PET Agents for Primary Brain Tumor Imaging

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Anja van der Kolk, MD, PhD
Dylan Henssen, MD, PhD
Harry W Schroeder III, MD, PhD
Lance T Hall, MD


The role of molecular imaging with positron emission tomography (PET) for diagnosis, treatment planning and post-treatment monitoring of brain tumors has grown substantially in the last decades. In the last 25 years, almost 50 different PET agents have been developed and tested in human clinical studies. While some of these PET agents are yet to make their way into clinical practice, others have already established pivotal roles in brain tumor imaging. Although all these agents share an affinity for brain tumor cells, they target different tumor-altered molecular pathways within these cells: some agents are taken up by the cell through overexpressed transporters and become trapped, altered, or incorporated into upregulated metabolic pathways, while other agents bind to overexpressed receptors or to cells present in the tumor microenvironment. In this monograph, we explore the major genetic and molecular changes characteristic of brain tumors, how they are used by PET agents to gain access to tumor cells and their environment, and how this translates to uptake in clinical practice. Gaining insight in these processes is essential for correct image interpretation and helps to understand why some agents are more successful than others.


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Author Biographies

Anja van der Kolk, MD, PhD, Department of Medical Imaging, Radboudumc, Nijmegen, the Netherlands; Donders Center for Cognitive Neuroscience, Nijmegen University, Nijmegen, the Netherlands

Anja G van der Kolk, MD PhDDr. Anja van der Kolk is a radiologist and clinician-scientist, and an expert in MR and PET imaging of neurological diseases, in particular brain tumors. Her current research includes metabolic imaging of primary brain tumors and epilepsy, and non-invasive imaging of neuroinflammation, both at ultrahigh field (7 tesla) MRI.

Dylan Henssen, MD, PhD, Department of Medical Imaging, Radboudumc, Nijmegen, the Netherlands

Dylan Henssen, MD, PhDDr. Dylan Henssen is a resident in radiology and nuclear medicine, as well as a clinician-scientist with a primary focus on experimental neuro-imaging. Utilizing both MRI and PET, Dr. Henssen investigates neuro-oncological and neurodegenerative disorders. His current research also encompasses the early health technology assessment of Artificial Intelligence applications in clinical imaging for neuro-oncological diseases.

Harry W Schroeder III, MD, PhD, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA

Dr. Harry W. Schroeder IIIDr. Harry W. Schroeder III is a diagnostic radiologist and nuclear medicine physician. He was trained as a physician-scientist in biochemistry and biophysics, currently enjoys his clinical work and teaching residents at an academic medical center, and provides PET/CT image analysis for oncology clinical trials.

Lance T Hall, MD, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA

Lance T. HallDr. Lance T. Hall is a Nuclear Medicine and Molecular Imaging physician. He has extensive clinical and research experience in molecular imaging of central nervous system disease processes and is the principle investigator of first-in-human and first-in-child clinical trials evaluating novel molecular imaging agents in brain tumors.