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Heinz Peter Schlemmer - One of the best experts on this subject based on the ideXlab platform.
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A look ahead: PET/MR versus PET/CT
European Journal of Nuclear Medicine and Molecular Imaging, 2009Co-Authors: Gustav K Von Schulthess, Heinz Peter SchlemmerAbstract:Introduction Integration of positron emission tomography (PET) and magnetic resonance (MR) has become a topic of increasing interest to the imaging community over the past two years. Objectives In this text, the authors attempt to distinguish facts from fiction concerning such integrated systems. Analysis of existing information of combined imaging on existing brain PET/MR systems and imaging experience with PET-computed tomography (CT) is reviewed. Various types of system integration of PET and MR are discussed with completely independent systems on one hand and completely integrated systems with the possibility of simultaneous data acquisition on the other hand. Furthermore, it is discussed, what simultaneous data acquisition with nuclear imaging systems combined with MR or CT really means, as technical simultaneity may not be relevant in light of the pharmacokinetics of the nuclear tracers used. Discussion The authors conclude that combining PET/MR is an interesting research endeavor with uncertain outcome. They argue that, while completely simultaneous brain applications are of research interest immediately, clinical applications do not currently warrant the construction of fully integrated systems. Systems adjacent to each other, where imaging tables are linked with a patient “shuttle” thereby requiring only patient translation but no repositioning, may be a good start to assess the value of integrated PET/MR.
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A look ahead: PET/MR versus PET/CT
European Journal of Nuclear Medicine and Molecular Imaging, 2008Co-Authors: Gustav K. Von Schulthess, Heinz Peter SchlemmerAbstract:Introduction Integration of positron emission tomography (PET) and magnetic resonance (MR) has become a topic of increasing interest to the imaging community over the past two years.
Marcus Unterrainer - One of the best experts on this subject based on the ideXlab platform.
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Comparison of ^18F-GE-180 and dynamic ^18F-FET PET in high grade glioma: a double-tracer pilot study
European Journal of Nuclear Medicine and Molecular Imaging, 2019Co-Authors: Marcus Unterrainer, D. F. Fleischmann, C. Diekmann, L. Vomacka, S. Lindner, F. Vettermann, M. Brendel, V. Wenter, B. Ertl-wagner, J. HermsAbstract:Background PET represents a valuable tool for glioma imaging. In addition to amino acid tracers such as ^18F-FET, PET targeting the 18-kDa mitochondrial translocator-protein (TSPO) is of high interest for high-grade glioma (HGG) imaging due to its upregulation in HGG cells. ^18F-GE-180, a novel TSPO ligand, has shown a high target-to-background contrast in HGG. Therefore, we intra-individually compared its uptake characteristics to dynamic ^18F-FET PET and contrast-enhanced MRI in patients with HGG. Methods Twenty HGG patients (nine IDH -wildtype, 11 IDH -mutant) at initial diagnosis ( n = 8) or recurrence ( n = 12) were consecutively included and underwent ^18F-GE-180 PET, dynamic ^18F-FET PET, and MRI. The maximal tumour-to-background ratios (TBR_max) and biological tumour volumes (BTV) were evaluated in ^18F-GE-180 and ^18F-FET PET. Dynamic ^18F-FET PET analysis included the evaluation of minimal time-to-peak (TTP_min). In MRI, the volume of contrast-enhancement was delineated (VOL_CE). Volumes were spatially correlated using the Sørensen–Dice coefficient. Results The median TBR_max