Monitoring brain cancer treatments with PET imaging may spare many from unnecessary procedures

Positron emission tomography scanning offers unique insights into novel treatments for brain cancer that traditional imaging cannot, researchers reported recently in the Journal of Nuclear Medicine.

State-of-the-art treatments for brain metastases, such as immune checkpoint inhibitors and targeted therapies, are effective but conventional MRI isn’t strong enough to determine if these approaches are actually working.

By adding 18F-FET PET, known scientifically as O-(2-18F-fluoroethyl)-l-tyrosine PET, to the process, however, researchers were able to better diagnose these brain diseases and gauge patients’ response to treatment, German authors wrote in the April issue of JNM.

"In cases of ambiguous MRI findings, supplemental FET PET is helpful for treatment monitoring,” Norbert Galldiks, MD, professor of neurology at the University Hospital Cologne and Research Center in Juelich, Germany, said on May 4. “It provides physicians with a longer time window for subsequent patient management and allows them to optimize the treatment strategy for each individual patient.”

For their retrospective investigation, Galldiks et al. enrolled patients with melanoma and lung cancer that had spread to the brain. The 60 participants were treated with immune checkpoint inhibitors, targeted therapy alone, or with added radiotherapy.

The researchers determined 18-FET PET can be best used when traditional contrast-enhanced MRI is inconclusive. This novel molecular imaging approach correctly diagnosed brain metastases relapses and spotted those who were improving with treatment versus patients who were not.

“Since this approach is so accurate, it has the potential to influence clinical decision-making,” Galldiks concluded Tuesday. “This may help to reduce the number of invasive procedures and limit overtreatment for a considerable number of seriously ill patients with brain metastases."

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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