Amino acid PET successfully differentiated recurrent brain metastases,

Reston, VA—A recently published meta-analysis demonstrated that amino acid PET can accurately differentiate recurrent or progressive brain metastases from treatment-related changes. A specificity of 84 percent indicates that it can reduce the number of invasive procedures and over-medication in patients who are actually experiencing treatment-related changes. This research was published in the May issue Journal of Nuclear Medicine.

Brain metastases occur in 20 to 40 percent of all cancer patients and are most likely to occur in those with lung, breast and kidney cancer, melanoma, and gastrointestinal cancer. Management of patients with brain metastases usually includes surgery, radiation and chemotherapy. Some patients develop treatment-related changes such as radiation necrosis or pseudoprogression.

“Distinguishing between recurrent or progressive brain metastases and treatment-related changes is a challenge,” said Igor Yakushev, senior physician in the department of nuclear medicine at the Technical University of Munich in Germany. “Because the management of patients with recurrent or progressive brain metastases and treatment-related changes is quite different, accurate and early differential diagnosis is essential.”

The meta-analysis included 12 studies with the amino acid PET radiotracer. The study included a total of 397 patients with 547 lesions. Overall, 269 lesions (49 percent) were found to be recurrent or progressive brain metastases. Using histological examination and/or radiological and clinical follow-up as a reference, the sensitivity and specificity pools of amino acid PET were found to be 82 and 84 percent, respectively.

“This study provides class IIa evidence of the diagnostic utility of amino acid PET in the differential diagnosis of recurrent or progressive brain metastases,” said Yakushev. “These findings are in line with the increasing role of molecular imaging in the management of patients with brain tumors, but the results also point to the potential for further increasing diagnostic accuracy.”

the writers”Diagnostic utility of amino acid PET in the differential diagnosis of recurrent brain metastases and treatment-related changes: a meta-analysisincluding Timo Schlürmann, Wolfgang Weber, and Igor Yakushev, Department of Nuclear Medicine, Faculty of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Germany; Birgit Waschulzik, Institute of AI and Informatics in Medicine, Faculty of Medicine, Klinikum Rechts der Isar, Technical University Munich, Germany; Stephanie Combs, Department of Radiation Oncology, Institute of Radiation Medicine (IRM), Department of Radiation Science (DRS), Helmholtz Zentrum München (HMGU), Oberschleißheim, Germany, German Consortium for Translational Cancer Research (DKTK), Partner Site; Jens Gempt, Department of Neurosurgery, Faculty of Medicine, Klinikum Rechts der Isar, Technical University Munich, Germany; and Benedikt Wiestler, Department of Neuroradiology, Faculty of Medicine, Klinikum Rechts der Isar, Technical University Munich, Germany.

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