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Graillon T, Salgues B, Horowitz T, Padovani L, Appay R, Tabouret E, Guedj E, Chinot O. Peptide radionuclide radiation therapy with Lutathera in multirecurrent nonanaplastic meningiomas: antitumoral activity study by growth rate analysis. J Neurooncol 2024:10.1007/s11060-024-04622-5. [PMID: 38451361 DOI: 10.1007/s11060-024-04622-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Several retrospective studies and meta-analyses of Peptide Radionuclide Radiation Therapy in meningiomas suggest six-month progression-free survival improvement for WHO grade 1 and 2 meningiomas. In the present study, we aimed to evaluate the impact of such treatment on three-dimensional volume growth rate (3DVGR) in nonanaplastic meningiomas. METHODS The authors performed a retrospective study including eight patients treated with Lutathera®. Millimetric 3D T1-weighted with gadolinium enhancement magnetic resonance imaging sequences were requested for volume measurement. Then, tumor growth rate was classified following a previously described 3DVGR classification (Graillon et al.). RESULTS Patients harbored seven WHO grade 2 meningiomas and one aggressive WHO grade 1. All patients, except one, underwent four treatment cycles. 3DVGR significantly decreased at 3, 6, and 12 months after treatment initiation analyzing each lesion separately. Mean and median 3DVGR from all patients were respectively at 29.5% and 44.5%/6 months before treatment initiation, then at 16.5% and 25%/6 months at three months post-treatment initiation, 9.5% and 4.5%/6 months after 6 months, as well as 9.5% and 10.5%/6 months after 12 months. At 3, 6, and 12 months after treatment initiation, 4/8, 6/7, and 5/6 patients were class 2 (stabilization or severe 3DVGR slowdown), respectively. No patient was class 1 at 6 and 12 months, suggesting a lack of drug response. CONCLUSION In nonanaplastic meningiomas, Lutathera®'s antitumoral activity appeared delayed and more likely observed at six months, while no major response was observed under treatment. Moreover, its antitumoral activity persisted for 12-18 months following treatment initiation.
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Affiliation(s)
- Thomas Graillon
- Department of Neurosurgery, Aix Marseille Univ, INSERM, APHM, MMG, UMR1251, Marmara Institute, La Timone Hospital, 264 rue Saint-Pierre, 13005, Marseille, France.
| | - Betty Salgues
- CERIMED, Nuclear Medicine Department, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, Aix-Marseille University, Marseille, France
| | - Tatiana Horowitz
- CERIMED, Nuclear Medicine Department, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, Aix-Marseille University, Marseille, France
| | | | - Romain Appay
- Service d'Anatomie Pathologique et de Neuropathologie, APHM, CHU Timone, Marseille, France
- Inst Neurophysiopathol, GlioME Team, Aix-Marseille Univ, CNRS, INP, PETRA network, Marseille, France
| | - Emeline Tabouret
- Neuro-Oncology Department, APHM, Timone Hospital, Marseille, France
- Aix Marseille Univ, CNRS, Ecole Centrale Marseille, UMR 7249, Institut Fresnel, Marseille, France
| | - Eric Guedj
- CERIMED, Nuclear Medicine Department, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, Aix-Marseille University, Marseille, France
| | - Olivier Chinot
- Neuro-Oncology Department, APHM, Timone Hospital, Marseille, France
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Horowitz T, Salgues B, Padovani L, Farah K, Dufour H, Chinot O, Guedj E, Graillon T. Optic Nerve Sheath Meningiomas: Solving Diagnostic Challenges with 68Ga-DOTATOC PET/CT. Diagnostics (Basel) 2023; 13:2307. [PMID: 37443701 DOI: 10.3390/diagnostics13132307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/18/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
68Ga-DOTATOC PET could be a noninvasive, highly sensitive, and specific technique for the challenging diagnosis of optic nerve sheath meningioma (ONSM). Our objective was to report the use and results of 68Ga-DOTATOC PET in suspected ONSM. Twelve subjects who underwent 68Ga-DOTATOC PET for suspected ONSM in our department were retrospectively included. Standardised clinical and radiological data were collected. The PET examination results were classified as positive or negative, and lesion standardised uptake values (SUVmax) were recorded. 68Ga-DOTATOC PET confirmed positive uptake in six cases (SUVmax > 5), leading to ONSM diagnoses followed by radiation therapy in patients with vision loss. Six 68Ga-DOTATOC PET scans were considered negative (SUVmax < 5); these comprised one case of neurosarcoidosis, one cavernous malformation, and four uncertain diagnoses, leading to further investigation. 68Ga-DOTATOC PET was helpful in tumour volume delineation before radiation therapy, leading to a decrease in dose exposure. Noninvasive 68Ga-DOTATOC PET should be performed before treating nonhistologically proven meningiomas with radiotherapy or stereotactic radiosurgery, particularly in cases of uncertain diagnosis with MRI, which characterises most ONSM cases. PET SUVmax thresholds to distinguish meningioma from nonspecific uptake in other lesions need to be adapted to ONSM. 68Ga-DOTATOC PET improves the intraorbital lesion diagnostic approach and therefore impacts therapeutic management.
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Affiliation(s)
- Tatiana Horowitz
- Nuclear Medicine Department, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Aix Marseille University, 13005 Marseille, France
| | - Betty Salgues
- Nuclear Medicine Department, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Aix Marseille University, 13005 Marseille, France
| | - Laetitia Padovani
- Radiotherapy Department, APHM, Timone Hospital, 13005 Marseille, France
| | - Kaissar Farah
- Neurosurgery Department, INSERM, MMG, APHM, Timone Hospital, Aix-Marseille University, 13005 Marseille, France
| | - Henry Dufour
- Neurosurgery Department, INSERM, MMG, APHM, Timone Hospital, Aix-Marseille University, 13005 Marseille, France
| | - Olivier Chinot
- Neuro-Oncology Department, APHM, Timone Hospital, 13005 Marseille, France
| | - Eric Guedj
- Nuclear Medicine Department, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Aix Marseille University, 13005 Marseille, France
| | - Thomas Graillon
- Neurosurgery Department, INSERM, MMG, APHM, Timone Hospital, Aix-Marseille University, 13005 Marseille, France
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Graillon T, Tabouret E, Salgues B, Horowitz T, Padovani L, Appay R, Farah K, Dufour H, Régis J, Guedj E, Barlier A, Chinot O. Innovative treatments for meningiomas. Rev Neurol (Paris) 2023; 179:449-463. [PMID: 36959063 DOI: 10.1016/j.neurol.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/25/2023]
Abstract
Multi-recurrent high-grade meningiomas remain an unmet medical need in neuro-oncology when iterative surgeries and radiation therapy sessions fail to control tumor growth. Nevertheless, the last 10years have been marked by multiple advances in the comprehension of meningioma tumorigenesis via the discovery of new driver mutations, the identification of activated intracellular signaling pathways, and DNA methylation analyses, providing multiple potential therapeutic targets. Today, Anti-VEGF and mTOR inhibitors are the most used and probably the most active drugs in aggressive meningiomas. Peptide radioactive radiation therapy aims to target SSTR2A receptors, which are strongly expressed in meningiomas, but have an insufficient effect in most aggressive meningiomas, requiring the development of new techniques to increase the dose applied to the tumor. Based on the multiple potential intracellular targets, multiple targeted therapy clinical trials targeting Pi3K-Akt-mTOR and MAP kinase pathways as well as cell cycle and particularly, cyclin D4-6 are ongoing. Recently discovered driver mutations, SMO, Akt, and PI3KCA, offer new targets but are mostly observed in benign meningiomas, limiting their clinical relevance mainly to rare aggressive skull base meningiomas. Therefore, NF2 mutation remains the most frequent mutation and main challenging target in high-grade meningioma. Recently, inhibitors of focal adhesion kinase (FAK), which is involved in tumor cell adhesion, were tested in a phase 2 clinical trial with interesting but insufficient activity. The Hippo pathway was demonstrated to interact with NF2/Merlin and could be a promising target in NF2-mutated meningiomas with ongoing multiple preclinical studies and a phase 1 clinical trial. Recent advances in immune landscape comprehension led to the proposal of the use of immunotherapy in meningiomas. Except in rare cases of MSH2/6 mutation or high tumor mass burden, the activity of PD-1 inhibitors remains limited; however, its combination with various radiation therapy modalities is particularly promising. On the whole, therapeutic management of high-grade meningiomas is still challenging even with multiple promising therapeutic targets and innovations.
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Affiliation(s)
- T Graillon
- Aix-Marseille University, AP-HM, Inserm, MMG, Neurosurgery department, La Timone Hospital, Marseille, France.
| | - E Tabouret
- Aix-Marseille University, AP-HM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service de Neurooncologie, Marseille, France
| | - B Salgues
- Nuclear Medicine Department, Groupe Hospitalier Pitié-Salpêtrière-Charles-Foix, Assistance publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - T Horowitz
- AP-HM, CNRS, centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Nuclear Medicine Department, Aix-Marseille University, Marseille, France
| | - L Padovani
- AP-HM, Timone Hospital, Radiotherapy Department, Marseille, France
| | - R Appay
- AP-HM, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France; Aix-Marseille University, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - K Farah
- Aix-Marseille University, Institut de Neurosciences des Systèmes, UMR Inserm 1106, Functional Neurosurgery and Radiosurgery, Timone University Hospital, Marseille, France
| | - H Dufour
- Aix-Marseille University, AP-HM, Inserm, MMG, Neurosurgery department, La Timone Hospital, Marseille, France
| | - J Régis
- Aix-Marseille University, Institut de Neurosciences des Systèmes, UMR Inserm 1106, Functional Neurosurgery and Radiosurgery, Timone University Hospital, Marseille, France
| | - E Guedj
- AP-HM, CNRS, centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Nuclear Medicine Department, Aix-Marseille University, Marseille, France
| | - A Barlier
- Aix-Marseille University, AP-HM, Inserm, MMG, Laboratory of Molecular Biology Hospital La Conception, Marseille, France
| | - O Chinot
- Aix-Marseille University, AP-HM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service de Neurooncologie, Marseille, France
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Branzoli F, Salgues B, Marjańska M, Laloi-Michelin M, Herman P, Le Collen L, Delemer B, Riancho J, Kuhn E, Jublanc C, Burnichon N, Amar L, Favier J, Gimenez-Roqueplo AP, Buffet A, Lussey-Lepoutre C. SDHx mutation and pituitary adenoma: can in vivo 1H-MR spectroscopy unravel the link? Endocr Relat Cancer 2023; 30:ERC-22-0198. [PMID: 36449569 PMCID: PMC9885742 DOI: 10.1530/erc-22-0198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022]
Abstract
Germline mutations in genes encoding succinate dehydrogenase (SDH) are frequently involved in pheochromocytoma/paraganglioma (PPGL) development and were implicated in patients with the '3PAs' syndrome (associating pituitary adenoma (PA) and PPGL) or isolated PA. However, the causality link between SDHx mutation and PA remains difficult to establish, and in vivo tools for detecting hallmarks of SDH deficiency are scarce. Proton magnetic resonance spectroscopy (1H-MRS) can detect succinate in vivo as a biomarker of SDHx mutations in PGL. The objective of this study was to demonstrate the causality link between PA and SDH deficiency in vivo using 1H-MRS as a novel noninvasive tool for succinate detection in PA. Three SDHx-mutated patients suffering from a PPGL and a macroprolactinoma and one patient with an apparently sporadic non-functioning pituitary macroadenoma underwent MRI examination at 3 T. An optimized 1H-MRS semi-LASER sequence (TR = 2500 ms, TE = 144 ms) was employed for the detection of succinate in vivo. Succinate and choline-containing compounds were identified in the MR spectra as single resonances at 2.44 and 3.2 ppm, respectively. Choline compounds were detected in all the tumors (three PGL and four PAs), while a succinate peak was only observed in the three macroprolactinomas and the three PGL of SDHx-mutated patients, demonstrating SDH deficiency in these tumors. In conclusion, the detection of succinate by 1H-MRS as a hallmark of SDH deficiency in vivo is feasible in PA, laying the groundwork for a better understanding of the biological link between SDHx mutations and the development of these tumors.
