Response Assessment in Neuro-Oncology working group and European Association for Neuro-Oncology recommendations for the clinical use of PET imaging in gliomas.

This guideline provides recommendations for the use of PET imaging in gliomas. The review examines established clinical benefit in glioma patients of PET using glucose ((18)F-FDG) and amino acid tracers ((11)C-MET, (18)F-FET, and (18)F-FDOPA). An increasing number of studies have been published on PET imaging in the setting of diagnosis, biopsy, and resection as well radiotherapy planning, treatment monitoring, and response assessment. Recommendations are based on evidence generated from studies which validated PET findings by histology or clinical course. This guideline emphasizes the clinical value of PET imaging with superiority of amino acid PET over glucose PET and provides a framework for the use of PET to assist in the management of patients with gliomas.

[1]  J. Mehrkens,et al.  The positive predictive value of O-(2-[18F]fluoroethyl)-l-tyrosine (FET) PET in the diagnosis of a glioma recurrence after multimodal treatment , 2008, Journal of Neuro-Oncology.

[2]  Jean-Yves Delattre,et al.  Pitfalls in the diagnosis of brain tumours , 2006, The Lancet Neurology.

[3]  Wei Chen,et al.  18F-FDOPA Kinetics in Brain Tumors , 2007, Journal of Nuclear Medicine.

[4]  Susan M. Chang,et al.  Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  C. Belka,et al.  [18F]Fluoroethyltyrosine–Positron Emission Tomography-Based Therapy Monitoring after Stereotactic Iodine-125 Brachytherapy in Patients with Recurrent High-Grade Glioma , 2013, Molecular imaging.

[6]  G Di Chiro,et al.  Prediction of survival in glioma patients by means of positron emission tomography. , 1985, Journal of neurosurgery.

[7]  M. Chopp,et al.  Treatment of traumatic brain injury in rats with erythropoietin and carbamylated erythropoietin. , 2007, Journal of neurosurgery.

[8]  K. Herholz,et al.  Methyl-l-11C-Methionine PET as a Diagnostic Marker for Malignant Progression in Patients with Glioma , 2009, Journal of Nuclear Medicine.

[9]  Gereon R. Fink,et al.  Diagnosis of pseudoprogression in patients with glioblastoma using O-(2-[18F]fluoroethyl)-l-tyrosine PET , 2015, European Journal of Nuclear Medicine and Molecular Imaging.

[10]  Olivier Dewitte,et al.  Integrated positron emission tomography and magnetic resonance imaging-guided resection of brain tumors: a report of 103 consecutive procedures. , 2006, Journal of neurosurgery.

[11]  H. Tsujii,et al.  l-[METHYL-(11)C] methionine positron emission tomography for target delineation in malignant gliomas: impact on results of carbon ion radiotherapy. , 2008, International journal of radiation oncology, biology, physics.

[12]  Christian Woiciechowsky,et al.  Correlation of F-18-fluoro-ethyl-tyrosin uptake with vascular and cell density in non-contrast-enhancing gliomas , 2008, Journal of Neuro-Oncology.

[13]  C. Brennan,et al.  Phase II Study of Bevacizumab, Temozolomide, and Hypofractionated Stereotactic Radiotherapy for Newly Diagnosed Glioblastoma , 2014, Clinical Cancer Research.

[14]  Michael E Phelps,et al.  18F-FDOPA and 18F-FLT positron emission tomography parametric response maps predict response in recurrent malignant gliomas treated with bevacizumab. , 2012, Neuro-oncology.

[15]  John O. Prior,et al.  Performance of 18F-Fluoro-Ethyl-Tyrosine (18F-FET) PET for the Differential Diagnosis of Primary Brain Tumor: A Systematic Review and Metaanalysis , 2012, The Journal of Nuclear Medicine.

[16]  T. Maehara,et al.  Glioma surgery using a multimodal navigation system with integrated metabolic images. , 2009, Journal of neurosurgery.

[17]  Elena Prieto,et al.  Voxel-Based Analysis of Dual-Time-Point 18F-FDG PET Images for Brain Tumor Identification and Delineation , 2011, The Journal of Nuclear Medicine.

[18]  Harumi Itoh,et al.  18F-FDG PET of common enhancing malignant brain tumors. , 2008, AJR. American journal of roentgenology.

