1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0f811441-9716-488f-bd16-294a438c1ec1] => Array
        (
            [runtime-id] => 0f811441-9716-488f-bd16-294a438c1ec1
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [ffb6b515-c427-4692-9885-0206642d0c7e] => Array
                        (
                            [runtime-id] => ffb6b515-c427-4692-9885-0206642d0c7e
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;a529eb6ac41dea158dc32960319a8e917566f92e
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [1e40c2e0-2bdd-47f1-a6fd-b6b7e704b28f] => Array
        (
            [runtime-id] => 1e40c2e0-2bdd-47f1-a6fd-b6b7e704b28f
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [88562afb-a99e-4a17-a12b-bccda9ede7dc] => Array
                        (
                            [runtime-id] => 88562afb-a99e-4a17-a12b-bccda9ede7dc
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;a529eb6ac41dea158dc32960319a8e917566f92e
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [f9cd5a1e-3d38-4b8e-bcfc-52716366a738] => Array
        (
            [runtime-id] => f9cd5a1e-3d38-4b8e-bcfc-52716366a738
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [cc2e3b9d-479d-407f-9459-cd6f0a28dde1] => Array
                        (
                            [runtime-id] => cc2e3b9d-479d-407f-9459-cd6f0a28dde1
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;a529eb6ac41dea158dc32960319a8e917566f92e
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0f811441-9716-488f-bd16-294a438c1ec1] => Array
        (
            [runtime-id] => 0f811441-9716-488f-bd16-294a438c1ec1
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [ffb6b515-c427-4692-9885-0206642d0c7e] => Array
                        (
                            [runtime-id] => ffb6b515-c427-4692-9885-0206642d0c7e
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;a529eb6ac41dea158dc32960319a8e917566f92e
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0f811441-9716-488f-bd16-294a438c1ec1] => Array
        (
            [runtime-id] => 0f811441-9716-488f-bd16-294a438c1ec1
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [ffb6b515-c427-4692-9885-0206642d0c7e] => Array
                        (
                            [runtime-id] => ffb6b515-c427-4692-9885-0206642d0c7e
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;a529eb6ac41dea158dc32960319a8e917566f92e
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0f811441-9716-488f-bd16-294a438c1ec1] => Array
        (
            [runtime-id] => 0f811441-9716-488f-bd16-294a438c1ec1
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [ffb6b515-c427-4692-9885-0206642d0c7e] => Array
                        (
                            [runtime-id] => ffb6b515-c427-4692-9885-0206642d0c7e
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;a529eb6ac41dea158dc32960319a8e917566f92e
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0f811441-9716-488f-bd16-294a438c1ec1] => Array
        (
            [runtime-id] => 0f811441-9716-488f-bd16-294a438c1ec1
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [ffb6b515-c427-4692-9885-0206642d0c7e] => Array
                        (
                            [runtime-id] => ffb6b515-c427-4692-9885-0206642d0c7e
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;a529eb6ac41dea158dc32960319a8e917566f92e
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [ac223649-f015-471c-be55-5d7df0c80838] => Array
        (
            [runtime-id] => ac223649-f015-471c-be55-5d7df0c80838
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [77710171-b08b-43b4-afdf-2ad4440804a0] => Array
                        (
                            [runtime-id] => 77710171-b08b-43b4-afdf-2ad4440804a0
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;a529eb6ac41dea158dc32960319a8e917566f92e
                )

        )

)


  
    



























































































    Introducing the American Society of Neuroradiology PET-Guided Diagnosis and Management in Neuro-Oncology Study Group | American Journal of Neuroradiology  
    



















    

































    
  
  




    
    

  

      


    

      

  
  
  

    

  

    

  

                
    

      

  

    

  
      
  
  

    


Advertisement



  



  


  
  



  



    

  


  


  


  
  
  
  
  
  

  	      


    
      

    
  
    
        
    

  

    
                        

  

                
    

      

	  

		
		

			

			  

  
      
  
  

    

  
  
      
EditorialEditorial

  
      

  
      
Introducing the American Society of Neuroradiology PET-Guided Diagnosis and Management in Neuro-Oncology Study Group
  
