Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0

Antoine Verger; Nelleke Tolboom; Francesco Cicone; Susan M Chang; Julia Furtner; Norbert Galldiks; Jens Gempt; Eric Guedj; Raymond Y Huang; Derek R Johnson; Ian Law; Emilie Le Rhun; Susan C Short; M J Van den Bent; Donatienne Van Weehaeghe; Michael A Vogelbaum; Patrick Y Wen; Nathalie L Albert; Matthias Preusser

doi:10.1007/s00259-024-07038-5

Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0

Eur J Nucl Med Mol Imaging. 2025 Jan 7. doi: 10.1007/s00259-024-07038-5. Online ahead of print.

Authors

Antoine Verger¹, Nelleke Tolboom², Francesco Cicone³, Susan M Chang⁴, Julia Furtner⁵, Norbert Galldiks⁶, Jens Gempt⁷, Eric Guedj⁸, Raymond Y Huang⁹, Derek R Johnson¹⁰, Ian Law¹¹, Emilie Le Rhun¹², Susan C Short¹³, M J Van den Bent¹⁴, Donatienne Van Weehaeghe¹⁵, Michael A Vogelbaum¹⁶, Patrick Y Wen¹⁷, Nathalie L Albert¹⁸, Matthias Preusser¹⁹

Affiliations

¹ Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy and IADI INSERM, UMR 1254, Université de Lorraine, Nancy, France. [email protected].
² Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
³ Nuclear Medicine Unit, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
⁴ Division of NeuroOncology, Department of Neurological Surgery, University of California San Francisco (UCSF), San Francisco, CA, USA.
⁵ Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Faculty of Medicine and Dentistry, Danube Private University, Krems, 3500, Austria.
⁶ Department of Neurology, Medical Faculty and University Hospital of Cologne, Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, University of Cologne, Juelich, Germany.
⁷ Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁸ Département de Médecine Nucléaire, Hôpital de la Timone, CERIMED, Institut Fresnel, Aix Marseille University, APHM, CNRS, Centrale Marseille, Marseille, France.
⁹ Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
¹⁰ Department of Radiology, Mayo Clinic, Rochester, MN, USA.
¹¹ Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark.
¹² Departments of Neurosurgery and Neurology, University Hospital Zurich, Zurich, Switzerland.
¹³ Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
¹⁴ Department of Neurology, Brain Tumor Center at Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands.
¹⁵ Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, Ghent, 9000, Belgium.
¹⁶ Department of NeuroOncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
¹⁷ Center For Neuro-Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA.
¹⁸ Department of Nuclear Medicine, LMU Hospital, LMU Munich, Munich, Germany.
¹⁹ Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.

PMID: 39762634
DOI: 10.1007/s00259-024-07038-5

Abstract

This joint practice guideline/procedure standard was collaboratively developed by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neuro-Oncology (EANO), and the PET task force of the Response Assessment in Neurooncology Working Group (PET/RANO). Brain metastases are the most common malignant central nervous system (CNS) tumors. PET imaging with radiolabeled amino acids and to lesser extent [¹⁸F]FDG has gained considerable importance in the assessment of brain metastases, especially for the differential diagnosis between recurrent metastases and treatment-related changes which remains a limitation using conventional MRI. The aim of this guideline is to assist nuclear medicine physicians in recommending, performing, interpreting and reporting the results of brain PET imaging in patients with brain metastases. This practice guideline will define procedure standards for the application of PET imaging in patients with brain metastases in routine practice and clinical trials and will help to harmonize data acquisition and interpretation across centers.

Keywords: Brain metastases; Brain metastasis; FDG; FDOPA; FET; Fluciclovine; Metastatic brain tumors; Methionine; PET; Recurrence.