[19]  Punit Sharma,et al.  18F-FDOPA PET/CT for detection of recurrence in patients with glioma: prospective comparison with 18F-FDG PET/CT , 2013, European Journal of Nuclear Medicine and Molecular Imaging.

[20]  Eugen Trinka,et al.  [18F]-fluoro-ethyl-L-tyrosine PET: a valuable diagnostic tool in neuro-oncology, but not all that glitters is glioma. , 2013, Neuro-oncology.

[21]  Maximilian Niyazi,et al.  Prognostic Significance of Dynamic 18F-FET PET in Newly Diagnosed Astrocytic High-Grade Glioma , 2015, The Journal of Nuclear Medicine.

[22]  K. Hoang-Xuan,et al.  Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma. , 2014, The New England journal of medicine.

[23]  Morand Piert,et al.  Reirradiation of recurrent high-grade gliomas using amino acid PET (SPECT)/CT/MRI image fusion to determine gross tumor volume for stereotactic fractionated radiotherapy. , 2004, International journal of radiation oncology, biology, physics.

[24]  Karl Herholz,et al.  Brain Tumor Extent with [11C]-L-methionine Positron Emission Tomography: Local Comparison with Stereotactic Histopatholoy. , 2004 .

[25]  M. Morino,et al.  Methionine positron emission tomography for differentiation of recurrent brain tumor and radiation necrosis after stereotactic radiosurgery —In malignant glioma— , 2004, Annals of nuclear medicine.

[26]  T. Cascino,et al.  Response criteria for phase II studies of supratentorial malignant glioma. , 1990, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[27]  John O. Prior,et al.  Combination of MRI and dynamic FET PET for initial glioma grading , 2014, Nuklearmedizin.

[28]  I. Steffen,et al.  18F-FET-PET guided surgical biopsy and resection in children and adolescence with brain tumors , 2015, Child's Nervous System.

[29]  G. Fink,et al.  Volumetry of [11C]-Methionine Positron Emission Tomographic Uptake as a Prognostic Marker before Treatment of Patients with Malignant Glioma , 2012, Molecular imaging.

[30]  M. Rosenthal,et al.  Imaging modalities in high-grade gliomas: Pseudoprogression, recurrence, or necrosis? , 2012, Journal of Clinical Neuroscience.

[31]  Val J Lowe,et al.  Biopsy validation of 18F-DOPA PET and biodistribution in gliomas for neurosurgical planning and radiotherapy target delineation: results of a prospective pilot study. , 2013, Neuro-oncology.

[32]  R. Mirimanoff,et al.  Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. , 2005, The New England journal of medicine.

[33]  Michael E Phelps,et al.  Comparison of visual and semiquantitative analysis of 18F-FDOPA-PET/CT for recurrence detection in glioblastoma patients. , 2013, Neuro-oncology.

[34]  F. O’Sullivan,et al.  2-[(18)F]Fluoro-2-deoxyglucose and glucose uptake in malignant gliomas before and after radiotherapy: correlation with outcome. , 2002, Clinical cancer research : an official journal of the American Association for Cancer Research.

[35]  G. Barnett,et al.  The sensitivity and specificity of FDG PET in distinguishing recurrent brain tumor from radionecrosis in patients treated with stereotactic radiosurgery , 2001, International journal of cancer.

[36]  S. Goldman,et al.  Results of positron emission tomography guidance and reassessment of the utility of and indications for stereotactic biopsy in children with infiltrative brainstem tumors. , 2007, Journal of neurosurgery.

[37]  Michael E Phelps,et al.  Correlation of 6-18F-Fluoro-l-Dopa PET Uptake with Proliferation and Tumor Grade in Newly Diagnosed and Recurrent Gliomas , 2010, The Journal of Nuclear Medicine.

[38]  Gereon R Fink,et al.  The use of dynamic O-(2-18F-fluoroethyl)-l-tyrosine PET in the diagnosis of patients with progressive and recurrent glioma. , 2015, Neuro-oncology.

[39]  Irène Buvat,et al.  Evaluation of Quantitative Criteria for Glioma Grading With Static and Dynamic 18F-FDopa PET/CT , 2013, Clinical nuclear medicine.

[40]  O. Ratib,et al.  Recurrence pattern after [(18)F]fluoroethyltyrosine-positron emission tomography-guided radiotherapy for high-grade glioma: a prospective study. , 2009, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[41]  O. Chinot,et al.  Independent prognostic value of pre-treatment 18-FDG-PET in high-grade gliomas , 2012, Journal of Neuro-Oncology.

