Advantages and limitations of amino acid PET for tracking therapy response in glioma patients

ABSTRACT

Introduction: Today, magnetic resonance imaging (MRI) is the standard method for monitoring patients with brain tumors. The ability of conventional MRI in differentiating neoplastic tissue from nonspecific, treatment-related changes after surgery, radio-, chemo- or immunotherapy, however, remains limited. Therefore, advanced MRI sequences and positron emission tomography (PET) are increasingly being considered to improve decision-making.

Areas covered: PET using radiolabeled amino acids has evolved into an important diagnostic tool to overcome some of the shortcomings of conventional MRI. In view of the rapidly developing novel treatment strategies, a reliable statement on the response to therapy is becoming increasingly important. This article gives an overview of the current results of PET with radiolabelled amino acids in therapy monitoring of standard therapy as well as various innovative approaches in the treatment of patients with cerebral gliomas.

Expert opinion: Amino acid PET has proven to be helpful in therapy monitoring of gliomas, the costs are low in relation to the costs of therapy and the clinical benefit, and a widespread clinical use is highly desirable.

KEYWORDS:

• Cerebral glioma
• PET
• radiolabeled amino acids
• treatment monitoring

Article highlights

• Amino acid PET provides significant additional information for tracking therapy response in glioma patients.

• Amino acid PET requires additional scanning but is robust and attractive for clinicians in neurooncology because of easy scan reading.

• Amino acid PET in therapy monitoring of gliomas is cost-efficient and well justified to avoid overtreatment and unnecessary side effects.

• Improvement of therapy monitoring in gliomas is necessary because therapy is extremely expensive and efficient use of these therapies is mandatory.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.