MRI alone has its limitations for target selection in biopsy or resection in newly diagnosed and pretreated pediatric brain tumor patients. 18F-FET-PET imaging is considered to identify metabolically active tumor tissue and to differentiate it from therapy-associated changes. We retrospectively analyzed our experience with 18F-FET-PET in targeted surgical interventions for pediatric brain tumors.
In 26 cases with lesions suspicious of a growing brain tumor on MRI, either newly diagnosed or after antitumoral treatment led to 18F-FET-PET imaging for target selection prior to stereotactic biopsy, navigated open biopsy or navigated microsurgical tumor resection. Indications for 18F-FET-PET imaging were visualization of metabolic active tumor tissue within diffuse tumors or pretreated lesions as well as depicting their extent.
18F-FET-PET integration in surgery was feasible in all patients using stereotaxy or neuronavigation. Sensitivity for tumor detection was 20/24. 18F-FET-PET was false positive in two pretreated patients.
18F-FET-PET imaging is helpful for target selection and can be integrated in surgical guidance. 18F-FET-PET image-guided surgical targeting yielded histological diagnosis with decent specificity and high sensitivity in our cohort of pediatric brain tumor patients. Our results warrant further evaluation of 18F-FET-PET imaging for surgical guidance.
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Martin Misch and Andreas Guggemos contributed equally to this manuscript.
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Misch, M., Guggemos, A., Driever, P.H. et al. 18F-FET-PET guided surgical biopsy and resection in children and adolescence with brain tumors. Childs Nerv Syst 31, 261–267 (2015). https://doi.org/10.1007/s00381-014-2552-y
- Pediatric brain tumor
- Targeted tissue sampling