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Holy EN, Li E, Bhattarai A, Fletcher E, Alfaro ER, Harvey DJ, Spencer BA, Cherry SR, DeCarli CS, Fan AP. Non-invasive quantification of 18F-florbetaben with total-body EXPLORER PET. EJNMMI Res 2024; 14:39. [PMID: 38625413 PMCID: PMC11021392 DOI: 10.1186/s13550-024-01104-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/02/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Kinetic modeling of 18F-florbetaben provides important quantification of brain amyloid deposition in research and clinical settings but its use is limited by the requirement of arterial blood data for quantitative PET. The total-body EXPLORER PET scanner supports the dynamic acquisition of a full human body simultaneously and permits noninvasive image-derived input functions (IDIFs) as an alternative to arterial blood sampling. This study quantified brain amyloid burden with kinetic modeling, leveraging dynamic 18F-florbetaben PET in aorta IDIFs and the brain in an elderly cohort. METHODS 18F-florbetaben dynamic PET imaging was performed on the EXPLORER system with tracer injection (300 MBq) in 3 individuals with Alzheimer's disease (AD), 3 with mild cognitive impairment, and 9 healthy controls. Image-derived input functions were extracted from the descending aorta with manual regions of interest based on the first 30 s after injection. Dynamic time-activity curves (TACs) for 110 min were fitted to the two-tissue compartment model (2TCM) using population-based metabolite corrected IDIFs to calculate total and specific distribution volumes (VT, Vs) in key brain regions with early amyloid accumulation. Non-displaceable binding potential ([Formula: see text] was also calculated from the multi-reference tissue model (MRTM). RESULTS Amyloid-positive (AD) patients showed the highest VT and VS in anterior cingulate, posterior cingulate, and precuneus, consistent with [Formula: see text] analysis. [Formula: see text]and VT from kinetic models were correlated (r² = 0.46, P < 2[Formula: see text] with a stronger positive correlation observed in amyloid-positive participants, indicating reliable model fits with the IDIFs. VT from 2TCM was highly correlated ([Formula: see text]= 0.65, P < 2[Formula: see text]) with Logan graphical VT estimation. CONCLUSION Non-invasive quantification of amyloid binding from total-body 18F-florbetaben PET data is feasible using aorta IDIFs with high agreement between kinetic distribution volume parameters compared to [Formula: see text]in amyloid-positive and amyloid-negative older individuals.
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Affiliation(s)
- Emily Nicole Holy
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA.
- Department of Biomedical Engineering, UC Davis, Davis, USA.
| | - Elizabeth Li
- Department of Biomedical Engineering, UC Davis, Davis, USA
| | - Anjan Bhattarai
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
- Department of Biomedical Engineering, UC Davis, Davis, USA
| | - Evan Fletcher
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
| | - Evelyn R Alfaro
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
| | | | - Benjamin A Spencer
- Department of Biomedical Engineering, UC Davis, Davis, USA
- Department of Radiology, UC Davis Health, Davis, USA
| | - Simon R Cherry
- Department of Biomedical Engineering, UC Davis, Davis, USA
- Department of Radiology, UC Davis Health, Davis, USA
| | - Charles S DeCarli
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
| | - Audrey P Fan
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
- Department of Biomedical Engineering, UC Davis, Davis, USA
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Holy EN, Li E, Bhattarai A, Fletcher E, Alfaro ER, Harvey DJ, Spencer BA, Cherry SR, DeCarli CS, Fan AP. Non-invasive quantification of 18F-florbetaben with total-body EXPLORER PET. RESEARCH SQUARE 2023:rs.3.rs-3764930. [PMID: 38234716 PMCID: PMC10793501 DOI: 10.21203/rs.3.rs-3764930/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Purpose Kinetic modeling of 18F-florbetaben provides important quantification of brain amyloid deposition in research and clinical settings but its use is limited by the requirement of arterial blood data for quantitative PET. The total-body EXPLORER PET scanner supports the dynamic acquisition of a full human body simultaneously and permits noninvasive image-derived input functions (IDIFs) as an alternative to arterial blood sampling. This study quantified brain amyloid burden with kinetic modeling, leveraging dynamic 18F-florbetaben PET in aorta IDIFs and the brain in an elderly cohort. Methods 18F-florbetaben dynamic PET imaging was performed on the EXPLORER system with tracer injection (300 MBq) in 3 individuals with Alzheimer's disease (AD), 3 with mild cognitive impairment, and 9 healthy controls. Image-derived input functions were extracted from the descending aorta with manual regions of interest based on the first 30 seconds after injection. Dynamic time-activity curves (TACs) for 110 minutes were fitted to the two-tissue compartment model (2TCM) using population-based metabolite corrected IDIFs to calculate total and specific distribution volumes (VT, Vs) in key brain regions with early amyloid accumulation. Non-displaceable binding potential (BPND) was also calculated from the multi-reference tissue model (MRTM). Results Amyloid-positive (AD) patients showed the highest VT and VS in anterior cingulate, posterior cingulate, and precuneus, consistent with BPND analysis. BPND and VT from kinetic models were correlated (r2 = 0.46, P<2e-16) with a stronger positive correlation observed in amyloid-positive participants, indicating reliable model fits with the IDIFs. VT from 2TCM was highly correlated (r2 = 0.65, P< 2e-16) with Logan graphical VT estimation. Conclusion Non-invasive quantification of amyloid binding from total-body 18F-florbetaben PET data is feasible using aorta IDIFs with high agreement between kinetic distribution volume parameters compared to BPND in amyloid-positive and negative older individuals.
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Affiliation(s)
- Emily N Holy
- Department of Neurology, University of California (UC) Davis Health
- Department of Biomedical Engineering, UC Davis
| | | | - Anjan Bhattarai
- Department of Neurology, University of California (UC) Davis Health
- Department of Biomedical Engineering, UC Davis
| | - Evan Fletcher
- Department of Neurology, University of California (UC) Davis Health
| | - Evelyn R Alfaro
- Department of Neurology, University of California (UC) Davis Health
| | | | - Benjamin A Spencer
- Department of Biomedical Engineering, UC Davis
- Department of Radiology, UC Davis Health
| | - Simon R Cherry
- Department of Biomedical Engineering, UC Davis
- Department of Radiology, UC Davis Health
| | | | - Audrey P Fan
- Department of Neurology, University of California (UC) Davis Health
- Department of Biomedical Engineering, UC Davis
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Ouyang ZQ, Zheng GR, Duan XR, Zhang XR, Ke TF, Bao SS, Yang J, He B, Liao CD. Diagnostic accuracy of glioma pseudoprogression identification with positron emission tomography imaging: a systematic review and meta-analysis. Quant Imaging Med Surg 2023; 13:4943-4959. [PMID: 37581048 PMCID: PMC10423382 DOI: 10.21037/qims-22-1340] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/15/2023] [Indexed: 08/16/2023]
Abstract
Background Positron emission tomography (PET) imaging is a promising molecular neuroimaging technique and has been proposed as one of the criteria for glioma management. However, there is some controversy concerning the diagnostic accuracy of PET using different radiotracers to differentiate between glioma pseudoprogression (PsP) and true progression (TPR). The purpose of this meta-analysis was to systematically evaluate the methodological quality and clinical value of original studies for distinguishing PsP from TPR in glioma. Methods The Medline, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov were searched from inception until September 1, 2022. Retrieved clinical studies only investigated the PsP cases but did not include the cases of radiation necrosis or other treatment-related changes. Eligible studies were screened for data extraction and evaluated by 2 independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. A random effects model was used to describe summary receiver operating characteristics. Meta-regression and subgroup analyses were applied to identify any sources of heterogeneity. Results The meta-analysis included 20 studies, comprising 317 (30.9%) patients with PsP and 708 (69.1%) with TPR. The summary sensitivity and specificity of general PET for identifying PsP were 0.86 [95% confidence interval (CI): 0.77-0.91] and 0.84 (95% CI: 0.79-0.88), respectively. The statistical heterogeneity was explained by sample size, study design, World Health Organization (WHO) grade, gold standard, and radiotracer type. The summary sensitivity and specificity of O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET PET) were 0.80 (95% CI: 0.68-0.88) and 0.81 (95% CI: 0.75-0.85), respectively. The maximum tumor-to-brain ratio (TBRmax) and the mean tumor-to-brain ratio (TBRmean) both showed excellent diagnostic performance in 18F-FET studies, the summary sensitivity was 0.83 (95% CI: 0.72-0.91) and 0.79 (95% CI: 0.65-0.98), respectively, and the specificity was 0.76 (95% CI: 0.68-0.84) and 0.78 (95% CI: 0.64-0.88), respectively. Conclusions PET imaging is generally accurate in identifying glioma PsP. Considering the credibility of meta-evidence and the practicability of using radiotracer, 18F-FET PET holds the highest clinical value, while TBRmax and TBRmean should be regarded as reliable parameters. PET used with the radiotracers and multiple-parameter combinations of PET with magnetic resonance imaging (MRI) and radiomics analysis have broad research and application prospects, whose diagnostic values for identifying glioma PsP warrant further investigation.
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Affiliation(s)
- Zhi-Qiang Ouyang
- Department of Radiology, Yan’an Hospital of Kunming City (Yan’an Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Guang-Rong Zheng
- Department of Radiology, Yan’an Hospital of Kunming City (Yan’an Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Xi-Rui Duan
- Department of Radiology, Yunnan Cancer Hospital (the Third Affiliated Hospital of Kunming Medical University), Kunming, China
| | - Xue-Rong Zhang
- Department of Radiology, Yunnan Cancer Hospital (the Third Affiliated Hospital of Kunming Medical University), Kunming, China
| | - Teng-Fei Ke
- Department of Radiology, Yunnan Cancer Hospital (the Third Affiliated Hospital of Kunming Medical University), Kunming, China
| | - Sha-Sha Bao
- Department of Radiology, Yunnan Cancer Hospital (the Third Affiliated Hospital of Kunming Medical University), Kunming, China
| | - Jun Yang
- Department of Radiology, Yunnan Cancer Hospital (the Third Affiliated Hospital of Kunming Medical University), Kunming, China
| | - Bin He
- Department of Neurosurgery, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Cheng-De Liao
- Department of Radiology, Yan’an Hospital of Kunming City (Yan’an Hospital Affiliated to Kunming Medical University), Kunming, China
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Zhang-Yin JT, Girard A, Bertaux M. What Does PET Imaging Bring to Neuro-Oncology in 2022? A Review. Cancers (Basel) 2022; 14:cancers14040879. [PMID: 35205625 PMCID: PMC8870476 DOI: 10.3390/cancers14040879] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Positron emission tomography (PET) imaging is increasingly used to supplement MRI in the management of patient with brain tumors. In this article, we provide a review of the current place and perspectives of PET imaging for the diagnosis and follow-up of from primary brain tumors such as gliomas, meningiomas and central nervous system lymphomas, as well as brain metastases. Different PET radiotracers targeting different biological processes are used to accurately depict these brain tumors and provide unique metabolic and biologic information. Radiolabeled amino acids such as [18F]FDOPA or [18F]FET are used for imaging of gliomas while both [18F]FDG and amino acids can be used for brain metastases. Meningiomas can be seen with a high contrast using radiolabeled ligands of somatostatin receptors, which they usually carry. Unconventional tracers that allow the study of other biological processes such as cell proliferation, hypoxia, or neo-angiogenesis are currently being studied for brain tumors imaging. Abstract PET imaging is being increasingly used to supplement MRI in the clinical management of brain tumors. The main radiotracers implemented in clinical practice include [18F]FDG, radiolabeled amino acids ([11C]MET, [18F]FDOPA, [18F]FET) and [68Ga]Ga-DOTA-SSTR, targeting glucose metabolism, L-amino-acid transport and somatostatin receptors expression, respectively. This review aims at addressing the current place and perspectives of brain PET imaging for patients who suffer from primary or secondary brain tumors, at diagnosis and during follow-up. A special focus is given to the following: radiolabeled amino acids PET imaging for tumor characterization and follow-up in gliomas; the role of amino acid PET and [18F]FDG PET for detecting brain metastases recurrence; [68Ga]Ga-DOTA-SSTR PET for guiding treatment in meningioma and particularly before targeted radiotherapy.
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Affiliation(s)
| | - Antoine Girard
- Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, 35000 Rennes, France
| | - Marc Bertaux
- Department of Nuclear Medicine, Foch Hospital, 92150 Suresnes, France
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Girard A, François M, Chaboub N, Le Reste PJ, Devillers A, Saint-Jalmes H, Le Jeune F, Palard-Novello X. Impact of point-spread function reconstruction on dynamic and static 18F-DOPA PET/CT quantitative parameters in glioma. Quant Imaging Med Surg 2022; 12:1397-1404. [PMID: 35111633 DOI: 10.21037/qims-21-742] [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: 07/20/2021] [Accepted: 09/17/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Quantification of dynamic and static parameters extracted from 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine (18F-DOPA, FDOPA) positron emission tomography (PET)/computed tomography (CT) plays a critical role for glioma assessment. The objective of the present study was to investigate the impact of point-spread function (PSF) reconstruction on these quantitative parameters. METHODS Fourteen patients with untreated gliomas and investigated with FDOPA PET/CT were analyzed. The distribution of the 14 cases was as follows: 6 astrocytomas-isocitrate dehydrogenase-mutant; 2 oligodendrogliomas/1p19q-codeleted-isocitrate dehydrogenase-mutant; and 6 isocitrate dehydrogenase-wild-type glioblastomas. A 0-20-min dynamic images (8×15, 2×30, 2×60, and 3×300 s post-injection) and a 0-20-min static image were reconstructed with and without PSF. Tumoral volumes-of-interest were generated on all of the PET series and the background volumes-of-interest were generated on the 0-20-min static image with and without PSF. Static parameters (SUVmax and SUVmean) of the tumoral and the background volumes-of-interest and kinetic parameters (K1 and k2) of the tumoral volumes-of-interest extracted from using full kinetic analysis were provided. PSF and non-PSF quantitative parameters values were compared. RESULTS Thirty-three tumor volumes-of-interest and 14 background volumes-of-interest were analyzed. PSF images provided higher tumor SUVmax than non-PSF images for 23/33 VOIs [median SUVmax =3.0 (range, 1.4-10.2) with PSF vs. 2.7 (range, 1.4-9.1) without PSF; P<0.001] and higher tumor SUVmean for 13/33 volumes-of-interest [median SUVmean =2.0 (range, 0.8-7.6) with PSF vs. 2.0 (range, 0.8-7.4) without PSF; P=0.002]. K1 and k2 were significantly lower with PSF than without PSF [respectively median K1 =0.077 mL/ccm/min (range, 0.043-0.445 mL/ccm/min) with PSF vs. 0.101 mL/ccm/min (range, 0.055-0.578 mL/ccm/min) without PSF; P<0.001 and median k2 =0.070 min-1 (range, 0.025-0.146 min-1) with PSF vs. 0.081 min-1 (range, 0.027-0.180 min-1) without PSF; P<0.001]. Background SUVmax and SUVmean were statistically unaffected [respectively median SUVmax =1.7 (range, 1.3-2.0) with PSF vs. 1.7 (range, 1.3-1.9) without PSF; P=0.346 and median SUVmean =1.5 (range, 1.0-1.8) with PSF vs. 1.5 (range, 1.0-1.7) without PSF; P=0.371]. CONCLUSIONS The present study confirms that PSF significantly increases tumor activity concentrations measured on PET images. PSF algorithms for quantitative PET/CT analysis should be used with caution, especially for quantification of kinetic parameters.
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Affiliation(s)
- Antoine Girard
- Univ Rennes, CLCC Eugène Marquis, Noyau Gris Centraux EA 4712, Rennes, France
| | - Madani François
- Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI-UMR 1099, Rennes, France
| | - Nibras Chaboub
- Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI-UMR 1099, Rennes, France
| | | | - Anne Devillers
- Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI-UMR 1099, Rennes, France
| | | | - Florence Le Jeune
- Univ Rennes, CLCC Eugène Marquis, Noyau Gris Centraux EA 4712, Rennes, France
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Girard A, Le Reste PJ, Metais A, Carsin Nicol B, Chiforeanu DC, Bannier E, Campillo-Gimenez B, Devillers A, Palard-Novello X, Le Jeune F. Combining 18F-DOPA PET and MRI with perfusion-weighted imaging improves delineation of high-grade subregions in enhancing and non-enhancing gliomas prior treatment: a biopsy-controlled study. J Neurooncol 2021; 155:287-295. [PMID: 34686993 DOI: 10.1007/s11060-021-03873-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE We aimed to compare spatial extent of high-grade subregions detected with combined [18F]-dihydroxyphenylalanine (18F-DOPA) PET and MRI to the one provided by advanced multimodal MRI alone including Contrast-enhanced (CE) and Perfusion weighted imaging (PWI). Then, we compared the accuracy between imaging modalities, in a per biopsy analysis. METHODS Participants with suspected diffuse glioma were prospectively included between June 2018 and September 2019. Volumes of high-grade subregions were delineated respectively on 18F-DOPA PET and MRI (CE and PWI). Up to three per-surgical neuronavigation-guided biopsies were performed per patient. RESULTS Thirty-eight biopsy samples from sixteen participants were analyzed. Six participants (38%) had grade IV IDH wild-type glioblastoma, six (38%) had grade III IDH-mutated astrocytoma and four (24%) had grade II IDH-mutated gliomas. Three patients had intratumoral heterogeneity with coexisting high- and low-grade tumor subregions. High-grade volumes determined with combined 18F-DOPA PET/MRI (median of 1.7 [interquartile range (IQR) 0.0, 19.1] mL) were larger than with multimodal MRI alone (median 1.3 [IQR 0.0, 12.8] mL) with low overlap (median Dice's coefficient 0.24 [IQR 0.08, 0.59]). Delineation volumes were substantially increased in five (31%) patients. In a per biopsy analysis, combined 18F-DOPA PET/MRI detected high-grade subregions with an accuracy of 58% compared to 42% (p = 0.03) with CE MRI alone and 50% (p = 0.25) using multimodal MRI (CE + PWI). CONCLUSIONS The addition of 18F-DOPA PET to multimodal MRI (CE and PWI) enlarged the delineation volumes and enhanced overall accuracy for detection of high-grade subregions. Thus, combining 18F-DOPA with advanced MRI may improve treatment planning in newly diagnosed gliomas.
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Affiliation(s)
- Antoine Girard
- Department of Nuclear Medicine, Eugène Marquis Center, Avenue de la Bataille Flandres-Dunkerque, 35000, Rennes, France.
- Signal and Image Processing Laboratory (LTSI), INSERM-University of Rennes 1, Rennes, France.
| | | | - Alice Metais
- Department of Pathology, Rennes University Hospital, Rennes, France
| | | | | | - Elise Bannier
- Department of Radiology, Rennes University Hospital, Rennes, France
- Empenn IRISA Research Team, Rennes University-CNRS-INRIA-INSERM, Rennes, France
| | - Boris Campillo-Gimenez
- Department of Medical Oncology, Eugène Marquis Center, Rennes, France
- Signal and Image Processing Laboratory (LTSI), INSERM-University of Rennes 1, Rennes, France
| | - Anne Devillers
- Department of Nuclear Medicine, Eugène Marquis Center, Avenue de la Bataille Flandres-Dunkerque, 35000, Rennes, France
| | - Xavier Palard-Novello
- Department of Nuclear Medicine, Eugène Marquis Center, Avenue de la Bataille Flandres-Dunkerque, 35000, Rennes, France
- Signal and Image Processing Laboratory (LTSI), INSERM-University of Rennes 1, Rennes, France
| | - Florence Le Jeune
- Department of Nuclear Medicine, Eugène Marquis Center, Avenue de la Bataille Flandres-Dunkerque, 35000, Rennes, France
- Signal and Image Processing Laboratory (LTSI), INSERM-University of Rennes 1, Rennes, France
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Girard A, Le Reste PJ, Metais A, Chaboub N, Devillers A, Saint-Jalmes H, Jeune FL, Palard-Novello X. Additive Value of Dynamic FDOPA PET/CT for Glioma Grading. Front Med (Lausanne) 2021; 8:705996. [PMID: 34307430 PMCID: PMC8299331 DOI: 10.3389/fmed.2021.705996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose: The aim of this study was to assess the value of the FDOPA PET kinetic parameters extracted using full kinetic analysis for tumor grading with neuronavigation-guided biopsies as reference in patients with newly-diagnosed gliomas. Methods: Fourteen patients with untreated gliomas were investigated. Twenty minutes of dynamic positron-emission tomography (PET) imaging and a 20-min static image 10 min after injection were reconstructed from a 40-min list-mode acquisition immediately after FDOPA injection. Tumors volume-of-interest (VOI) were generated based on the MRI-guided brain biopsies. Static parameters (TBRmax and TBRmean) and kinetic parameters [K1 and k2 using full kinetic analysis with the reversible single-tissue compartment model with blood volume parameter and the time-to-peak (TTP)] were extracted. Performances of each parameter for differentiating low-grade gliomas (LGG) from high-grade gliomas (HGG) were evaluated by receiver-operating characteristic analyses (area under the curve; AUC). Results: Thirty-two tumoral VOI were analyzed. K1, k2, and TTP were significantly higher for HGG than for LGG (median K1-value = 0.124 vs. 0.074 ml/ccm/min, p = 0.025, median k2-value = 0.093 vs. 0.063 min−1, p = 0.025, and median TTP-value = 10.0 vs. 15.0 min, p = 0.025). No significant difference was observed for the static parameters. The AUC for the kinetic parameters was higher than the AUC for the static parameters (respectively, AUCK1 = 0.787, AUCk2 = 0.785, AUCTTP = 0.775, AUCTBRmax = 0.551, AUCTBRmean = 0.575), significantly compared to TBRmax (respectively, p = 0.001 for K1, p = 0.031 for k2, and p = 0.029 for TTP). Conclusion: The present study suggests an additive value of FDOPA PET/CT kinetic parameters for newly-diagnosed gliomas grading.
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Affiliation(s)
- Antoine Girard
- Univ Rennes, CLCC Eugène Marquis, Noyau Gris Centraux EA 4712, Rennes, France
| | | | | | - Nibras Chaboub
- Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI - UMR 1099, Rennes, France
| | - Anne Devillers
- Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI - UMR 1099, Rennes, France
| | - Hervé Saint-Jalmes
- Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI - UMR 1099, Rennes, France
| | - Florence Le Jeune
- Univ Rennes, CLCC Eugène Marquis, Noyau Gris Centraux EA 4712, Rennes, France
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Somme F, Bender L, Namer IJ, Noël G, Bund C. Usefulness of 18F-FDOPA PET for the management of primary brain tumors: a systematic review of the literature. Cancer Imaging 2020; 20:70. [PMID: 33023662 PMCID: PMC7541204 DOI: 10.1186/s40644-020-00348-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 09/21/2020] [Indexed: 11/30/2022] Open
Abstract
Contrast-enhanced magnetic resonance imaging is currently the standard of care in the management of primary brain tumors, although certain limitations remain. Metabolic imaging has proven useful for an increasing number of indications in oncology over the past few years, most particularly 18F-FDG PET/CT. In neuro-oncology, 18F-FDG was insufficient to clearly evaluate brain tumors. Amino-acid radiotracers such as 18F-FDOPA were then evaluated in the management of brain diseases, notably tumoral diseases. Even though European guidelines on the use of amino-acid PET in gliomas have been published, it is crucial that future studies standardize acquisition and interpretation parameters. The aim of this article was to systematically review the potential effect of this metabolic imaging technique in numerous steps of the disease: primary and recurrence diagnosis, grading, local and systemic treatment assessment, and prognosis. A total of 41 articles were included and analyzed in this review. It appears that 18F-FDOPA PET holds promise as an effective additional tool in the management of gliomas. More consistent prospective studies are still needed.
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Affiliation(s)
- François Somme
- Nuclear medicine Department, Hautepierre University Hospital, 1, rue Molière, F-67000, Strasbourg, France.
| | - Laura Bender
- Oncology Department, Hautepierre University Hospital, 1, rue Molière, F-67000, Strasbourg, France
| | - Izzie Jacques Namer
- Nuclear medicine Department, Hautepierre University Hospital, 1, rue Molière, F-67000, Strasbourg, France
- Strasbourg University, Unistra/CNRS UMR 7237, Strasbourg, France
| | - Georges Noël
- Radiotherapy Department, Paul Strauss Comprehensive Cancer Center, 3, rue de la porte de l'hôpital, F-67065, Strasbourg, France
- Strasbourg University, CNRS, IPHC UMR 7178, Centre Paul Strauss, UNICANCER, F-67000, Strasbourg, France
| | - Caroline Bund
- Nuclear medicine Department, Hautepierre University Hospital, 1, rue Molière, F-67000, Strasbourg, France
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