tended to be higher in ^18F-GE-180 PET compared to ^18F-FET PET [4.58 (2.33–8.95) vs 3.89 (1.56–7.15); p = 0.062] in the overall group. In subgroup analyses, IDH -wildtype gliomas showed a significantly higher median TBR_max in ^18F-GE-180 PET compared to ^18F-FET PET [5.45 (2.56–8.95) vs 4.06 (1.56–4.48); p = 0.008]; by contrast, no significant difference was observed in IDH -mutant gliomas [3.97 (2.33–6.81) vs 3.79 (2.01–7.15) p = 1.000]. Only 5/20 cases showed higher TBR_max in ^18F-FET PET compared to ^18F-GE-180 PET, all of them being IDH -mutant gliomas. No parameter in ^18F-GE-180 PET correlated with TTP_min ( p > 0.05 each). There was a tendency towards higher median BTV_GE-180 [32.1 (0.4–236.0) ml] compared to BTV_FET [19.3 (0.7–150.2) ml; p = 0.062] with a moderate spatial overlap [median Sørensen–Dice coefficient 0.55 (0.07–0.85)]. In MRI, median VOL_CE [9.7 (0.1–72.5) ml] was significantly smaller than both BTV_FET and BTV_GE180 ( p
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comparison of 18f ge 180 and dynamic 18f fet pet in high grade glioma a double tracer pilot study
European Journal of Nuclear Medicine and Molecular Imaging, 2019Co-Authors: Marcus Unterrainer, D. F. Fleischmann, C. Diekmann, L. Vomacka, S. Lindner, F. Vettermann, M. Brendel, V. WenterAbstract:PET represents a valuable tool for glioma imaging. In addition to amino acid tracers such as 18F-FET, PET targeting the 18-kDa mitochondrial translocator-protein (TSPO) is of high interest for high-grade glioma (HGG) imaging due to its upregulation in HGG cells. 18F-GE-180, a novel TSPO ligand, has shown a high target-to-background contrast in HGG. Therefore, we intra-individually compared its uptake characteristics to dynamic 18F-FET PET and contrast-enhanced MRI in patients with HGG. Twenty HGG patients (nine IDH-wildtype, 11 IDH-mutant) at initial diagnosis (n = 8) or recurrence (n = 12) were consecutively included and underwent 18F-GE-180 PET, dynamic 18F-FET PET, and MRI. The maximal tumour-to-background ratios (TBRmax) and biological tumour volumes (BTV) were evaluated in 18F-GE-180 and 18F-FET PET. Dynamic 18F-FET PET analysis included the evaluation of minimal time-to-peak (TTPmin). In MRI, the volume of contrast-enhancement was delineated (VOLCE). Volumes were spatially correlated using the Sorensen–Dice coefficient. The median TBRmax tended to be higher in 18F-GE-180 PET compared to 18F-FET PET [4.58 (2.33–8.95) vs 3.89 (1.56–7.15); p = 0.062] in the overall group. In subgroup analyses, IDH-wildtype gliomas showed a significantly higher median TBRmax in 18F-GE-180 PET compared to 18F-FET PET [5.45 (2.56–8.95) vs 4.06 (1.56–4.48); p = 0.008]; by contrast, no significant difference was observed in IDH-mutant gliomas [3.97 (2.33–6.81) vs 3.79 (2.01–7.15) p = 1.000]. Only 5/20 cases showed higher TBRmax in 18F-FET PET compared to 18F-GE-180 PET, all of them being IDH-mutant gliomas. No parameter in 18F-GE-180 PET correlated with TTPmin (p > 0.05 each). There was a tendency towards higher median BTVGE-180 [32.1 (0.4–236.0) ml] compared to BTVFET [19.3 (0.7–150.2) ml; p = 0.062] with a moderate spatial overlap [median Sorensen–Dice coefficient 0.55 (0.07–0.85)]. In MRI, median VOLCE [9.7 (0.1–72.5) ml] was significantly smaller than both BTVFET and BTVGE180 (p < 0.001 each), leading to a poor spatial correlation with BTVGE-180 [0.29 (0.01–0.48)] and BTVFET [0.38 (0.01–0.68)]. PET with 18F-GE-180 and 18F-FET provides differing imaging information in HGG dependent on the IDH-mutational status, with diverging spatial overlap and vast exceedance of contrast-enhancement in MRI. Combined PET imaging might reveal new insights regarding non-invasive characterization of tumour heterogeneity and might influence patients’ management.