[42]  Isabelle Salmon,et al.  Correlation between dynamic susceptibility contrast perfusion MRI and methionine metabolism in brain gliomas: Preliminary results , 2006, Journal of magnetic resonance imaging : JMRI.

[43]  Karl-Josef Langen,et al.  O-(2-[18F]fluoroethyl)-L-tyrosine PET combined with MRI improves the diagnostic assessment of cerebral gliomas. , 2005, Brain : a journal of neurology.

[44]  A. Mishra,et al.  Comparative Evaluation of F-18 FDOPA, F-18 FDG, and F-18 FLT-PET/CT for Metabolic Imaging of Low Grade Gliomas , 2009, Clinical nuclear medicine.

[45]  T. Nihashi,et al.  Diagnostic Accuracy of PET for Recurrent Glioma Diagnosis: A Meta-Analysis , 2013, American Journal of Neuroradiology.

[46]  Wei Chen,et al.  18F-FDOPA PET imaging of brain tumors: comparison study with 18F-FDG PET and evaluation of diagnostic accuracy. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[47]  Isabelle Salmon,et al.  Comparison of 18F-FDG and 11C-methionine for PET-guided stereotactic brain biopsy of gliomas. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[48]  P Van Tassel,et al.  Malignant gliomas: MR imaging spectrum of radiation therapy- and chemotherapy-induced necrosis of the brain after treatment. , 2000, Radiology.

[49]  M. J. van den Bent,et al.  Pseudoprogression and pseudoresponse in the treatment of gliomas , 2009, Current opinion in neurology.

[50]  S. Goldman,et al.  Regional methionine and glucose uptake in high-grade gliomas: a comparative study on PET-guided stereotactic biopsy. , 1997, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[51]  A. von Deimling,et al.  Hot spots in dynamic (18)FET-PET delineate malignant tumor parts within suspected WHO grade II gliomas. , 2011, Neuro-oncology.

[52]  R. Tanaka,et al.  Magnetic resonance imaging and histopathology of cerebral gliomas , 2004, Neuroradiology.

[53]  S. Crozier,et al.  Correlation of MRI-Derived Apparent Diffusion Coefficients in Newly Diagnosed Gliomas with [18F]-Fluoro-L-Dopa PET: What Are We Really Measuring with Minimum ADC? , 2013, American Journal of Neuroradiology.

[54]  Gereon R Fink,et al.  Comparison of 18F-FET PET and Perfusion-Weighted MR Imaging: A PET/MR Imaging Hybrid Study in Patients with Brain Tumors , 2014, The Journal of Nuclear Medicine.

[55]  Riemer H. J. A. Slart,et al.  Value of 11C-methionine PET in imaging brain tumours and metastases , 2013, European Journal of Nuclear Medicine and Molecular Imaging.

[56]  R. Floris,et al.  The Role of PET [18F]FDOPA in Evaluating Low-grade Glioma. , 2015, Anticancer research.

[57]  G. Fink,et al.  Assessment of Treatment Response in Patients with Glioblastoma Using O-(2-18F-Fluoroethyl)-l-Tyrosine PET in Comparison to MRI , 2012, The Journal of Nuclear Medicine.

[58]  C. Götz,et al.  Serial O-(2-[18F]fluoroethyl)-L-tyrosine PET for monitoring the effects of intracavitary radioimmunotherapy in patients with malignant glioma , 2006, European Journal of Nuclear Medicine and Molecular Imaging.

[59]  I. Elmaci Color illustrations and neurosurgical techniques of Serefeddin Sabuncuoğlu in the 15th century. , 2000, Neurosurgery.

[60]  O. Chinot,et al.  FDG-PET predicts survival in recurrent high-grade gliomas treated with bevacizumab and irinotecan. , 2012, Neuro-oncology.

[61]  John O. Prior,et al.  Performance of 18F-FET versus 18F-FDG-PET for the diagnosis and grading of brain tumors: systematic review and meta-analysis. , 2016, Neuro-oncology.

[62]  G. Bydder,et al.  Early change in glucose metabolic rate measured using FDG-PET in patients with high-grade glioma predicts response to temozolomide but not temozolomide plus radiotherapy. , 2006, International journal of radiation oncology, biology, physics.

