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Zinsz A, Ahrari S, Becker J, Mortada A, Roch V, Doriat L, Santi M, Blonski M, Taillandier L, Zaragori T, Verger A. Amino-acid PET as a prognostic tool after post Stupp protocol temozolomide therapy in high-grade glioma patients. J Neurooncol 2024:10.1007/s11060-024-04722-2. [PMID: 38842696 DOI: 10.1007/s11060-024-04722-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE This study aimed to evaluate the prognostic performance of amino-acid PET in high-grade gliomas (HGG) patients at the time of temozolomide (TMZ) treatment discontinuation, after the Stupp protocol. METHODS The analysis included consecutive HGG patients with dynamic [18F]FDOPA PET imaging within 3 months of the end of TMZ therapy, post-Stupp protocol. Static and dynamic PET parameters, responses to RANO criteria for MRI and clinical and histo-molecular factors were correlated to progression-free (PFS). RESULTS Thirty-two patients (59.4 [54.0;67.6] years old, 13 (41%) women) were included. Static PET parameters peak tumor-to-background ratio and metabolic tumor volume (respective thresholds of 1.9 and 1.5 mL) showed the best 84% accuracies for predicting PFS at 6 months (p = 0.02). These static PET parameters were also independent predictor of PFS in multivariate analysis (p ≤ 0.05). CONCLUSION In HGG patients having undergone a Stupp protocol, the absence of significant PET uptake after TMZ constitutes a favorable prognostic factor.
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Affiliation(s)
- Adeline Zinsz
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, 54000, Nancy, France
| | - Shamimeh Ahrari
- Université de Lorraine, IADI, INSERM U1254, F-54000, Nancy, France
| | - Jason Becker
- Department of Neuro-Oncology, Université de Lorraine, CHRU Nancy, 54000, Nancy, France
| | - Ali Mortada
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, 54000, Nancy, France
| | - Veronique Roch
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, 54000, Nancy, France
| | - Louis Doriat
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, 54000, Nancy, France
| | - Matthieu Santi
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, 54000, Nancy, France
| | - Marie Blonski
- Department of Neuro-Oncology, Université de Lorraine, CHRU Nancy, 54000, Nancy, France
| | - Luc Taillandier
- Department of Neuro-Oncology, Université de Lorraine, CHRU Nancy, 54000, Nancy, France
| | - Timothée Zaragori
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, 54000, Nancy, France
| | - Antoine Verger
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, 54000, Nancy, France.
- Université de Lorraine, IADI, INSERM U1254, F-54000, Nancy, France.
- Nuclear Medicine Department, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre Les Nancy, France.
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Wu X, Chen W, Deng H, Wang L, Nicewicz DA, Li Z, Wu Z. Manufacturing 6-[ 18F]Fluoro- L-DOPA via Flow Chemistry-Enhanced Photoredox Radiofluorination. Org Lett 2024; 26:4308-4313. [PMID: 38728659 DOI: 10.1021/acs.orglett.4c01114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
In this study, we introduce a practical methodology for the synthesis of PET probes by seamlessly combining flow chemistry with photoredox radiofluorination. The clinical PET tracer 6-[18F]FDOPA was smoothly prepared in a 24.3% non-decay-corrected yield with over 99.0% radiochemical purity (RCP) and enantiomeric excess (ee), notably by a simple cartridge-based purification. The flow chemistry-enhanced photolabeling method supplies an efficient and versatile solution for the synthesis of 6-[18F]FDOPA and for more PET tracer development.