    	
A. Nabavizadeh, N. Galldiks, M. Veronesi, P. Lohmann, J.E. McConathy, D.R. Johnson, M.S. Aboian, R.F. Barajas and J. Ivanidze

  
    	
American Journal of Neuroradiology May 2024,  45 (5) 535-536; DOI: https://doi.org/10.3174/ajnr.A8243 

  
  
  



  


  
  



			

		

	
	
 	
	  
  

		
		

			

			  

  
      
  
  

    
  


  
  



  
      
  
  

    

  

    

  
      
  
  

    
The American Society of Neuroradiology (ASNR) is pleased to introduce its latest initiative: the PET-Guided Diagnosis and Management in Neuro-Oncology Study Group. This group will focus on leveraging molecular imaging and theranostics to enhance the care of adult and pediatric patients with primary and metastatic brain tumors, driving progress through collaborative research, consensus recommendations, and advocacy efforts.
The rapid clinical translation of PET and theranostics in recent years has expanded our understanding of brain tumor metabolism and is opening new pathways for personalized medicine. However, the rapid pace of these advancements has also introduced challenges, including standardization of clinical practices, health care economics, and the need for a coordinated approach that aligns with the interests of all stakeholders. The new Study Group embodies a multidisciplinary effort to empower clinical neuroradiologists and other health care professionals and to bridge the gap between cutting-edge technology and everyday clinical practice by uniting experts from neuroradiology, nuclear medicine, clinical neuro-oncology, and translational sciences.
The objectives are multifaceted. The primary goal is to disseminate the latest evidence regarding the clinical utility of validated radiotracers in adult and pediatric CNS tumors. This knowledge empowers clinicians to make informed decisions regarding the delineation of brain tumor extent, treatment planning, and response assessment. In the near-term, the focus will be on amino acid PET in gliomas1⇓⇓-4 and brain metastases5 as well as somatostatin receptor (SSTR) targeted PET in meningiomas and other SSTR-positive brain tumors.6,7 For example, gallium 68 DOTA-D-Phe1-Tyr3-octreotate (68Ga DOTATATE PET) has shown utility and is increasingly used in the clinical setting in meningioma and paraganglioma diagnosis and radiation therapy planning. Numerous prospective studies have shown added clinical value of fluorine 18 [18F] labeled amino acids in combination with MR imaging for brain tumor management, including O-(2-[18F] fluoroethyl)-L-tyrosine1 (18F-FET), anti-1-amino-3-[18F]fluorocyclobutane-1-carboxylic acid2 (18F Fluciclovine), and 3,4-dihydroxy-6-[18F]-fluorolphenylalanine8 (18F-FDOPA), with ongoing effort toward US FDA approval for amino acid PET currently underway. In addition, unique applications of PET/MR imaging and theranostics to pediatric CNS tumors will be highlighted.
The Study Group also acknowledges the current limitations of companion diagnostics in neuro-oncology due to lack of validated imaging probes, as well as the heterogeneity of patient management contributing to therapeutic clinical trials with negative outcomes.9 To address these limitations, the Study Group advocates biomarker-driven patient selection, akin to the successful application of prostate-specific membrane antigen (PSMA) PET in prostate cancer, and [18F] fluoroestradiol PET in breast cancer.10 Tailoring treatments based on specific biomarkers can optimize therapeutic efficacy and improve patient outcomes.11 In addition to amino acid metabolism and SSTR overexpression, which were discussed above, emerging targets for primary and metastatic brain tumors can include imaging probes for cell proliferation and cell membrane biosynthesis, epidermal growth factor receptor expression, chemokine receptor expression, the 18 kDa translocator protein (TSPO), PSMA, integrins, hypoxia, and finally the immune system.12,13 Additionally, targeted PET agents for primary neoplasms outside the CNS can be applied to improve the detection and biologic characterization of brain metastases.11
Short-term goals are focused on the ASNR 2024 Annual Meeting, where 2 sessions will be offered to introduce the critical topics in molecular neuro-oncology and discuss the clinical use of state-of-the-art PET and theranostics. After the ASNR meeting, the Study Group plans to publish a state-of-practice article, summarizing the evidence presented in the 2 sessions.
In the longer term, we aim to accelerate translational research by leveraging the collective expertise of physicians and scientists working in the field of neuro-oncology. Collaboration will be the key to advancing the development of novel radiotracers, which is essential for enhancing diagnostic accuracy and therapeutic efficacy in neuro-oncology. In collaboration with the Society of Nuclear Medicine and Molecular Imaging and the Society for Neuro-Oncology, the ASNR Study Group will work to establish research priorities and consensus recommendations and develop evidence to support reimbursement for neuro-oncologic PET through cost-effectiveness studies as well as educational sessions during national meetings and webinars. These efforts will provide clarity and direction regarding the optimal applications of PET in neuro-oncology, ensuring consistency and quality of care across institutions.