Françoise Montravers - One of the best experts on this subject based on the ideXlab platform.
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68ga dotatoc pet ct in detecting neuroendocrine tumours responsible for initial or recurrent paraneoplastic cushing s syndrome
Endocrine, 2020Co-Authors: Ophelie Belissant Benesty, Valérie Nataf, Yves Reznik, Laure Michaud, Jessica Ohnona, Jean-noël Talbot, Jerome Bertherat, Philippe Chanson, Jules Zhangyin, Françoise MontraversAbstract:PURPOSE Paraneoplastic Cushing's syndrome (PCS) is frequently caused by neuroendocrine tumours (NETs). Approximately 20% of tumours are still occult years later. Gallium-68 somatostatin receptor-PET/CT is promising for the detection of the causal primary NET, but its role in case of recurrent PCS is rarely reported. We report our experience with DOTATOC PET/CT in localising the causal NET in cases of initial but also recurrent PCS, and its clinical impact. METHODS A retrospective review of all DOTATOC PET/CTs performed in consecutive patients referred for PCS to our centre, between January 2011 and June 2017, was done. Nineteen patients underwent 26 PET/CTs, 13 for detection of a primary NET, seven for persistent or recurrent PCS after resection, and six for surveillance after resection of NETs previously detected on a DOTATOC PET/CT in our centre. RESULTS Among the 13 PET/CTs performed to search for primary NET, five were positive: four carcinoid lung tumours were confirmed after resection and one lung focus was not confirmed since surgery would have carried a high risk. Clinical impact was 23% (3/13). Among the seven PET/CTs performed for persistent or recurrent PCS, six were true-positive, with confirmation of metastatic lymph nodes after resection. Clinical impact was 57% (4/7). All PET/CTs performed for surveillance were true-negative. CONCLUSIONS DOTATOC PET/CT seems to be a valuable tool for detection of the NET responsible for persistent or recurrent PCS after surgery. In this context, DOTATOC PET/CT was more effective than for the detection of the causal tumour in initial PCS.
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^68Ga-DOTATOC PET/CT in detecting neuroendocrine tumours responsible for initial or recurrent paraneoplastic Cushing’s syndrome
Endocrine, 2019Co-Authors: Ophélie Bélissant Benesty, Valérie Nataf, Jules Zhang-yin, Yves Reznik, Laure Michaud, Jessica Ohnona, Jean-noël Talbot, Jerome Bertherat, Philippe Chanson, Françoise MontraversAbstract:Purpose Paraneoplastic Cushing’s syndrome (PCS) is frequently caused by neuroendocrine tumours (NETs). Approximately 20% of tumours are still occult years later. Gallium-68 somatostatin receptor-PET/CT is promising for the detection of the causal primary NET, but its role in case of recurrent PCS is rarely reported. We report our experience with DOTATOC PET/CT in localising the causal NET in cases of initial but also recurrent PCS, and its clinical impact. Methods A retrospective review of all DOTATOC PET/CTs performed in consecutive patients referred for PCS to our centre, between January 2011 and June 2017, was done. Nineteen patients underwent 26 PET/CTs, 13 for detection of a primary NET, seven for persistent or recurrent PCS after resection, and six for surveillance after resection of NETs previously detected on a DOTATOC PET/CT in our centre. Results Among the 13 PET/CTs performed to search for primary NET, five were positive: four carcinoid lung tumours were confirmed after resection and one lung focus was not confirmed since surgery would have carried a high risk. Clinical impact was 23% (3/13). Among the seven PET/CTs performed for persistent or recurrent PCS, six were true-positive, with confirmation of metastatic lymph nodes after resection. Clinical impact was 57% (4/7). All PET/CTs performed for surveillance were true-negative. Conclusions DOTATOC PET/CT seems to be a valuable tool for detection of the NET responsible for persistent or recurrent PCS after surgery. In this context, DOTATOC PET/CT was more effective than for the detection of the causal tumour in initial PCS.
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Paediatric and adolescent Hodgkin lymphoma: information derived from diffuse organ uptake of 18 F-fluorodeoxyglucose on pre-treatment and on interim PET/CT
European Journal of Nuclear Medicine and Molecular Imaging, 2016Co-Authors: Linda Jorgov, Françoise Montravers, Sona Balogova, Christine Ragu, Hélène Pacquement, Thierry Leblanc, Samuel Abbou, Hubert Ducou-lepointe, Judith Landman-parker, Jean-noёl TalbotAbstract:Purpose To evaluate, in children with Hodgkin lymphoma (HL), the frequency and intensity of visually diffuse FDG uptake by selected organs at baseline (bPET) and on interim PET/CT (iPET), and to evaluate the relation between FDG uptake, metabolic response and evolution of the disease with treatment. Patients and methods Thirty children with HL had bPET and then iPET after two cycles of treatment, which were blind-read retrospectively. Excluding sites with focal uptake, diffuse FDG uptake by thymus, bone marrow at iliac crests, liver, spleen, and the spinal cord at the 12th thoracic vertebra (Th12) was evaluated visually using a three-point scoring method and semiquantitatively by measuring SUVmax. Visualisation of activated brown adipose tissue (BAT) was also quoted. Five children had refractory HL. Recurrence-free survival was determined for each patient. Nine patients relapsed; in 21 non-relapsing patients, the median follow-up period was 43 months (range: 28–61). Results On bPET, the rate of diffuse and intense (visual score = 3) FDG uptake was 48 % in the spleen, 43 % in the spinal cord at Th12, 37 % in bone marrow, 21 % in the thymus and 7 % in BAT. At least one of those sites showed diffuse and intense FDG uptake in 77 % of patients. On iPET, a significant decrease in SUVmax was observed in thymus, iliac crest bone marrow and spleen, but not in spinal cord. In contrast, the FDG uptake by the liver significantly increased. The absence of SUVmax increase in the liver between bPET and iPET was the best criterion to predict a refractory disease (PPV = 55 %, NPV = 100 %). Its area under ROC (AUC) was 0.9 vs. 0.73 for five-point Deauville criteria. For prediction of relapse, two criteria were derived from the evolution of diffuse uptake between bPET and iPET: no increase in liver uptake and an increase > 5 % in spinal cord uptake. As compared with 13 patients who matched none of those criteria, the hazard ratio (HR) for relapse was 2.1 in 13 patients who matched one criterion, and 10.3 in four patients who matched both (Kaplan-Meier analysis p = 0.005). Conclusion Diffuse and intense FDG uptake by organs is frequent in children with HL on bPET. On iPET, it is frequently reduced in all sites except the liver, which may pose problems for visual quotation of the FDG intensity of HL foci. The variation of SUVmax between bPET and iPET permitted us to achieve a prediction of refractory or relapsing HL that was at least as effective as using criteria based on FDG uptake by the HL lesions. The results of this retrospective pilot study need further validation.