[63]  J. Tonn,et al.  Molecular imaging of gliomas with PET: opportunities and limitations. , 2011, Neuro-oncology.

[64]  S. Goldman,et al.  POSITRON EMISSION TOMOGRAPHY‐GUIDED VOLUMETRIC RESECTION OF SUPRATENTORIAL HIGH‐GRADE GLIOMAS: A SURVIVAL ANALYSIS IN 66 CONSECUTIVE PATIENTS , 2009, Neurosurgery.

[65]  稲垣 隆介,et al.  The International Society for Pediatric Neurosurgery に参加して , 2008 .

[66]  Satoshi O. Suzuki,et al.  Differentiating primary CNS lymphoma from glioblastoma multiforme: assessment using arterial spin labeling, diffusion-weighted imaging, and 18F-fluorodeoxyglucose positron emission tomography , 2013, Neuroradiology.

[67]  S. Goldman,et al.  PET in stereotactic conditions increases the diagnostic yield of brain biopsy. , 1994, Stereotactic and functional neurosurgery.

[68]  G. Reifenberger,et al.  EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. , 2014, The Lancet. Oncology.

[69]  G. Reifenberger,et al.  Prognostic Value of O-(2-18F-Fluoroethyl)-l-Tyrosine PET and MRI in Low-Grade Glioma , 2007, Journal of Nuclear Medicine.

[70]  Masayuki Matsuo,et al.  Re-irradiation of recurrent glioblastoma multiforme using 11C-methionine PET/CT/MRI image fusion for hypofractionated stereotactic radiotherapy by intensity modulated radiation therapy , 2014, Radiation oncology.

[71]  Michael E Phelps,et al.  Treatment Response Evaluation Using 18F-FDOPA PET in Patients with Recurrent Malignant Glioma on Bevacizumab Therapy , 2014, Clinical Cancer Research.

[72]  Gereon R Fink,et al.  Role of O-(2-18F-Fluoroethyl)-l-Tyrosine PET as a Diagnostic Tool for Detection of Malignant Progression in Patients with Low-Grade Glioma , 2013, The Journal of Nuclear Medicine.

[73]  W. Koch,et al.  Positron Emission Tomography with O-(2-[18F]fluoroethyl)-l-tyrosine versus Magnetic Resonance Imaging in the Diagnosis of Recurrent Gliomas , 2005, Neurosurgery.

[74]  S. Goldman,et al.  Combined magnetic resonance imaging- and positron emission tomography-guided stereotactic biopsy in brainstem mass lesions: diagnostic yield in a series of 30 patients. , 2000, Journal of neurosurgery.

[75]  H. Herzog,et al.  Prognostic impact of postoperative, pre-irradiation (18)F-fluoroethyl-l-tyrosine uptake in glioblastoma patients treated with radiochemotherapy. , 2011, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[76]  J. Tonn,et al.  FET-PET assessed recurrence pattern after radio-chemotherapy in newly diagnosed patients with glioblastoma is influenced by MGMT methylation status. , 2012, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[77]  Lutz Tellmann,et al.  Dual-time-point O-(2-[18F]fluoroethyl)-L-tyrosine PET for grading of cerebral gliomas , 2015, European Radiology.

[78]  U. Haberkorn,et al.  Intra-individual comparison of 18 F-FET and 18 F-DOPA in PET imaging of recurrent brain tumors , 2014 .

[79]  F. Floeth,et al.  Finding the anaplastic focus in diffuse gliomas: The value of Gd-DTPA enhanced MRI, FET-PET, and intraoperative, ALA-derived tissue fluorescence , 2011, Clinical Neurology and Neurosurgery.

[80]  R. Goldbrunner,et al.  O-(2-[18F]fluoroethyl)-l-tyrosine PET for monitoring the effects of convection-enhanced delivery of paclitaxel in patients with recurrent glioblastoma , 2005, European Journal of Nuclear Medicine and Molecular Imaging.

[81]  G. Reifenberger,et al.  18F-FET PET differentiation of ring-enhancing brain lesions. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[82]  G. Fink,et al.  Response assessment of bevacizumab in patients with recurrent malignant glioma using [18F]Fluoroethyl-l-tyrosine PET in comparison to MRI , 2012, European Journal of Nuclear Medicine and Molecular Imaging.

[83]  M. Mehta,et al.  Early changes in tumor metabolism after treatment: the effects of stereotactic radiotherapy. , 1991, International journal of radiation oncology, biology, physics.