We invite our colleagues from seasoned experts to early-career professionals to engage with the Study Group, whether through active participation in meetings, contribution to collaborative research, or dissemination of knowledge within their networks. Together, we can overcome the challenges that lie ahead, ensuring that neuroradiologists have a seat at the table in this multidisciplinary effort to improve patient outcomes.
In conclusion, we hope that the establishment of the PET-Guided Diagnosis and Management in Neuro-Oncology Study Group will facilitate continued progress in neuro-oncologic imaging. Through collaborative research, consensus recommendations, and advocacy efforts, the Study Group aims to address challenges and drive progress in the field. When neuroradiologists join forces with nuclear medicine physicians, neuro-oncologists, neurologic surgeons, radiation oncologists, and other physicians and members of the multidisciplinary care team, along with physicists and other imaging scientists and advocates, we can work toward a brighter future for patients battling CNS tumors.
References
  1. 1.↵
    1. Smith  NJ, 
    2. Deaton  TK, 
    3. Territo  W, et al
    . Hybrid (18)F-fluoroethyltyrosine PET and MRI with perfusion to distinguish disease progression from treatment-related change in malignant brain tumors: the quest to beat the toughest cases. J Nucl Med 2023;64:1087–92 doi:10.2967/jnumed.122.265149 pmid:37116915
    Abstract/FREE Full Text
  2. 2.↵
    1. Nabavizadeh  A, 
    2. Bagley  SJ, 
    3. Doot  RK, et al
    . Distinguishing progression from pseudoprogression in glioblastoma using (18)F-Fluciclovine PET. J Nucl Med 2023;64:852–58 doi:10.2967/jnumed.122.264812 pmid:36549916
    Abstract/FREE Full Text
  3. 3.↵
    1. Law  I, 
    2. Albert  NL, 
    3. Arbizu  J, et al
    . Joint EANM/EANO/RANO practice guidelines/SNMMI procedure standards for imaging of gliomas using PET with radiolabelled amino acids and [18F] FDG: version 1.0. Eur J Nucl Med Mol Imaging 2019;46:540–57 doi:10.1007/s00259-018-4207-9 pmid:30519867
    CrossRefPubMed
  4. 4.↵
    1. Albert  NL, 
    2. Weller  M, 
    3. Suchorska  B, et al
    . Response Assessment in Neuro-Oncology Working Group and European Association for Neuro-Oncology recommendations for the clinical use of PET imaging in gliomas. Neuro Oncol 2016;18:1199–208 doi:10.1093/neuonc/now058 pmid:27106405
    CrossRefPubMed
  5. 5.↵
    1. Galldiks  N, 
    2. Lohmann  P, 
    3. Fink  GR, et al
    . Amino acid PET in neurooncology. J Nucl Med 2023;64:693–700 doi:10.2967/jnumed.122.264859 pmid:37055222
    Abstract/FREE Full Text
  6. 6.↵
    1. Galldiks  N, 
    2. Albert  NL, 
    3. Sommerauer  M, et al
    . PET imaging in patients with meningioma-report of the RANO/PET Group. Neuro Oncol 2017;19:1576–87 doi:10.1093/neuonc/nox112 pmid:28605532
    CrossRefPubMed
  7. 7.↵
    1. Ivanidze  J, 
    2. Roytman  M, 
    3. Skafida  M, et al
    . Dynamic (68)Ga-DOTATATE PET/MRI in the diagnosis and management of intracranial meningiomas. Radiol Imaging Cancer 2022;4:e210067 doi:10.1148/rycan.210067 pmid:35275019
    CrossRefPubMed
  8. 8.↵
    1. Darcourt  J, 
    2. Chardin  D, 
    3. Bourg  V, et al
    . Added value of [18F]FDOPA PET to the management of high-grade glioma patients after their initial treatment: a prospective multicentre study. Eur J Nucl Med Mol Imaging 2023;50:2727–35 doi:10.1007/s00259-023-06225-0 pmid:37086272
    CrossRefPubMed
  9. 9.↵
    1. Mankoff  DA, 
    2. Edmonds  CE, 
    3. Farwell  MD, et al
    . Development of companion diagnostics. Semin Nucl Med 2016;46:47–56 doi:10.1053/j.semnuclmed.2015.09.002 pmid:26687857
    CrossRefPubMed
  10. 10.↵
    1. Ivanidze  J, 
    2. Subramanian  K, 
    3. Youn  T, et al
    . Utility of [18F]-fluoroestradiol (FES) PET/CT with dedicated brain acquisition in differentiating brain metastases from posttreatment change in estrogen receptor-positive breast cancer. Neurooncol Adv 2021;3:vdab178 doi:10.1093/noajnl/vdab178 pmid:34988456
    CrossRefPubMed
  11. 11.↵
    1. Burkett  BJ, 
    2. Bartlett  DJ, 
    3. McGarrah  PW, et al
    . A review of theranostics: perspectives on emerging approaches and clinical advancements. Radiol Imaging Cancer 2023;5:e220157 doi:10.1148/rycan.220157 pmid:37477566
    CrossRefPubMed
  12. 12.↵
    1. Kersch  CN, 
    2. Ambady  P, 
    3. Hamilton  BE, et al
    . MRI and PET of brain tumor neuroinflammation in the era of immunotherapy, from the AJR Special Series on Inflammation. AJR Am J Roentgenol 2022;218:582–96 doi:10.2214/AJR.21.26159 pmid:34259035
    CrossRefPubMed
  13. 13.↵
    1. Galldiks  N, 
    2. Langen  KJ, 
    3. Albert  NL, et al
    . Investigational PET tracers in neuro-oncology: what's on the horizon? A report of the PET/RANO group. Neuro Oncol 2022;24:1815–26 doi:10.1093/neuonc/noac131 pmid:35674736
    CrossRefPubMed
  


