Diagnosis of Gliomas and Current Use of Positron Emission Tomography (PET) Tracers

Yıl 2025, Cilt: 34 Sayı: 4, 305 - 314, 24.12.2025

Uğur Akça , Berna Özdem , İbrahim Tekedereli

https://doi.org/10.17827/aktd.1701145

https://izlik.org/JA56LD84KC

Öz

Gliomas are among the most common and complex tumors of the central nervous system, presenting significant challenges in diagnosis and treatment. Conventional imaging modalities often fail to fully capture the heterogeneous nature of glioma biology. Anatomical imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) play a crucial role in determining tumor location and size but have limitations in assessing functional and metabolic processes. Positron emission tomography (PET), particularly with amino acid-based tracers, enables a more precise evaluation of glioma biology, improving diagnostic accuracy. Traditional FDG-PET is limited by the high glucose metabolism of normal brain tissue, which has led to the development of alternative tracers for glioma detection and monitoring. In this context, tracers targeting system L amino acid transporters such as ¹¹C-MET, ¹⁸F-FET and ¹⁸F-DOPA, along with system A amino acid transporter-based agents, provide significant contributions to diagnostic and therapeutic processes by enhancing tumor-to-brain contrast ratios. This review addresses the current challenges in glioma diagnosis and treatment while providing a comprehensive evaluation of the latest advancements in PET tracer applications. In the future, integrating these imaging techniques with molecular and genetic biomarkers is expected to facilitate the development of personalized and more effective strategies for glioma management.

Anahtar Kelimeler

Amino Acid-Based Tracer , FDG-PET , Glioma , PET , Pseudoprogression

Gliomaların Tanısı ve Pozitron Emisyon Tomografisi (PET) İzleyicilerin (Tracer'larının) Güncel Kullanımı

https://izlik.org/JA56LD84KC

Öz

Gliomalar, merkezi sinir sisteminin en yaygın ve karmaşık tümörleri arasında yer almakta olup, tanı ve tedavi süreçlerinde önemli zorluklar sunmaktadır. Konvansiyonel görüntüleme yöntemleri, glioma biyolojisinin heterojen yapısını tam olarak yansıtmakta yetersiz kalabilmektedir. Manyetik rezonans görüntüleme (MRI) ve bilgisayarlı tomografi (CT) gibi anatomik görüntüleme teknikleri, tümör yerleşimini ve büyüklüğünü belirlemede kritik rol oynarken, fonksiyonel ve metabolik süreçleri anlamada sınırlamalar içermektedir. Pozitron emisyon tomografisi (PET), özellikle amino asit bazlı izleyicilerle glioma biyolojisinin daha hassas bir şekilde değerlendirilmesini sağlayarak, tanı doğruluğunu artırmaktadır. Geleneksel FDG-PET ’in normal beyin dokusundaki yüksek glukoz metabolizması nedeniyle sınırlı kontrast sunması, gliomaların tespiti ve takibinde alternatif izleyicilerin geliştirilmesini teşvik etmiştir. Bu bağlamda, ¹¹C-MET, ¹⁸F-FET ve ¹⁸F-DOPA gibi sistem L amino asit taşıyıcılarını hedefleyen izleyiciler ile sistem A amino asit taşıyıcı bazlı ajanlar, tümör-beyin kontrast oranlarını artırarak tanı ve tedavi süreçlerine önemli katkılar sağlamaktadır. Bu derleme, gliomaların tanı ve tedavisinde mevcut zorlukları ele almakta ve PET izleyicilerinin klinik kullanımına yönelik güncel gelişmeleri kapsamlı bir şekilde değerlendirmektedir. Gelecekte, moleküler ve genetik biyobelirteçlerle entegre edilen bu tekniklerin, glioma yönetiminde kişiselleştirilmiş ve daha etkili stratejilerin geliştirilmesine olanak sağlayacağı öngörülmektedir.

Anahtar Kelimeler

Amino Asit Bazlı Tracer , FDG-PET , Glioma , PET , Psödoprogresyon

Kaynakça

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