====== Positron emission tomography for intracranial metastases ======

Anatomic imaging modalities including standard MRI have limitations in accurately characterizing post-therapeutic reactive changes and treatment response. Molecular imaging techniques such as [[positron emission tomography]] ([[PET]]) characterize specific metabolic and cellular features of [[metastases]], potentially providing clinically relevant information supplementing anatomic MRI. The [[RANO]] working group provides recommendations for the use of PET imaging in the clinical management of patients with BM based on evidence from studies validated by histology and/or clinical outcome
((Galldiks N, Langen KJ, Albert NL, Chamberlain M, Soffietti R, Kim MM, Law I,
Le Rhun E, Chang S, Schwarting J, Combs SE, Preusser M, Forsyth P, Pope W, Weller
M, Tonn JC. PET Imaging in Patients with Brain Metastasis - Report of the
RANO/PET Group. Neuro Oncol. 2019 Jan 5. doi: 10.1093/neuonc/noz003. [Epub ahead 
of print] PubMed PMID: 30615138.
)).
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The use of [[PET]] with radiolabeled [[amino acid]]s, in particular, has been validated as an important diagnostic tool in brain cancer
((Langen KJ, Galldiks N, Hattingen E, Shah NJ. Advances in neuro-oncology imaging.
Nat Rev Neurol. 2017; 13(5):279-289)). 
((Albert NL, Weller M, 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(9):1199-1208.))
((Galldiks N, Albert NL, Sommerauer M, et al. PET imaging in patients with
meningioma-report of the RANO/PET Group. Neuro Oncol. 2017; 19(12):1576-1587.))
((Langen KJ, Watts C. Neuro-oncology: Amino acid PET for brain tumours - ready for
the clinic? Nat Rev Neurol. 2016; 12(7):375-376.)).

The overexpression of [[LAT1]] transports in BM make intracranial metastases a compelling target for amino acid PET imaging
((Papin-Michault C, Bonnetaud C, Dufour M, et al. Study of LAT1 Expression in Brain
Metastases: Towards a Better Understanding of the Results of Positron Emission
Tomography Using Amino Acid Tracers. PloS one. 2016; 11(6):e0157139.)).
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Fink in 2013 stated that [[nuclear medicine]] studies including [[FDG PET]] and other molecular imaging may play a larger role in the future.
((Fink KR, Fink JR. Imaging of brain metastases. Surg Neurol Int. 2013 May
2;4(Suppl 4):S209-19. doi: 10.4103/2152-7806.111298. Print 2013. PubMed PMID:
23717792; PubMed Central PMCID: PMC3656556.
)).

===== References =====