TY - JOUR
T1 - Performance of 18F-fluoro-ethyl-tyrosine ( 18F-FET) PET for the differential diagnosis of primary brain tumor
T2 - A systematic review and metaanalysis
AU - Dunet, Vincent
AU - Rossier, Christine
AU - Buck, Alfred
AU - Stupp, Roger
AU - Prior, John O.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012/2/1
Y1 - 2012/2/1
N2 - For the past decade, PET with 18F-fluoro-ethyl-tyrosine ( 18F-FET) has been used in the evaluation of patients with primary brain tumors (PBTs), but so far series have reported only a limited number of patients. The purpose of this systematic review and metaanalysis was to assess the diagnostic performance of 18F-FET PET in patients with suspicion of PBT. Methods: We examined studies published in the literature using MEDLINE and EMBASE databases. Inclusion criteria were use of 18F-FET PET for initial assessment of patients with a newly diagnosed brain lesion; patients who had no radiotherapy, surgery, or chemotherapy before 18F-FET PET; and use of histology as a gold standard. Metaanalysis was performed on a per-patient basis. We secondarily performed receiver-operating-characteristic analysis of pooled patients to determine tumor-to-background ratio (TBR) of 18F-FET uptake and best diagnostic value. Results: Thirteen studies totaling 462 patients were included. For the diagnosis of PBT, 18F-FET PET demonstrated a pooled sensitivity of 0.82 (95% confidence interval [CI], 0.74-0.88), specificity of 0.76 (95% CI, 0.44-0.92), area under the curve of 0.84 (95% CI, 0.80-0.87), positive likelihood ratio of 3.4 (95% CI, 1.2-9.5), and negative likelihood ratio of 0.24 (95% CI, 0.14-0.39). Receiver-operating-characteristic analysis indicated that a mean TBR threshold of at least 1.6 and a maximum TBR of at least 2.1 had the best diagnostic value for differentiating PBTs from nontumoral lesions. Conclusion: 18F-FET PET demonstrated excellent performance for diagnosing PBTs. Strict standardization of PET acquisition protocols and prospective, multicenter studies investigating the added value over current MRI are now needed to establish 18F-FET PET as a highly relevant tool for patient management.
AB - For the past decade, PET with 18F-fluoro-ethyl-tyrosine ( 18F-FET) has been used in the evaluation of patients with primary brain tumors (PBTs), but so far series have reported only a limited number of patients. The purpose of this systematic review and metaanalysis was to assess the diagnostic performance of 18F-FET PET in patients with suspicion of PBT. Methods: We examined studies published in the literature using MEDLINE and EMBASE databases. Inclusion criteria were use of 18F-FET PET for initial assessment of patients with a newly diagnosed brain lesion; patients who had no radiotherapy, surgery, or chemotherapy before 18F-FET PET; and use of histology as a gold standard. Metaanalysis was performed on a per-patient basis. We secondarily performed receiver-operating-characteristic analysis of pooled patients to determine tumor-to-background ratio (TBR) of 18F-FET uptake and best diagnostic value. Results: Thirteen studies totaling 462 patients were included. For the diagnosis of PBT, 18F-FET PET demonstrated a pooled sensitivity of 0.82 (95% confidence interval [CI], 0.74-0.88), specificity of 0.76 (95% CI, 0.44-0.92), area under the curve of 0.84 (95% CI, 0.80-0.87), positive likelihood ratio of 3.4 (95% CI, 1.2-9.5), and negative likelihood ratio of 0.24 (95% CI, 0.14-0.39). Receiver-operating-characteristic analysis indicated that a mean TBR threshold of at least 1.6 and a maximum TBR of at least 2.1 had the best diagnostic value for differentiating PBTs from nontumoral lesions. Conclusion: 18F-FET PET demonstrated excellent performance for diagnosing PBTs. Strict standardization of PET acquisition protocols and prospective, multicenter studies investigating the added value over current MRI are now needed to establish 18F-FET PET as a highly relevant tool for patient management.
KW - Brain tumor
KW - F-fluoro-ethyl-tyrosine
KW - Glioma
KW - Metaanalysis
KW - PET
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U2 - 10.2967/jnumed.111.096859
DO - 10.2967/jnumed.111.096859
M3 - Article
C2 - 22302961
AN - SCOPUS:84856802355
VL - 53
SP - 207
EP - 214
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
SN - 0161-5505
IS - 2
ER -