IMG-82. Positron emission tomography (PET) use among European Organisation for Research and Treatment of Cancer – Brain Tumour Group (EORTC-BTG) sites – a cross-sectional survey

BACKGROUND Positron emission tomography (PET) is increasingly used in patients with brain tumors, yet its adoption varies across institutions. METHODS To assess the current landscape, a cross-sectional survey was conducted among European Organization for Research and Treatment of Cancer (EORTC) – Brain Tumour Group (BTG) sites between June 2024 and August 2024. RESULTS Out of the 312 sites invited, 103 replies from 20 countries in the Europe/Middle East region were received. PET availability was reported by 96/103 (93.2%) sites, of whom 74 reported PET use in patients with brain tumors. Most frequently, PET was performed in glioma (69/74, 93.2%), followed by brain metastasis (58/74, 78.4%), meningioma (52/74, 70.3%), and CNS lymphoma (46/74, 62.2%). Amino acid PET was used at 62/71 centers (87.3%), mainly in glioma (58/59, 98.3%) and for differentiation of tumor progression from treatment-related changes (58/59, 98.3%), differential diagnosis (54/59, 91.5%), and hotspot delineation (47/59, 79.7%). Somatostatin receptor (SSTR) PET was performed at 50/68 sites (73.5%), predominantly in meningioma (48/49, 98.0%), and for patient selection before radioligand therapy (41/49, 83.7%) as well as for target volume definition in radiotherapy (33/49, 67.3%) and differential diagnosis (27/49, 55.1%). PET was covered by statutory health insurance at 46/59 (78.0%) centers for amino acid PET and 33/49 (67.3%) for SSTR PET according to self-reported information. Main reasons for not performing PET in clinical routine included limited availability of tracers (14/29, 48.3%), high cost (11/29, 37.9%), and PET considered unnecessary by referring physicians (8/29, 27.6%). CONCLUSION PET is widely used among EORTC-BTG sites, although implementation varies and is influenced by factors such as tracer availability, cost, and institutional perceptions. While further data from broader surveys including non-academic institutions is needed, the findings support the implementation of PET as clinical trial endpoint.