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Affiliation(s)
- Xuedan Wu
- Biomedical Research Imaging Center, Department of Radiology, and UNC Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, 125 Mason Farm Road, Marsico Hall, Chapel Hill, North Carolina 27599, United States
- LED Radiofluidics Corp., 250 Bell Tower Drive, Genome Science Building, Chapel Hill, North Carolina 27599, United States
| | - Wei Chen
- Biomedical Research Imaging Center, Department of Radiology, and UNC Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, 125 Mason Farm Road, Marsico Hall, Chapel Hill, North Carolina 27599, United States
| | - Huaifu Deng
- Biomedical Research Imaging Center, Department of Radiology, and UNC Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, 125 Mason Farm Road, Marsico Hall, Chapel Hill, North Carolina 27599, United States
| | - Li Wang
- Biomedical Research Imaging Center, Department of Radiology, and UNC Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, 125 Mason Farm Road, Marsico Hall, Chapel Hill, North Carolina 27599, United States
| | - David A Nicewicz
- Department of Chemistry, University of North Carolina-Chapel Hill, 125 South Road, Chapel Hill, North Carolina 27514, United States
| | - Zibo Li
- Biomedical Research Imaging Center, Department of Radiology, and UNC Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, 125 Mason Farm Road, Marsico Hall, Chapel Hill, North Carolina 27599, United States
| | - Zhanhong Wu
- Biomedical Research Imaging Center, Department of Radiology, and UNC Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, 125 Mason Farm Road, Marsico Hall, Chapel Hill, North Carolina 27599, United States
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Li Z, Chen J, Kong Z, Shi Y, Xu M, Mu BS, Li N, Ma W, Yang Z, Wang Y, Liu Z. A bis-boron boramino acid PET tracer for brain tumor diagnosis. Eur J Nucl Med Mol Imaging 2024; 51:1703-1712. [PMID: 38191817 DOI: 10.1007/s00259-024-06600-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/01/2024] [Indexed: 01/10/2024]
Abstract
PURPOSE Boramino acids are a class of amino acid biomimics that replace the carboxylate group with trifluoroborate and can achieve the 18F-labeled positron emission tomography (PET) and boron neutron capture therapy (BNCT) with identical chemical structure. METHODS This study reports a trifluoroborate-derived boronophenylalanine (BBPA), a derived boronophenylalanine (BPA) for BNCT, as a promising PET tracer for tumor imaging. RESULTS Competition inhibition assays in cancer cells suggested the cell accumulation of [18F]BBPA is through large neutral amino acid transporter type-1 (LAT-1). Of note, [18F]BBPA is a pan-cancer probe that shows notable tumor uptake in B16-F10 tumor-bearing mice. In the patients with gliomas and metastatic brain tumors, [18F]BBPA-PET shows good tumor uptake and notable tumor-to-normal brain ratio (T/N ratio, 18.7 ± 5.5, n = 11), higher than common amino acid PET tracers. The [18F]BBPA-PET quantitative parameters exhibited no difference in diverse contrast-enhanced status (P = 0.115-0.687) suggesting the [18F]BBPA uptake was independent from MRI contrast-enhancement. CONCLUSION This study outlines a clinical trial with [18F]BBPA to achieve higher tumor-specific accumulation for PET, provides a potential technique for brain tumor diagnosis, and might facilitate the BNCT of brain tumors.
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Affiliation(s)
- Zhu Li
- Key Laboratory of Carcinogenesis and Translational Research, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Junyi Chen
- Beijing National Laboratory for Molecular Sciences, Radiochemistry and Radiation Chemistry Key Laboratory of Fundamental Science, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, College of Chemistry and Molecular Engineering, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals, Peking University, Beijing, China
| | - Ziren Kong
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Head and Neck Surgery, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yixin Shi
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mengxin Xu
- Beijing National Laboratory for Molecular Sciences, Radiochemistry and Radiation Chemistry Key Laboratory of Fundamental Science, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, College of Chemistry and Molecular Engineering, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals, Peking University, Beijing, China
| | - Bo-Shuai Mu
- Beijing National Laboratory for Molecular Sciences, Radiochemistry and Radiation Chemistry Key Laboratory of Fundamental Science, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, College of Chemistry and Molecular Engineering, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals, Peking University, Beijing, China
| | - Nan Li
- Key Laboratory of Carcinogenesis and Translational Research, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhi Yang
- Key Laboratory of Carcinogenesis and Translational Research, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Zhibo Liu
- Key Laboratory of Carcinogenesis and Translational Research, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China.
- Beijing National Laboratory for Molecular Sciences, Radiochemistry and Radiation Chemistry Key Laboratory of Fundamental Science, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, College of Chemistry and Molecular Engineering, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals, Peking University, Beijing, China.
- Peking University-Tsinghua University Center for Life Sciences, Beijing, China.
- Changping Laboratory, Beijing, China.
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Yu P, Wang Y, Su F, Chen Y. Comparing [18F]FET PET and [18F]FDOPA PET for glioma recurrence diagnosis: a systematic review and meta-analysis. Front Oncol 2024; 13:1346951. [PMID: 38269019 PMCID: PMC10805829 DOI: 10.3389/fonc.2023.1346951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024] Open
Abstract
Purpose The purpose of our meta-analysis and systematic review was to evaluate and compare the diagnostic effectiveness of [18F]FET PET and [18F]FDOPA PET in detecting glioma recurrence. Methods Sensitivities and specificities were assessed using the DerSimonian and Laird methodology, and subsequently transformed using the Freeman-Tukey double inverse sine transformation. Confidence intervals were computed employing the Jackson method, while heterogeneity within and between groups was evaluated through the Cochrane Q and I² statistics. If substantial heterogeneity among the studies was observed (P < 0.10 or I² > 50%), we conducted meta-regression and sensitivity analyses. Publication bias was assessed through the test of a funnel plot and the application of Egger's test. For all statistical tests, except for assessing heterogeneity (P < 0.10), statistical significance was determined when the two-tailed P value fell below 0.05. Results Initially, 579 publications were identified, and ultimately, 22 studies, involving 1514 patients(1226 patients for [18F]FET PET and 288 patients for [18F]FDOPA PET), were included in the analysis. The sensitivity and specificity of [18F]FET PET were 0.84 (95% CI, 0.75-0.90) and 0.86 (95% CI, 0.80-0.91), respectively, while for [18F]FDOPA PET, the values were 0.95 (95% CI, 0.86-1.00) for sensitivity and 0.90 (95% CI, 0.77-0.98) for specificity. A statistically significant difference in sensitivity existed between these two radiotracers (P=0.04), while no significant difference was observed in specificity (P=0.58). Conclusion It seems that [18F]FDOPA PET demonstrates superior sensitivity and similar specificity to [18F] FET PET. Nevertheless, it's crucial to emphasize that [18F]FDOPA PET results were obtained from studies with limited sample sizes. Further larger prospective studies, especially head-to-head comparisons, are needed in this issue. Systematic Review Registration identifier CRD42023463476.
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Affiliation(s)
| | | | | | - Yan Chen
- Department of Neurosurgery, The Second Hospital of Jilin University, Changchun, China
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Chen Q, Wang K, Ren X, Zhao X, Chen Q, Fan D, Zhang S, Li X, Ai L. Individualized discrimination of tumor progression from treatment-related changes in different types of adult-type diffuse gliomas using [ 11C]methionine PET. J Neurooncol 2023; 165:547-559. [PMID: 38095773 DOI: 10.1007/s11060-023-04529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE This study aimed to assess the ability of [11C]methionine (MET) PET in distinguishing between tumor progression (TP) and treatment-related changes (TRCs) among different types of adult-type diffuse gliomas according to the 2021 World Health Organization classification and predict overall survival (OS). METHODS We retrospectively selected 113 patients with adult-type diffuse gliomas with suspected TP who underwent MET PET imaging. Maximum and mean tumor-to-background ratios (TBRmax, TBRmean) and metabolic tumor volume (MTV) were calculated. Diagnoses were verified by histopathology (n = 50) or by clinical/radiological follow-up (n = 63). The diagnostic performance of MET PET parameters was evaluated through receiver operating characteristic (ROC) analysis and area under the curve (AUC) calculation. Survival analysis employed the Kaplan-Meier method and Cox proportional-hazards regression. RESULTS TP and TRCs were diagnosed in 76 (67%) and 37 (33%) patients, respectively. ROC analysis revealed TBRmax had the best performance in differentiating TP from TRCs with a cut-off of 1.96 in IDH-mutant astrocytoma (AUC, 0.87; sensitivity, 93%; specificity 69%), 1.80 in IDH-mutant and 1p/19q-codeleted oligodendroglioma (AUC, 0.96; sensitivity, 100%; specificity, 89%), and 2.13 in IDH wild-type glioblastoma (AUC, 0.89; sensitivity, 89%; specificity, 78%), respectively. On multivariate analysis, higher TBRmean and MTV were significantly correlated with shorter OS in all IDH-mutant gliomas, as well as in IDH-mutant astrocytoma subgroup. CONCLUSION This work confirms that MET PET has varying diagnostic performances in distinguishing TP from TRCs within three types of adult-type diffuse gliomas, and highlights its high diagnostic accuracy in IDH-mutant and 1p/19q-codeleted oligodendroglioma and potential prognostic value for IDH-mutant gliomas, particularly IDH-mutant astrocytoma.
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Affiliation(s)
- Qiang Chen
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119 West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Kai Wang
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119 West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Xiaohui Ren
- Department of Neurosurgical Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Xiaobin Zhao
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119 West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Qian Chen
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119 West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Di Fan
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119 West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Shu Zhang
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119 West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Xiaotong Li
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119 West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Lin Ai
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119 West Road of South 4th Ring, Fengtai District, Beijing, China.
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Darcourt J, Chardin D, Bourg V, Gal J, Schiappa R, Blonski M, Koulibaly PM, Almairac F, Mondot L, Le Jeune F, Collombier L, Kas A, Taillandier L, Verger A. Added value of [ 18F]FDOPA PET to the management of high-grade glioma patients after their initial treatment: a prospective multicentre study. Eur J Nucl Med Mol Imaging 2023; 50:2727-2735. [PMID: 37086272 DOI: 10.1007/s00259-023-06225-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/04/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Diagnostic value of 3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine ([18F]FDOPA) PET in patients with suspected recurrent gliomas is recognised. We conducted a multicentre prospective study to assess its added value in the practical management of patients suspected of recurrence of high grade gliomas (HGG). METHODS Patients with a proven HGG (WHO grade III and IV) were referred to the multidisciplinary neuro-oncology board (MNOB) during their follow-up after initial standard of care treatment and when MRI findings were not fully conclusive. Each case was discussed in 2 steps. For step 1, a diagnosis and a management proposal were made only based on the clinical and the MRI data. For step 2, the same process was repeated taking the [18F]FDOPA PET results into consideration. A level of confidence for the decisions was assigned to each step. Changes in diagnosis and management induced by [18F]FDOPA PET information were measured. When unchanged, the difference in the confidence of the decisions were assessed. The diagnostic performances of each step were measured. RESULTS 107 patients underwent a total of 138 MNOB assessments. The proposed diagnosis changed between step 1 and step 2 in 37 cases (26.8%) and the proposed management changed in 31 cases (22.5%). When the management did not change, the confidence in the MNOB final decision was increased in 87 cases (81.3%). Step 1 had a sensitivity, specificity and accuracy of 83%, 58% and 66% and step 2, 86%, 64% and 71% respectively. CONCLUSION [18F]FDOPA PET adds significant information for the follow-up of HGG patients in clinical practice. When MRI findings are not straightforward, it can change the management for more than 20% of the patients and increases the confidence level of the multidisciplinary board decisions.
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Affiliation(s)
- Jacques Darcourt
- Department of Nuclear Medicine, Centre Antoine Lacassagne and UMR 4320 CEA-UCA, Université Côte d'Azur, Nice, France.
| | - David Chardin
- Department of Nuclear Medicine, Centre Antoine Lacassagne and UMR 4320 CEA-UCA, Université Côte d'Azur, Nice, France
| | - Véronique Bourg
- Department of Neurology, CHU, Nice, Université Cote d'Azur, Nice, France
| | - Jocelyn Gal
- Epidemiology and Biostatistics Department, Centre Antoine Lacassagne and Université Côte d'Azur, Nice, France
| | - Renaud Schiappa
- Epidemiology and Biostatistics Department, Centre Antoine Lacassagne and Université Côte d'Azur, Nice, France
| | - Marie Blonski
- Department of Neuro-Oncology, CHU, Nancy and CNRS, UMR 7039, Université de Lorraine, Nancy, France
| | - Pierre-Malick Koulibaly
- Department of Nuclear Medicine, Centre Antoine Lacassagne and UMR 4320 CEA-UCA, Université Côte d'Azur, Nice, France
| | - Fabien Almairac
- Department of Neurosurgery, CHU Nice and UR2CA Team PIN, Université Côte d'Azur, Nice, France
| | - Lydiane Mondot
- Department of Radiology, CHU Nice, Université Côte d'Azur, Nice, France
| | - Florence Le Jeune
- Department of Nuclear Medicine, Centre Eugène Marquis, Rennes and LTSI INSERM 1099, Université de Rennes 1, Rennes, France
| | - Laurent Collombier
- Department of Nuclear Medicine, CHU Nîmes, Université de Montpellier, Nîmes, France
| | - Aurélie Kas
- Department of Nuclear Medicine, AP-HP Hôpitaux Universitaires Pitié-Salpétrière Charles Foix and LIB INSERM U1146, Sorbonne University, Paris, France
| | - Luc Taillandier
- Department of Neuro-Oncology, CHU, Nancy and CNRS, UMR 7039, Université de Lorraine, Nancy, France
| | - Antoine Verger
- Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHU Nancy and IADI INSERM UMR 1254, Université de Lorraine, Nancy, France
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Galldiks N, Lohmann P, Fink GR, Langen KJ. Amino Acid PET in Neurooncology. J Nucl Med 2023; 64:693-700. [PMID: 37055222 DOI: 10.2967/jnumed.122.264859] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/10/2023] [Indexed: 04/15/2023] Open
Abstract
For decades, several amino acid PET tracers have been used to optimize diagnostics in patients with brain tumors. In clinical routine, the most important clinical indications for amino acid PET in brain tumor patients are differentiation of neoplasm from nonneoplastic etiologies, delineation of tumor extent for further diagnostic and treatment planning (i.e., diagnostic biopsy, resection, or radiotherapy), differentiation of treatment-related changes such as pseudoprogression or radiation necrosis after radiation or chemoradiation from tumor progression at follow-up, and assessment of response to anticancer therapy, including prediction of patient outcome. This continuing education article addresses the diagnostic value of amino acid PET for patients with either glioblastoma or metastatic brain cancer.
