Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0

Antoine Verger¹, Nelleke Tolboom², Francesco Cicone³, Susan M Chang⁴, Julia Furtner⁵, Norbert Galldiks⁶, Jens Gempt⁷, Eric Guedj⁸, Raymond Y Huang⁹, Derek R Johnson¹⁰, Ian Law¹¹, Emilie Le Rhun¹², Susan C Short¹³, M J Van den Bent¹⁴, Donatienne Van Weehaeghe¹⁵, Michael A Vogelbaum¹⁶, Patrick Y Wen¹⁷, Nathalie L Albert¹⁸, Matthias Preusser¹⁹

Affiliations

¹ Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy and IADI INSERM, UMR 1254, Université de Lorraine, Nancy, France. a.verger@chru-nancy.fr.
² Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
³ Nuclear Medicine Unit, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
⁴ Division of NeuroOncology, Department of Neurological Surgery, University of California San Francisco (UCSF), San Francisco, CA, USA.
⁵ Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Faculty of Medicine and Dentistry, Danube Private University, Krems, 3500, Austria.
⁶ Department of Neurology, Medical Faculty and University Hospital of Cologne, Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, University of Cologne, Juelich, Germany.
⁷ Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁸ Département de Médecine Nucléaire, Hôpital de la Timone, CERIMED, Institut Fresnel, Aix Marseille University, APHM, CNRS, Centrale Marseille, Marseille, France.
⁹ Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
¹⁰ Department of Radiology, Mayo Clinic, Rochester, MN, USA.
¹¹ Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark.
¹² Departments of Neurosurgery and Neurology, University Hospital Zurich, Zurich, Switzerland.
¹³ Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
¹⁴ Department of Neurology, Brain Tumor Center at Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands.
¹⁵ Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, Ghent, 9000, Belgium.
¹⁶ Department of NeuroOncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
¹⁷ Center For Neuro-Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA.
¹⁸ Department of Nuclear Medicine, LMU Hospital, LMU Munich, Munich, Germany.
¹⁹ Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.

PMID: 39762634
PMCID: PMC11928372
DOI: 10.1007/s00259-024-07038-5

Practice Guideline

Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0

Antoine Verger et al. Eur J Nucl Med Mol Imaging. 2025 Apr.

. 2025 Apr;52(5):1822-1839.

doi: 10.1007/s00259-024-07038-5. Epub 2025 Jan 7.

Authors

Affiliations

¹ Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy and IADI INSERM, UMR 1254, Université de Lorraine, Nancy, France. a.verger@chru-nancy.fr.
² Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
³ Nuclear Medicine Unit, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
⁴ Division of NeuroOncology, Department of Neurological Surgery, University of California San Francisco (UCSF), San Francisco, CA, USA.
⁵ Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Faculty of Medicine and Dentistry, Danube Private University, Krems, 3500, Austria.
⁶ Department of Neurology, Medical Faculty and University Hospital of Cologne, Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, University of Cologne, Juelich, Germany.
⁷ Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁸ Département de Médecine Nucléaire, Hôpital de la Timone, CERIMED, Institut Fresnel, Aix Marseille University, APHM, CNRS, Centrale Marseille, Marseille, France.
⁹ Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
¹⁰ Department of Radiology, Mayo Clinic, Rochester, MN, USA.
¹¹ Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark.
¹² Departments of Neurosurgery and Neurology, University Hospital Zurich, Zurich, Switzerland.
¹³ Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
¹⁴ Department of Neurology, Brain Tumor Center at Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands.
¹⁵ Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, Ghent, 9000, Belgium.
¹⁶ Department of NeuroOncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
¹⁷ Center For Neuro-Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA.
¹⁸ Department of Nuclear Medicine, LMU Hospital, LMU Munich, Munich, Germany.
¹⁹ Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.

