgery, Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, D-50937 Cologne, Germany.
⁶ Department of Orthopedics, Trauma, and Reconstructive Surgery, RWTH University Hospital, D-52074 Aachen, Germany.
⁷ Department of Palliative Medicine, University Hospital Cologne, D-50937 Cologne, Germany.
⁸ Department of Neurosurgery, University Hospital Düsseldorf, D-40225 Düsseldorf, Germany.
⁹ Department of Radiotherapy, RWTH University Hospital, D-52074 Aachen, Germany.
¹⁰ Department of Radiation Oncology, Helios University Hospital Wuppertal, Witten/Herdecke University, D-42283 Wuppertal, Germany.
¹¹ Department of Neurosurgery, RWTH University Hospital, D-52074 Aachen, Germany.
¹² Center for Neurosurgery, Department of General Neurosurgery, University Hospital Cologne, D-50937 Cologne, Germany.
¹³ Division of Clinical Neuro-Oncology, Department of Neurology, University of Bonn Medical Center, D-53127 Bonn, Germany.
¹⁴ Dr. Senckenberg Institute of Neurooncology, University Cancer Center Frankfurt (UCT), Goethe University Hospital, D-60528 Frankfurt am Main, Germany.
¹⁵ Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital Cologne, D-50937 Cologne, Germany.
¹⁶ JARA-BRAIN-Translational Medicine, RWTH Aachen University, D-52074 Aachen, Germany.
¹⁷ Department of Neurology, RWTH Aachen University Hospital, D-52074 Aachen, Germany.
¹⁸ Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), P.O. Box 5800, 6202 Maastricht, The Netherlands.

PMID: 35884396
PMCID: PMC9319157
DOI: 10.3390/cancers14143336

Two Decades of Brain Tumour Imaging with O-(2-[¹⁸F]fluoroethyl)-L-tyrosine PET: The Forschungszentrum Jülich Experience

Alexander Heinzel et al. Cancers (Basel). 2022.

. 2022 Jul 8;14(14):3336.

doi: 10.3390/cancers14143336.

Authors

Affiliations

¹ Department of Nuclear Medicine, RWTH University Hospital, D-52074 Aachen, Germany.
² Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5, INM-11), Forschungszentrum Jülich, D-52425 Jülich, Germany.
³ Center of Integrated Oncology (CIO), University of Aachen, D-52074 Aachen, D-53127 Bonn, D-50937 Cologne, D-40225 Düsseldorf, Germany.
⁴ Department of Neurology, University Hospital Cologne, D-50937 Cologne, Germany.
⁵ Center for Neurosurgery, Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, D-50937 Cologne, Germany.
⁶ Department of Orthopedics, Trauma, and Reconstructive Surgery, RWTH University Hospital, D-52074 Aachen, Germany.
⁷ Department of Palliative Medicine, University Hospital Cologne, D-50937 Cologne, Germany.
⁸ Department of Neurosurgery, University Hospital Düsseldorf, D-40225 Düsseldorf, Germany.
⁹ Department of Radiotherapy, RWTH University Hospital, D-52074 Aachen, Germany.
¹⁰ Department of Radiation Oncology, Helios University Hospital Wuppertal, Witten/Herdecke University, D-42283 Wuppertal, Germany.
¹¹ Department of Neurosurgery, RWTH University Hospital, D-52074 Aachen, Germany.
¹² Center for Neurosurgery, Department of General Neurosurgery, University Hospital Cologne, D-50937 Cologne, Germany.
¹³ Division of Clinical Neuro-Oncology, Department of Neurology, University of Bonn Medical Center, D-53127 Bonn, Germany.
¹⁴ Dr. Senckenberg Institute of Neurooncology, University Cancer Center Frankfurt (UCT), Goethe University Hospital, D-60528 Frankfurt am Main, Germany.
¹⁵ Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital Cologne, D-50937 Cologne, Germany.
¹⁶ JARA-BRAIN-Translational Medicine, RWTH Aachen University, D-52074 Aachen, Germany.
¹⁷ Department of Neurology, RWTH Aachen University Hospital, D-52074 Aachen, Germany.
¹⁸ Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), P.O. Box 5800, 6202 Maastricht, The Netherlands.

PMID: 35884396
PMCID: PMC9319157
DOI: 10.3390/cancers14143336

Abstract

O-(2-[¹⁸F]fluoroethyl)-L-tyrosine (FET) is a widely used amino acid tracer for positron emission tomography (PET) imaging of brain tumours. This retrospective study and survey aimed to analyse our extensive database regarding the development of FET PET investigations, indications, and the referring physicians' rating concerning the role of FET PET in the clinical decision-making process. Between 2006 and 2019, we performed 6534 FET PET scans on 3928 different patients against a backdrop of growing demand for FET PET. In 2019, indications for the use of FET PET were as follows: suspected recurrent glioma (46%), unclear brain lesions (20%), treatment monitoring (19%), and suspected recurrent brain metastasis (13%). The referring physicians were neurosurgeons (60%), neurologists (19%), radiation oncologists (11%), general oncologists (3%), and other physicians (7%). Most patients travelled 50 to 75 km, but 9% travelled more than 200 km. The role of FET PET in decision-making in clinical practice was evaluated by a questionnaire consisting of 30 questions, which was filled out by 23 referring physicians with long experience in FET PET. Fifty to seventy per cent rated FET PET as being important for different aspects of the assessment of newly diagnosed gliomas, including differential diagnosis, delineation of tumour extent for biopsy guidance, and treatment planning such as surgery or radiotherapy, 95% for the diagnosis of recurrent glioma, and 68% for the diagnosis of recurrent brain metastases. Approximately 50% of the referring physicians rated FET PET as necessary for treatment monitoring in patients with glioma or brain metastases. All referring physicians stated that the availability of FET PET is essential and that it should be approved for routine use. Although the present analysis is limited by the fact that only physicians who frequently referred patients for FET PET participated in the survey, the results confirm the high relevance of FET PET in the clinical diagnosis of brain tumours and support the need for its approval for routine use.

Keywords: O-(2-[18F]fluoroethyl)-L-tyrosine (FET); amino acid PET; brain metastasis; brain tumour diagnosis; glioma; positron emission tomography.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Number of FET PET investigations at the FZJ since 2001.

**Figure 2**
Fraction of indications in 2019.

See this image and copyright information in PMC

References

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Two Decades of Brain Tumour Imaging with O-(2-[¹⁸F]fluoroethyl)-L-tyrosine PET: The Forschungszentrum Jülich Experience

Affiliations

Two Decades of Brain Tumour Imaging with O-(2-[¹⁸F]fluoroethyl)-L-tyrosine PET: The Forschungszentrum Jülich Experience

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources