Investigation of Cerebral O-(2-[18F]Fluoroethyl)-L-Tyrosine Uptake in Rat Epilepsy Models

Purpose A recent study reported on high, longer lasting and finally reversible cerebral uptake of O-(2-[F-18]fluoroethyl)-L-tyrosine ([F-18]FET) induced by epileptic activity. Therefore, we examined cerebral [F-18]FET uptake in two chemically induced rat epilepsy models and in patients with focal epilepsy to further investigate whether this phenomenon represents a major pitfall in brain tumor diagnostics and whether [F-18]FET may be a potential marker to localize epileptic foci. Procedures Five rats underwent kainic acid titration to exhibit 3 to 3.5 h of class IV-V motor seizures (status epilepticus, SE). Rats underwent 4x [F-18]FET PET and 4x MRI on the following 25 days. Six rats underwent kindling with pentylenetetrazol (PTZ) 3 to 8x/week over 10 weeks, and hence, seizures increased from class I to class IV. [F-18]FET PET and MRI were performed regularly on days with and without seizures. Four rats served as healthy controls. Additionally, five patients with focal epilepsy underwent [F-18]FET PET within 12 days after the last documented seizure. Results No abnormalities in [F-18]FET PET or MRI were detected in the kindling model. The SE model showed significantly decreased [F-18]FET uptake 3 days after SE in all examined brain regions, and especially in the amygdala region, which normalized within 2 weeks. Corresponding signal alterations in T-2-weighted MRI were noted in the amygdala and hippocampus, which recovered 24 days post-SE. No abnormality of cerebral [F-18]FET uptake was noted in the epilepsy patients. Conclusions There was no evidence for increased cerebral [F-18]FET uptake after epileptic seizures neither in the rat models nor in patients. The SE model even showed decreased [F-18]FET uptake throughout the brain. We conclude that epileptic seizures per se do not cause a longer lasting increased [F-18]FET accumulation and are unlikely to be a major cause of pitfall for brain tumor diagnostics.