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Affiliation(s)
- Norbert Galldiks
- Department of Neurology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany;
- Institute of Neuroscience and Medicine, Research Center Juelich, Juelich, Germany
- Center for Integrated Oncology, Universities of Aachen, Bonn, Cologne, and Duesseldorf, Germany; and
| | - Philipp Lohmann
- Institute of Neuroscience and Medicine, Research Center Juelich, Juelich, Germany
| | - Gereon R Fink
- Department of Neurology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine, Research Center Juelich, Juelich, Germany
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine, Research Center Juelich, Juelich, Germany
- Center for Integrated Oncology, Universities of Aachen, Bonn, Cologne, and Duesseldorf, Germany; and
- Department of Nuclear Medicine, RWTH University Hospital Aachen, Aachen, Germany
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Horowitz T, Tabouret E, Graillon T, Salgues B, Chinot O, Verger A, Guedj E. Contribution of nuclear medicine to the diagnosis and management of primary brain tumours. Rev Neurol (Paris) 2023; 179:394-404. [PMID: 36934021 DOI: 10.1016/j.neurol.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
Positron emission tomography (PET) is a powerful tool that can help physicians manage primary brain tumours at diagnosis and follow-up. In this context, PET imaging is used with three main types of radiotracers: 18F-FDG, amino acid radiotracers, and 68Ga conjugated to somatostatin receptor ligands (SSTRs). At initial diagnosis, 18F-FDG helps to characterize primary central nervous system (PCNS) lymphomas and high-grade gliomas, amino acid radiotracers are indicated for gliomas, and SSTR PET ligands are indicated for meningiomas. Such radiotracers provide information on tumour grade or type, assist in directing biopsies and help with treatment planning. During follow-up, in the presence of symptoms and/or MRI modifications, the differential diagnosis between tumour recurrence and post-therapeutic changes, in particular radiation necrosis, may be challenging, and there is strong interest in using PET to evaluate therapeutic toxicity. PET may also contribute to identifying specific complications, such as postradiation therapy encephalopathy, encephalitis associated with PCNS lymphoma, and stroke-like migraine after radiation therapy (SMART) syndrome associated with glioma recurrence and temporal epilepsy, originally illustrated in this review. This review summarizes the main contribution of PET to the diagnosis, management, and follow-up of brain tumours, specifically gliomas, meningiomas, and primary central nervous system lymphomas.
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Affiliation(s)
- T Horowitz
- CNRS, CERIMED, nuclear medicine department, Centrale Marseille, Institut Fresnel, Timone hospital, Aix-Marseille university, AP-HM, Marseille, France
| | - E Tabouret
- Neuro-oncology department, Timone hospital, AP-HM, Marseille, France; Team 8 GlioME, CNRS 7051, Inst. neurophysiopathol, Aix-Marseille university, Marseille, France
| | - T Graillon
- Inserm, MMG, neurosurgery department, Timone hospital, Aix-Marseille university, AP-HM, Marseille, France
| | - B Salgues
- CNRS, CERIMED, nuclear medicine department, Centrale Marseille, Institut Fresnel, Timone hospital, Aix-Marseille university, AP-HM, Marseille, France
| | - O Chinot
- Neuro-oncology department, Timone hospital, AP-HM, Marseille, France
| | - A Verger
- IADI, Inserm, UMR 1254, department of nuclear medicine & nancyclotep imaging platform, université de Lorraine, CHRU-Nancy, Nancy, France
| | - E Guedj
- CNRS, CERIMED, nuclear medicine department, Centrale Marseille, Institut Fresnel, Timone hospital, Aix-Marseille university, AP-HM, Marseille, France.
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