diagnosis of brain tumors using amino acid transport pet imaging with 18f-fluciclovine: a comparison study with l-methyl-11c-methionine pet imaging

Objective(s): 18f-fluciclovine (trans-1-amino-3-[18f] fluorocyclobutanecarboxylic acid, [facbc]) is an artificial amino acid radiotracer used for positron emission tomography (pet) studies, which is metabolically stable in vivo and has a long halflife. it has already been shown that facbc-pet is useful for glioma imaging. however, there have been no reports evaluating the efficiency of facbc-pet in the diagnosis of brain tumors in comparison with other pet tracers in clinical studies. the purpose of this study was to investigate the efficacy of facbc-pet imaging in glioma diagnosis, compared to l-methyl-11c-methionine (met)-pet. methods: six consecutive patients (four male, two female), who were clinically suspected of having high- or low-grade glioma, received both facbc-pet and metpet within a two-week interval. t1-weighted, contrast-enhanced, t1-weighted, and fluid-attenuated inversion recovery magnetic resonance imaging was performed to assist with subsequent tissue resection. visual findings and semi-quantitative analyses of facbc and met uptake, using standardized uptake values (suvs) and lesion-to-contralateral normal brain tissue (ln) ratios, were evaluated to compare pet images. results: suvs for facbc were lower than those for met in the non-lesion cerebral cortex, brain stem, and cerebellar hemisphere. there was a weak positive correlation between facbc and met uptake in glioma tissue, although l/n ratios for facbc were higher than those for met in all the cases. conclusion: facbc-pet showed higher contrast than met-pet by both visual and semi-quantitative analyses and may therefore provide better assessment for the detection of glioma. this study was registered as clinical trial (no. japiccti-132289).