Spatial relationship of glioma volume derived from 18F-FET PET and volumetric MR spectroscopy imaging: A hybrid PET/MRI study

Jörg Mauler, Andrew A. Maudsley, Karl Josef Langen, Omid Nikoubashman, Gabriele Stoffels, Sulaiman Sheriff, Philipp Lohmann, Christian Filss, Norbert Galldiks, Elena Rota Kops, N. Jon Shah

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


PET imaging of amino acid transport using O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) and proton MR spectroscopy (MRS) imaging of cell turnover measured by the ratio of choline to N-acetyl-aspartate (Cho/NAA) May provide additional information on tumor extent of cerebral gliomas compared with anatomic imaging; however, comparative studies are rare. Methods: In this prospective study, 41 patients (16 women, 25 men; mean age ± SD, 48 ± 14 y) with cerebral gliomas (World Health Organization [WHO] grade II: 10 [including 1 patient with 2 lesions], WHO III: 17, WHO IV: 13, without biopsy low-grade: 1, high-grade: 1) were investigated with a hybrid PET/MR scanner. Tumor extent, spatial overlap, and the distance between the corresponding centers of mass in 18F-FET PET and MRS imaging of Cho/NAA, determined by simultaneously acquired, 3-dimensional spatially resolved MRS imaging data, were compared. Results: The average tumor volumes for 18F-FET uptake and increased Cho/NAA were 19 ± 20 cm3 (mean ± SD) and 22 ± 24 cm3, respectively, with an overlap of 40% ± 25% and separation of the centers of mass by 9 ± 8 mm. None of the parameters showed a significant correlation with tumor grade. Conclusion: 18F-FET uptake and increased Cho/NAA ratio are not always congruent and May represent different properties of glioma metabolism. The relationship to histologic tumor extent needs to be further analyzed.

Original languageEnglish (US)
Pages (from-to)603-609
Number of pages7
JournalJournal of Nuclear Medicine
Issue number4
StatePublished - Apr 1 2018


  • 18F-FET
  • Congruency
  • Glioma
  • MRSI
  • PET

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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