[84]  N. Shah,et al.  Volumetric assessment of recurrent or progressive gliomas: comparison between F-DOPA PET and perfusion-weighted MRI , 2015, European Journal of Nuclear Medicine and Molecular Imaging.

[85]  Wolfgang A. Weber,et al.  O-(2-[18F]Fluoroethyl)-l-tyrosine and l-[methyl-11C]methionine uptake in brain tumours: initial results of a comparative study , 2000, European Journal of Nuclear Medicine.

[86]  Paul Cumming,et al.  Prediction of oligodendroglial histology and LOH 1p/19q using dynamic [(18)F]FET-PET imaging in intracranial WHO grade II and III gliomas. , 2012, Neuro-oncology.

[87]  T. Narayanan,et al.  11C-Methionine PET for Grading and Prognostication in Gliomas: A Comparison Study with 18F-FDG PET and Contrast Enhancement on MRI , 2012, The Journal of Nuclear Medicine.

[88]  Jae Jeong,et al.  Usefulness of 11C-methionine PET in the evaluation of brain lesions that are hypo- or isometabolic on 18F-FDG PET , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[89]  M. Weller,et al.  Biological tumor volume in 18FET-PET before radiochemotherapy correlates with survival in GBM , 2015, Neurology.

[90]  Thomas Czech,et al.  Brain tumour imaging with PET: a comparison between [18F]fluorodopa and [11C]methionine , 2003, European Journal of Nuclear Medicine and Molecular Imaging.

[91]  M Schwaiger,et al.  The value of F-18-fluorodeoxyglucose PET for the 3-D radiation treatment planning of malignant gliomas. , 1998, International journal of radiation oncology, biology, physics.

[92]  V. Sturm,et al.  11C-methionine and 18F-2-fluorodeoxyglucose positron emission tomography: a tool for diagnosis of cerebral glioma and monitoring after brachytherapy with 125I seeds. , 1997, Stereotactic and functional neurosurgery.

[93]  Wei Chen,et al.  18F-FDOPA PET/MRI fusion in patients with primary/recurrent gliomas: initial experience. , 2009, European journal of radiology.

[94]  S. Heiland,et al.  Pseudoprogression in patients with glioblastoma: clinical relevance despite low incidence. , 2015, Neuro-oncology.

[95]  Leland S. Hu,et al.  Biopsy validation of 18 F-DOPA PET and biodistribution in gliomas for neurosurgical planning and radiotherapy target delineation : results of a prospective pilot study , 2013 .

[96]  Gereon R. Fink,et al.  Volumetry of [11C]-methionine PET uptake and MRI contrast enhancement in patients with recurrent glioblastoma multiforme , 2009, European Journal of Nuclear Medicine and Molecular Imaging.

[97]  J. Tonn,et al.  MRI-suspected low-grade glioma: is there a need to perform dynamic FET PET? , 2012, European Journal of Nuclear Medicine and Molecular Imaging.

[98]  T. Cloughesy,et al.  Impact of 3,4-Dihydroxy-6-18F-Fluoro-l-Phenylalanine PET/CT on Managing Patients with Brain Tumors: The Referring Physician's Perspective , 2012, The Journal of Nuclear Medicine.

[99]  M. Wyss,et al.  Early metabolic responses in temozolomide treated low-grade glioma patients , 2009, Journal of Neuro-Oncology.

[100]  F. Floeth,et al.  Prognostic Value of 18F-Fluoroethyl-l-Tyrosine PET and MRI in Small Nonspecific Incidental Brain Lesions , 2008, Journal of Nuclear Medicine.

[101]  Koen Van Laere,et al.  Direct comparison of 18F-FDG and 11C-methionine PET in suspected recurrence of glioma: sensitivity, inter-observer variability and prognostic value , 2004, European Journal of Nuclear Medicine and Molecular Imaging.

[102]  David A Mankoff,et al.  Volumetric analysis of 18F-FDG PET in glioblastoma multiforme: prognostic information and possible role in definition of target volumes in radiation dose escalation. , 2002, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[103]  H. Kostron,et al.  O-(2-18F-Fluoroethyl)-L-Tyrosine PET Predicts Failure of Antiangiogenic Treatment in Patients with Recurrent High-Grade Glioma , 2011, The Journal of Nuclear Medicine.