V. Wenter - One of the best experts on this subject based on the ideXlab platform.
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Comparison of ^18F-GE-180 and dynamic ^18F-FET PET in high grade glioma: a double-tracer pilot study
European Journal of Nuclear Medicine and Molecular Imaging, 2019Co-Authors: Marcus Unterrainer, D. F. Fleischmann, C. Diekmann, L. Vomacka, S. Lindner, F. Vettermann, M. Brendel, V. Wenter, B. Ertl-wagner, J. HermsAbstract:Background PET represents a valuable tool for glioma imaging. In addition to amino acid tracers such as ^18F-FET, PET targeting the 18-kDa mitochondrial translocator-protein (TSPO) is of high interest for high-grade glioma (HGG) imaging due to its upregulation in HGG cells. ^18F-GE-180, a novel TSPO ligand, has shown a high target-to-background contrast in HGG. Therefore, we intra-individually compared its uptake characteristics to dynamic ^18F-FET PET and contrast-enhanced MRI in patients with HGG. Methods Twenty HGG patients (nine IDH -wildtype, 11 IDH -mutant) at initial diagnosis ( n = 8) or recurrence ( n = 12) were consecutively included and underwent ^18F-GE-180 PET, dynamic ^18F-FET PET, and MRI. The maximal tumour-to-background ratios (TBR_max) and biological tumour volumes (BTV) were evaluated in ^18F-GE-180 and ^18F-FET PET. Dynamic ^18F-FET PET analysis included the evaluation of minimal time-to-peak (TTP_min). In MRI, the volume of contrast-enhancement was delineated (VOL_CE). Volumes were spatially correlated using the Sørensen–Dice coefficient. Results The median TBR_max tended to be higher in ^18F-GE-180 PET compared to ^18F-FET PET [4.58 (2.33–8.95) vs 3.89 (1.56–7.15); p = 0.062] in the overall group. In subgroup analyses, IDH -wildtype gliomas showed a significantly higher median TBR_max in ^18F-GE-180 PET compared to ^18F-FET PET [5.45 (2.56–8.95) vs 4.06 (1.56–4.48); p = 0.008]; by contrast, no significant difference was observed in IDH -mutant gliomas [3.97 (2.33–6.81) vs 3.79 (2.01–7.15) p = 1.000]. Only 5/20 cases showed higher TBR_max in ^18F-FET PET compared to ^18F-GE-180 PET, all of them being IDH -mutant gliomas. No parameter in ^18F-GE-180 PET correlated with TTP_min ( p > 0.05 each). There was a tendency towards higher median BTV_GE-180 [32.1 (0.4–236.0) ml] compared to BTV_FET [19.3 (0.7–150.2) ml; p = 0.062] with a moderate spatial overlap [median Sørensen–Dice coefficient 0.55 (0.07–0.85)]. In MRI, median VOL_CE [9.7 (0.1–72.5) ml] was significantly smaller than both BTV_FET and BTV_GE180 ( p
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comparison of 18f ge 180 and dynamic 18f fet pet in high grade glioma a double tracer pilot study
European Journal of Nuclear Medicine and Molecular Imaging, 2019Co-Authors: Marcus Unterrainer, D. F. Fleischmann, C. Diekmann, L. Vomacka, S. Lindner, F. Vettermann, M. Brendel, V. WenterAbstract:PET represents a valuable tool for glioma imaging. In addition to amino acid tracers such as 18F-FET, PET targeting the 18-kDa mitochondrial translocator-protein (TSPO) is of high interest for high-grade glioma (HGG) imaging due to its upregulation in HGG cells. 