PT  - JOURNAL ARTICLE
AU  - Walter, Franziska
AU  - Cloughesy, Timothy
AU  - Walter, Martin A.
AU  - Lai, Albert
AU  - Nghiemphu, Phioanh
AU  - Wagle, Naveed
AU  - Fueger, Barbara
AU  - Satyamurthy, Nagichettiar
AU  - Phelps, Michael E.
AU  - Czernin, Johannes
TI  - Impact of 3,4-Dihydroxy-6-<sup>18</sup>F-Fluoro-<span class="sc">l</span>-Phenylalanine PET/CT on Managing Patients with Brain Tumors: The Referring Physician's Perspective
AID  - 10.2967/jnumed.111.095711
DP  - 2012 Mar 01
TA  - Journal of Nuclear Medicine
PG  - 393--398
VI  - 53
IP  - 3
4099  - http://jnm.snmjournals.org/content/53/3/393.short
4100  - http://jnm.snmjournals.org/content/53/3/393.full
SO  - J Nucl Med2012 Mar 01; 53
AB  - We investigated the impact of 18F-DOPA brain PET/CT on the clinical management of patients with known or suspected brain tumors. Methods: A prospective survey of referring physicians was conducted. A pre-PET questionnaire inquired about indication, tumor histology or grade, level of suspicion for tumor recurrence, and planned management. Early post-PET questionnaires asked referring physicians to categorize PET findings as negative, equivocal, or positive; assessed the level of suspicion for primary or recurrent brain tumor; and recorded intended management changes prompted by PET findings. A late follow-up questionnaire 6 mo after the scan aimed at determining patient outcome (recurrence, survival). In addition, all referring physicians were contacted to determine whether management changes intended after 18F-DOPA PET/CT were implemented. Results: Fifty-eight consecutive patients were included. The clinical suspicion for recurrence increased in 33%, remained unchanged in 50%, and decreased in 17% of patients after adding the PET/CT result to the available diagnostic data. The late post-PET questionnaire confirmed recurrence in 26 patients whereas 32 had stable disease or remained disease-free. 18F-DOPA PET/CT resulted in intended management changes in 41% of patients. Changes in intended management from wait and watch to chemotherapy (6 patients [25%]) and from chemotherapy to wait and watch (4 patients [17%]) occurred most frequently. Clinical follow-up revealed that 75% of intended treatment changes were implemented. Conclusion: 18F-DOPA PET/CT changed the intended management of 41% of patients with brain tumors, and intended management changes were implemented in 75% of these. These changes suggest a potentially important clinical role of imaging amino acid transport in the management of brain tumor patients.