18F-Fluciclovine PET to distinguish treatment-related effects from disease progression in recurrent glioblastoma: PET fusion with MRI guides neurosurgical sampling. Issue 2 (8th December 2019)

• Record Type: Journal Article
• Authors: Henderson, Fraser; Brem, Steven; O'Rourke, Donald M; Nasrallah, MacLean; Buch, Vivek P; Young, Anthony J; Doot, Robert K; Pantel, Austin; Desai, Arati; Bagley, Stephen J; Nabavizadeh, S Ali
• Is Part Of: Neuro-oncology practice. Volume 7:Issue 2(2020)
• Page Start: 152
• Page End: 157
• Publication Date: 2019-12-08
• Subjects: 18F-fluciclovine -- glioblastoma -- positron emission tomography (PET) -- pseudoprogression; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481005
• DOI: 10.1093/nop/npz068
• Languages: English
• ISSNs: 2054-2577

Abstract

Abstract: Differentiation of true tumor progression from treatment-related effects remains a major unmet need in caring for patients with glioblastoma. Here, we report how the intraoperative combination of MRI with 18 F-fluciclovine PET guided surgical sampling in 2 patients with recurrent glioblastoma. 18 F-Fluciclovine PET is FDA approved for use in prostate cancer and carries an orphan drug designation in glioma. To investigate its utility in recurrent glioblastoma, we fused PET and MRI images using 2 different surgical navigation systems and performed targeted stereotactic biopsies from the areas of high ("hot") and low ("cold") radiotracer uptake. Concordant histopathologic and imaging findings suggest that a combined 18 F-fluciclovine PET-MRI–guided approach can guide neurosurgical resection of viable recurrent glioblastoma in the background of treatment-related effects, which can otherwise look similar on MRI.