  
  



  
      
  
  

    
  


  
  



  




  


  
  



  
      
  
  

    
  


  
  



  
      
  
  

     Back to top  


  
  



			

		

		
		

			

			  

  
        
In this issue

    
  
  

    
  


  
  



  
      
  
  

    

  

    

  
      
  
  

    


Advertisement



  



  


  
  



  



  


  
  



  
      
  
  

    

	  
  

		

          

            

  
      
  
  

     Print  


  
  



  
      
  
  

     Download PDF  


  
  



  
      
  
  

    
 Email Article
  


  
  



  
      
  
  

    
 Citation Tools
  


  
  



          

        

        
        

          

            



  
      
  
  

    

  

    

  
      
  
  

    

  
  
  
  
      
Introducing the American Society of Neuroradiology PET-Guided Diagnosis and Management in Neuro-Oncology Study Group
  
    	
A. Nabavizadeh, N. Galldiks, M. Veronesi, P. Lohmann, J.E. McConathy, D.R. Johnson, M.S. Aboian, R.F. Barajas, J. Ivanidze

  
    	
American Journal of Neuroradiology May 2024, 45 (5) 535-536; DOI: 10.3174/ajnr.A8243 

  
  
  



  


  
  



  
      
  
  

    

  
    
  
  
    
  
  
    
  


  


  
  



  
      
  
  

    
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  


  
  



  



  


  
  



  
      
  
  

    
  


  
  



          

        

	
 	
	
	


  


  
  



  
      
  
  

    
              Purchase  


  
  



  
        
Jump to section

    
  
  

    
  


  
  



  
      
  
  

    

  

    
 Related Articles
  • No related articles found.
 Cited By...
  • No citing articles found.
 More in this TOC Section
 Similar Articles

  



  


  
  



			

		

	
	
 	
	
	


    

  



  

                
    

      

  

    

  
      
  
  

    


Advertisement