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18F-Fluciclovine PET/CT in Suspected Residual or Recurrent High-Grade Glioma

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  • Trond V. Bogsrud
  • Ayca Londalen, University of Oslo
  • ,
  • Petter Brandal, University of Oslo, Universitetet i Oslo
  • ,
  • Henning Leske, University of Oslo
  • ,
  • Ioannis Panagopoulos, University of Oslo
  • ,
  • Per Borghammer
  • Tore Bach-Gansmo, University of Oslo

Purpose To retrospectively investigate the uptake of 18F-fluciclovine on PET/CT in patients with suspected recurrent high-grade glioma (HGG). Methods Twenty-one patients were included. The standard of truth was histopathologic interpretation if available. When histopathology was not available or rebiopsy did not show signs of malignancy, clinical follow-up including MRI and clinical outcome was considered the standard of truth. Results All 21 patients met the reference standard of either histopathologic proof of HGG recurrence (n = 10) or disease progression clinically and with tumor growth corresponding to the primary tumor sites on follow-up MRI (n = 11). Median time from PET/CT to death was 5 months (range, 1-20 months). Median time from primary diagnosis to death was 14.5 months (range, 6 to >400). Average SUVmax of the lesions was 8.3 ± 5.3 (SD) and 0.34 ± 0.13 for normal brain tissue. Median lesion-to-background ratio was 21.6 (range, 3.1-84.4). In 4 patients, 18F-fluciclovine PET/CT detected small satellite tumors that had not been reported on MR. Conclusions The uptake of 18F-fluciclovine in clinically and/or histopathologically confirmed recurrent HGG is high compared with the uptake reported for other amino acid PET tracers. Because of the high tumor uptake and thus high tracer contrast, small satellite tumors with a diameter below usual reported PET spatial resolution and not reported on MRI were detected in 4 patients. As no patients with confirmed treatment-related changes were included, we cannot as of yet ascertain the ability of 18F-fluciclovine PET to discriminate between recurrent HGG and treatment-related changes, for example, pseudoprogression and radionecrosis.

Original languageEnglish
JournalClinical Nuclear Medicine
Pages (from-to)605-611
Number of pages7
Publication statusPublished - Aug 2019

    Research areas

  • F-fluciclovine, FACBC, high-grade glioma, PET/CT, recurrence

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