[104]  J. Barnholtz-Sloan,et al.  CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. , 2012, Neuro-oncology.

[105]  Yue Cao,et al.  Association of 11C-methionine PET uptake with site of failure after concurrent temozolomide and radiation for primary glioblastoma multiforme. , 2009, International journal of radiation oncology, biology, physics.

[106]  L. Cinotti,et al.  High and Low Grade Oligodendrogliomas (ODG): Correlation of Amino-Acid and Glucose Uptakes Using PET and Histological Classifications , 2004, Journal of Neuro-Oncology.

[107]  M. Weller,et al.  Dynamic 18F‐FET PET in suspected WHO grade II gliomas defines distinct biological subgroups with different clinical courses , 2015, International journal of cancer.

[108]  Dieta Brandsma,et al.  Clinical features, mechanisms, and management of pseudoprogression in malignant gliomas. , 2008, The Lancet. Oncology.

[109]  J. Menten,et al.  Non-invasive grading of brain tumours using dynamic amino acid PET imaging : does it work for 11C-Methionine? , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[110]  J. Martí-Climent,et al.  Quantitative volumetric analysis of gliomas with sequential MRI and 11C-methionine PET assessment: patterns of integration in therapy planning , 2012, European Journal of Nuclear Medicine and Molecular Imaging.

[111]  Abhishek Kumar,et al.  Comparative diagnostic accuracy of contrast-enhanced MRI and 18F-FDOPA PET-CT in recurrent glioma , 2013, European Radiology.

[112]  B. Drayer,et al.  Human cerebral gliomas: correlation of postmortem MR imaging and neuropathologic findings. , 1989, Radiology.

[113]  Jochen Herms,et al.  FET PET for the evaluation of untreated gliomas: correlation of FET uptake and uptake kinetics with tumour grading , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[114]  Branislav Jeremic,et al.  L-(methyl-11C) methionine positron emission tomography for target delineation in resected high-grade gliomas before radiotherapy. , 2005, International journal of radiation oncology, biology, physics.

[115]  G. Fink,et al.  Imaging of Non- or Very Subtle Contrast-Enhancing Malignant Gliomas with ( 11 C)-Methionine Positron , 2011 .

[116]  G. Stoffels,et al.  Integrated boost IMRT with FET-PET-adapted local dose escalation in glioblastomas , 2012, Strahlentherapie und Onkologie.

[117]  Thomas Beez,et al.  Diagnostic Performance of 18F-FET PET in Newly Diagnosed Cerebral Lesions Suggestive of Glioma , 2013, The Journal of Nuclear Medicine.

[118]  P. Bartenstein,et al.  Dynamic 18F-FET PET in Newly Diagnosed Astrocytic Low-Grade Glioma Identifies High-Risk Patients , 2014, The Journal of Nuclear Medicine.

[119]  S. Goldman,et al.  FDG-PET as a Prognostic Factor in High-grade Astrocytoma , 2000, Journal of Neuro-Oncology.

[120]  Uwe Haberkorn,et al.  Intra-individual comparison of ¹⁸F-FET and ¹⁸F-DOPA in PET imaging of recurrent brain tumors. , 2014, Neuro-oncology.

[121]  Marvin Bergsneider,et al.  Imaging proliferation in brain tumors with 18F-FLT PET: comparison with 18F-FDG. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[122]  H. P. Richter,et al.  Cranial Neuronavigation with Direct Integration of 11C Methionine Positron Emission Tomography (PET) Data – Results of a Pilot Study in 32 Surgical Cases , 2002, Acta Neurochirurgica.

[123]  Kenji Hirata,et al.  Oligodendroglial component complicates the prediction of tumour grading with metabolic imaging , 2015, European Journal of Nuclear Medicine and Molecular Imaging.

[124]  Jörg-Christian Tonn,et al.  Value of O-(2-[18F]fluoroethyl)-l-tyrosine PET for the diagnosis of recurrent glioma , 2004, European Journal of Nuclear Medicine and Molecular Imaging.

[125]  Karl Herholz,et al.  Use of 11C-methionine PET to monitor the effects of temozolomide chemotherapy in malignant gliomas , 2006, European Journal of Nuclear Medicine and Molecular Imaging.

[126]  Karl Herholz,et al.  Delineation of Brain Tumor Extent with [11C]l-Methionine Positron Emission Tomography , 2004, Clinical Cancer Research.