PMID: 39762634
PMCID: PMC11928372
DOI: 10.1007/s00259-024-07038-5

Abstract

This joint practice guideline/procedure standard was collaboratively developed by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neuro-Oncology (EANO), and the PET task force of the Response Assessment in Neurooncology Working Group (PET/RANO). Brain metastases are the most common malignant central nervous system (CNS) tumors. PET imaging with radiolabeled amino acids and to lesser extent [¹⁸F]FDG has gained considerable importance in the assessment of brain metastases, especially for the differential diagnosis between recurrent metastases and treatment-related changes which remains a limitation using conventional MRI. The aim of this guideline is to assist nuclear medicine physicians in recommending, performing, interpreting and reporting the results of brain PET imaging in patients with brain metastases. This practice guideline will define procedure standards for the application of PET imaging in patients with brain metastases in routine practice and clinical trials and will help to harmonize data acquisition and interpretation across centers.

Keywords: Brain metastases; Brain metastasis; FDG; FDOPA; FET; Fluciclovine; Metastatic brain tumors; Methionine; PET; Recurrence.

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Conflict of interest statement

Declarations. Ethical approval: Not applicable. Consent to participate: Not applicable. Consent to publish: Not applicable. Approval: This practice guideline was approved by the Board of Directors of the EANM, SNMMI, EANO and PET/RANO Working Group. Competing interests: AV: has received honoraria for lectures and advisory board participation from Curium, Eisai, General Electrics and Novartis. NT: no disclosures FC: no disclosures. SMC: no disclosures JF: has received honoraria for lectures and consultations from the following for-profit companies: Novartis, Seagen, Sanova, Servier. NG: has received honoraria for lectures from Blue Earth Diagnostics and for advisory board participation from Telix Pharmaceuticals and Servier, and for consultancy services from Telix Pharmaceuticals. JG: has received honoraria for consultation and advisory board participation from Seagan, Brain Lab, research support from Zeiss. EG: has received honoraria for consultation and advisory board participation from AAA/Novartis, Curium/LMI, General Electric, Keosys and Pfizer. RH: has received consultation fees for Telix, Servier, and Nuvation Bio and scientific advisory for Vysioneer,. DJ: has received honoraria for consultation and advisory board participation from Telix Pharmaceuticals, Cellectar and Novartis. IL: no disclosures. ELR: has received a research grant from BMS, and honoraria for advisory board participation from Astra Zeneca, Bayer, Bioderix, Janssen, Leo Pharma, Pfizer, Pierre Fabre, Seagen and Servier. SCS: has received honoraria and consulting fees from Chimerix, Servier, CeCaVa, Miltenyi, Roche and research support from Apollomics and Blue Earth Diagnostics. MJVdB: has received honoraria for consultation and advisory board participation from Servier, Anheart Therapeutics, Fore Biotherapeutics, Genenta, Roche, Chimerix, Mundipharm, Boehringer and Incyte, and research support from Boehringer Ingelheim. DVW: no disclosures. MAV: has received research support to his hospital from NIH, DeNovo Pharma, Infuseon, Therapeutics, Oncosynergy; and honoraria from Servier Pharma, and Biodexa Pharma. PYW: has received research support from Astra Zeneca, Black Diamond, Bristol Meyers Squibb, Chimerix, Eli Lily, Erasca, Global Coalition For Adaptive Research, Kazia, MediciNova, Merck, Novartis, Quadriga, Servier, and VBI Vaccines and honoraria for consultation and advisory board participation from Anheart, Astra Zeneca, Black Diamond, Celularity, Chimerix, Day One Bio, Genenta, Glaxo Smith Kline, Kintara, Merck, Mundipharma, Novartis, Novocure, Prelude Therapeutics, Sagimet, Sapience, Servier, Symbio, Tango, Telix, VBI Vaccines. NLA: has received honoraria for lectures, consultation or advisory board participation from Novartis, Advanced Accelerator Applications, Telix Pharmaceuticals, OncLive, Medsir and Servier, and research funding from Novocure and Telix Pharmaceuticals. MP: has received honoraria for lectures, consultation or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Journals, MedMedia, Astra Zeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo, Sanofi, Merck Sharp & Dome, Tocagen, Adastra, Gan & Lee Pharmaceuticals, Janssen, Servier, Miltenyi, Böhringer-Ingelheim, Telix, Medscape. IL: has received honoraria for lectures and consultations from Telix Pharmaceuticals and Ribocure.

References

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Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0

Affiliations

Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0

Authors

Affiliations

Abstract

Conflict of interest statement

References

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LinkOut - more resources

Full Text Sources

Medical