18F-GE-180, a novel TSPO ligand, has shown a high target-to-background contrast in HGG. Therefore, we intra-individually compared its uptake characteristics to dynamic 18F-FET PET and contrast-enhanced MRI in patients with HGG. Twenty HGG patients (nine IDH-wildtype, 11 IDH-mutant) at initial diagnosis (n = 8) or recurrence (n = 12) were consecutively included and underwent 18F-GE-180 PET, dynamic 18F-FET PET, and MRI. The maximal tumour-to-background ratios (TBRmax) and biological tumour volumes (BTV) were evaluated in 18F-GE-180 and 18F-FET PET. Dynamic 18F-FET PET analysis included the evaluation of minimal time-to-peak (TTPmin). In MRI, the volume of contrast-enhancement was delineated (VOLCE). Volumes were spatially correlated using the Sorensen–Dice coefficient. The median TBRmax tended to be higher in 18F-GE-180 PET compared to 18F-FET PET [4.58 (2.33–8.95) vs 3.89 (1.56–7.15); p = 0.062] in the overall group. In subgroup analyses, IDH-wildtype gliomas showed a significantly higher median TBRmax in 18F-GE-180 PET compared to 18F-FET PET [5.45 (2.56–8.95) vs 4.06 (1.56–4.48); p = 0.008]; by contrast, no significant difference was observed in IDH-mutant gliomas [3.97 (2.33–6.81) vs 3.79 (2.01–7.15) p = 1.000]. Only 5/20 cases showed higher TBRmax in 18F-FET PET compared to 18F-GE-180 PET, all of them being IDH-mutant gliomas. No parameter in 18F-GE-180 PET correlated with TTPmin (p > 0.05 each). There was a tendency towards higher median BTVGE-180 [32.1 (0.4–236.0) ml] compared to BTVFET [19.3 (0.7–150.2) ml; p = 0.062] with a moderate spatial overlap [median Sorensen–Dice coefficient 0.55 (0.07–0.85)]. In MRI, median VOLCE [9.7 (0.1–72.5) ml] was significantly smaller than both BTVFET and BTVGE180 (p < 0.001 each), leading to a poor spatial correlation with BTVGE-180 [0.29 (0.01–0.48)] and BTVFET [0.38 (0.01–0.68)]. PET with 18F-GE-180 and 18F-FET provides differing imaging information in HGG dependent on the IDH-mutational status, with diverging spatial overlap and vast exceedance of contrast-enhancement in MRI. Combined PET imaging might reveal new insights regarding non-invasive characterization of tumour heterogeneity and might influence patients’ management.
D. F. Fleischmann - One of the best experts on this subject based on the ideXlab platform.
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Comparison of ^18F-GE-180 and dynamic ^18F-FET PET in high grade glioma: a double-tracer pilot study
European Journal of Nuclear Medicine and Molecular Imaging, 2019Co-Authors: Marcus Unterrainer, D. F. Fleischmann, C. Diekmann, L. Vomacka, S. Lindner, F. Vettermann, M. Brendel, V. Wenter, B. Ertl-wagner, J. HermsAbstract:Background PET represents a valuable tool for glioma imaging. In addition to amino acid tracers such as ^18F-FET, PET targeting the 18-kDa mitochondrial translocator-protein (TSPO) is of high interest for high-grade glioma (HGG) imaging due to its upregulation in HGG cells. ^18F-GE-180, a novel TSPO ligand, has shown a high target-to-background contrast in HGG. Therefore, we intra-individually compared its uptake characteristics to dynamic ^18F-FET PET and contrast-enhanced MRI in patients with HGG. Methods Twenty HGG patients (nine IDH -wildtype, 11 IDH -mutant) at initial diagnosis ( n = 8) or recurrence ( n = 12) were consecutively included and underwent ^18F-GE-180 PET, dynamic ^18F-FET PET, and MRI. The maximal tumour-to-background ratios (TBR_max) and biological tumour volumes (BTV) were evaluated in ^18F-GE-180 and ^18F-FET PET. Dynamic ^18F-FET PET analysis included the evaluation of minimal time-to-peak (TTP_min). In MRI, the volume of contrast-enhancement was delineated (VOL_CE). Volumes were spatially correlated using the Sørensen–Dice coefficient. Results The median TBR_max tended to be higher in ^18F-GE-180 PET compared to ^18F-FET PET [4.58 (2.33–8.95) vs 3.89 (1.56–7.15); p = 0.062] in the overall group. In subgroup analyses, IDH -wildtype gliomas showed a significantly higher median