Novel tracer paper published
Results published in January 2010 in the Journal of Clinical Neuroscience show that a novel radiopharmaceutical tracer developed from an amino acid may provide better detection of brain tumours than the tracer currently in use.
“The pilot study was designed to investigate the diagnostic value of using FET[1] in conjunction with PET[2], rather than using FDG[3] to diagnose brain tumours,” says Associate Professor Eddie Lau, from the Peter MacCallum Cancer Centre. “And although the sample size was small, the results were consistent. The research emphasised the excellent sensitivity of FET in comparison to FDG, when assessing a brain tumour, especially in low-grade gliomas.”
“This was the first Australian experience of using this tracer for a brain tumour in a clinical study,” says Associate Professor Lau.
(Citation: Lau EWF et al. Comparative PET study using F-18 FET and F-18 FDG for the evaluation of patients with suspected brain tumour. Journal of Clinical Neuroscience 17 (2010) 43–49, doi:10.1016/j.jocn.2009.05.009
The publication of the clinical study in the Journal of Clinical Neuroscience is a significant step for research using FET in Australia. CRCBID’s Chief Executive Officer, Dr Gerard Roe says, “Such studies are progressing the development of FET for use in brain cancer management. I look forward to the progression of similar clinical studies in the near future by Associate Professor Lau and his research partners.”
Associate Professor Lau agrees. “What is particularly important is expanding options for patient management; any assistance in assessing how a brain tumour responds to drug treatment is of value. If we can measure more effectively, and earlier, how the drugs are working in a patient’s management, we can continue to develop better treatment.”
Associate Professor Lau says the team at Peter Mac was pleased with their paper’s acceptance by the Journal of Clinical Neuroscience. “We’ll now go forward and develop more clinically relevant studies, leading to further improvements for patients.”
In the study, twenty-five (25) FET PET and FDG PET scans were performed on 21 consecutive patients within 24 months. The accuracy of the diagnoses was followed up by either surgery or clinical/imaging.
The table below outlines the performance of FET in comparison to FDG.
| FET | FDG | |
| Sensitivity | 93% | 27% |
| Specificity | 100% | 90% |
| Accuracy | 96% | 52% |
| Positive Predictive Value | 100% | 80% |
| Negative Predictive Value | 91% | 45% |
Further investigations are being considered to ascertain answers to questions relating to the clinical value of FET PET for brain tumour patients.
FET PET was found to be more accurate than FDG PET for detecting malignant brain lesions, especially low-grade gliomas.
The top panel shows a fused PET/CT image and the bottom panel lateral MIP (maximum intensity projection) images with cross-line on the lesion. This is a case of a 39yo man who presented with focal seizure and a large left temporal mass on MRI. The mass was relatively photopenic on the FDG PET, ie, less active than the adjacent normal cerebral cortex, but demonstrated increased FET activity, suggesting a low grade glioma which was confirmed on open biopsy.
Images courtesy Associate Professor Eddie Lau, Peter Mac
[1] FET (O-(2-18F fluoro ethyl tyrosine)
[2] PET (Positron Emission Tomography) see http://www.crcbid.com.au/images/stories/CRCBID_Fact_Sheet_No_1_What_is_PET.pdf
[3] FDG (Fluorine-18 fluorodeoxyglucose)
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