Molecular Imaging in Focus: Can the Newly FDA-Approved PET Agent Floretyrosine F18 Have an Impact for Glioma Imaging?
In a recent episode of our Molecular Imaging in Focus series, Thomas Hope, MD, discussed challenges with conventional imaging for gliomas and the potential of the newly FDA-approved PET agent floretyrosine F18 (18F-FET) for differentiating between glioma progression and treatment-related effects.
After patients undergo surgery or radiation treatment for a brain tumor, Thomas Hope, MD, says subsequent MRI imaging findings can be challenging to interpret as recurrent tumor, residual tumor and the development of post-treatment granulation tissue and inflammation can look similar.
“The biggest conundrum in glioma imaging is to distinguish between residual tumor and treatment-related effects,” noted Dr. Hope, director of theranostics and vice chair of clinical operations and strategy in the Department of Radiology at the University of California, San Francisco (UCSF).
In a recent episode of our Molecular Imaging in Focus series, Dr. Hope discussed the potential of the PET amino acid radiotracer floretyrosine F18 (18F-FET), which r
“FET has been utilized historically at a small number of facilities around the world, particularly in Europe and Australia, and our site at UCSF. But getting lots of people to use this will help us learn a lot more about its application, how we should use it, and improve dramatically molecular imaging of brain tumors moving forward,” emphasized Dr. Hope.
What Are Key Advantages with Floretyrosine F18 in Contrast to Other PET Imaging Agents?
Dr. Hope noted that floretyrosine F18 (Pixclara, Telix Pharmaceuticals) offers key advantages in comparison to other PET imaging agents employed in cancer imaging and neuroimaging. While fluorodeoxyglucose (FDG) PET is commonly utilized for cancer assessment, Dr. Hope said the high amount of glucose in the brain leads to a high uptake of FDG PET in normal brain.
He noted that the PET radiopharmaceutical fluorodopa ((18F)-DOPA), which is indicated for imaging of patients with Parkinson’s disease, has been utilized off-label for glioma imaging. However, this agent has uptake in the basal ganglia, which hinders differentiation between residual tumor and normal brain structures.
“Those two aspects limit FDG (PET) and fluorodopa, (and) FET does not have those limitations,” pointed out Dr. Hope.
Could Floretyrosine F18 Enhance Serial Imaging for Glioma Assessment?
Dr. Hope suggested that the key value of floretyrosine F18 in differentiating residual tumor and the effects of glioma treatment will be revealed in serial PET imaging with the agent.
“It's that change over time that's going to become much more important and more accurate in distinguishing these very important clinical factors,” posited Dr. Hope.
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