TBR_max in ^18F-GE-180 PET compared to ^18F-FET PET [5.45 (2.56–8.95) vs 4.06 (1.56–4.48); p = 0.008]; by contrast, no significant difference was observed in IDH -mutant gliomas [3.97 (2.33–6.81) vs 3.79 (2.01–7.15) p = 1.000]. Only 5/20 cases showed higher TBR_max in ^18F-FET PET compared to ^18F-GE-180 PET, all of them being IDH -mutant gliomas. No parameter in ^18F-GE-180 PET correlated with TTP_min ( p > 0.05 each). There was a tendency towards higher median BTV_GE-180 [32.1 (0.4–236.0) ml] compared to BTV_FET [19.3 (0.7–150.2) ml; p = 0.062] with a moderate spatial overlap [median Sørensen–Dice coefficient 0.55 (0.07–0.85)]. In MRI, median VOL_CE [9.7 (0.1–72.5) ml] was significantly smaller than both BTV_FET and BTV_GE180 ( p
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comparison of 18f ge 180 and dynamic 18f fet pet in high grade glioma a double tracer pilot study
European Journal of Nuclear Medicine and Molecular Imaging, 2019Co-Authors: Marcus Unterrainer, D. F. Fleischmann, C. Diekmann, L. Vomacka, S. Lindner, F. Vettermann, M. Brendel, V. WenterAbstract:PET represents a valuable tool for glioma imaging. In addition to amino acid tracers such as 18F-FET, PET targeting the 18-kDa mitochondrial translocator-protein (TSPO) is of high interest for high-grade glioma (HGG) imaging due to its upregulation in HGG cells. 18F-GE-180, a novel TSPO ligand, has shown a high target-to-background contrast in HGG. Therefore, we intra-individually compared its uptake characteristics to dynamic 18F-FET PET and contrast-enhanced MRI in patients with HGG. Twenty HGG patients (nine IDH-wildtype, 11 IDH-mutant) at initial diagnosis (n = 8) or recurrence (n = 12) were consecutively included and underwent 18F-GE-180 PET, dynamic 18F-FET PET, and MRI. The maximal tumour-to-background ratios (TBRmax) and biological tumour volumes (BTV) were evaluated in 18F-GE-180 and 18F-FET PET. Dynamic 18F-FET PET analysis included the evaluation of minimal time-to-peak (TTPmin). In MRI, the volume of contrast-enhancement was delineated (VOLCE). Volumes were spatially correlated using the Sorensen–Dice coefficient. The median TBRmax tended to be higher in 18F-GE-180 PET compared to 18F-FET PET [4.58 (2.33–8.95) vs 3.89 (1.56–7.15); p = 0.062] in the overall group. In subgroup analyses, IDH-wildtype gliomas showed a significantly higher median TBRmax in 18F-GE-180 PET compared to 18F-FET PET [5.45 (2.56–8.95) vs 4.06 (1.56–4.48); p = 0.008]; by contrast, no significant difference was observed in IDH-mutant gliomas [3.97 (2.33–6.81) vs 3.79 (2.01–7.15) p = 1.000]. Only 5/20 cases showed higher TBRmax in 18F-FET PET compared to 18F-GE-180 PET, all of them being IDH-mutant gliomas. No parameter in 18F-GE-180 PET correlated with TTPmin (p > 0.05 each). There was a tendency towards higher median BTVGE-180 [32.1 (0.4–236.0) ml] compared to BTVFET [19.3 (0.7–150.2) ml; p = 0.062] with a moderate spatial overlap [median Sorensen–Dice coefficient 0.55 (0.07–0.85)]. In MRI, median VOLCE [9.7 (0.1–72.5) ml] was significantly smaller than both BTVFET and BTVGE180 (p < 0.001 each), leading to a poor spatial correlation with BTVGE-180 [0.29 (0.01–0.48)] and BTVFET [0.38 (0.01–0.68)]. PET with 18F-GE-180 and 18F-FET provides differing imaging information in HGG dependent on the IDH-mutational status, with diverging spatial overlap and vast exceedance of contrast-enhancement in MRI. Combined PET imaging might reveal new insights regarding non-invasive characterization of tumour heterogeneity and might influence patients’ management.