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Affiliation(s)
- Francesca Branzoli
- Paris Brain Institute - Institut du Cerveau (ICM), Center for Neuroimaging Research (CENIR), Paris, France
- Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, ICM, Paris, France
| | - Betty Salgues
- Sorbonne University, nuclear medicine department, Pitié-Salpêtrière Hospital, Assistance -Publique Hôpitaux de Paris, Paris, France
- Paris Cardiovascular Research Center (PARCC), Inserm, Paris, France
| | - Małgorzata Marjańska
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marie Laloi-Michelin
- Endocrinology department, Lariboisière Hospital, Assistance -Publique Hôpitaux de Paris, Paris, France
| | - Philippe Herman
- ENT unit, Lariboisière Hospital, Assistance -Publique Hôpitaux de Paris, Paris-Cité University, INSERM U1141, Paris, France
| | - Lauriane Le Collen
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, University of Lille, Lille, France
- Department of Endocrinology Diabetology, University Hospital Center of Reims, Reims, France
- Department of Genetic, University Hospital Center of Reims, Reims, France
| | - Brigitte Delemer
- Department of Endocrinology Diabetology, University Hospital Center of Reims, Reims, France
- CRESTIC EA 3804, University of Reims Champagne Ardenne, UFR Sciences Exactes et Naturelles, Moulin de La Housse, BP 1039, Reims, France
| | - Julien Riancho
- AP-HP, Hôpital Européen Georges Pompidou, Hypertension Unit, and Reference centre for rare adrenal diseases, Paris, France
| | - Emmanuelle Kuhn
- Pituitary Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Christel Jublanc
- Pituitary Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Nelly Burnichon
- Département de médecine génomique des tumeurs et des cancers, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Cité, Inserm, PARCC, Paris, France
| | - Laurence Amar
- AP-HP, Hôpital Européen Georges Pompidou, Hypertension Unit, and Reference centre for rare adrenal diseases, Paris, France
- Université Paris Cité, Inserm, PARCC, Paris, France
| | | | - Anne-Paule Gimenez-Roqueplo
- Département de médecine génomique des tumeurs et des cancers, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Cité, Inserm, PARCC, Paris, France
| | - Alexandre Buffet
- Département de médecine génomique des tumeurs et des cancers, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Cité, Inserm, PARCC, Paris, France
| | - Charlotte Lussey-Lepoutre
- Sorbonne University, nuclear medicine department, Pitié-Salpêtrière Hospital, Assistance -Publique Hôpitaux de Paris, Paris, France
- Paris Cardiovascular Research Center (PARCC), Inserm, Paris, France
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Moog S, Salgues B, Braik-Djellas Y, Viel T, Balvay D, Autret G, Robidel E, Gimenez-Roqueplo AP, Tavitian B, Lussey-Lepoutre C, Favier J. Preclinical evaluation of targeted therapies in Sdhb-mutated tumors. Endocr Relat Cancer 2022; 29:375-388. [PMID: 35348472 DOI: 10.1530/erc-22-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/29/2022] [Indexed: 11/08/2022]
Abstract
Therapies for metastatic SDHB-dependent pheochromocytoma and paraganglioma (PPGL) are limited and poorly efficient. New targeted therapies and identification of early non-invasive biomarkers of response are thus urgently needed for these patients. We characterized an in vivo allograft model of spontaneously immortalized murine chromaffin cells (imCC) with inactivation of the Sdhb gene by dynamic contrast-enhanced MRI (DCE-MRI) and 18FDG-PET. We evaluated the response to several therapies: IACS-010759 (mitochondrial respiratory chain complex I inhibitor), sunitinib (tyrosine kinase inhibitor with anti-angiogenic activity), talazoparib (poly ADP ribose polymerase (PARP) inhibitor) combined or not to temozolomide (alkylating agent), pharmacological inhibitors of HIF2a (PT2385 and PT2977 (belzutifan)) and molecular inactivation of HIF2a (imCC Sdhb-/- shHIF2a). Multimodal imaging was performed, including magnetic resonance spectroscopy (1H-MRS) to monitor the level of succinate in vivo. The allografted model of Sdhb-/- imCC reflected SDHB-deficient tumors, with increased angiogenesis and a particular avidity for 18FDG. After 14 days of treatment, IACS-010759, sunitinib and talazoparib at high doses allowed a significant reduction of the tumor volumes. In contrast to the tumor growth inhibition observed in Sdhb-/- shHIF2a imCC tumors, pharmacological inhibitors of HIF2a (PT2385 and belzutifan) showed no antitumor action in this model, alone or in combination with sunitinib. 1H-MRS, but not DCE-MRI, enabled the monitoring response to sunitinib, which was the best treatment in this study, promoting a decrease in succinate levels detected in vivo. This study paves the way for new therapeutic options and reveals a potential new early biomarker of response to treatment in SDHB-dependent PPGL.
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Affiliation(s)
- Sophie Moog
- Université de Paris Cité, PARCC INSERM UMR970, Paris, France
| | - Betty Salgues
- PARCC INSERM UMR970, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Radiologie, Paris, France
| | | | - Thomas Viel
- Université de Paris Cité, PARCC INSERM UMR970, Paris, France
- Sorbonne Université, Service de Médecine Nucléaire, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Paris, France
| | - Daniel Balvay
- Université de Paris Cité, PARCC INSERM UMR970, Paris, France
- Sorbonne Université, Service de Médecine Nucléaire, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Paris, France
| | - Gwennhael Autret
- Université de Paris Cité, PARCC INSERM UMR970, Paris, France
- Sorbonne Université, Service de Médecine Nucléaire, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Paris, France
| | - Estelle Robidel
- Université de Paris Cité, PARCC INSERM UMR970, Paris, France
| | - Anne-Paule Gimenez-Roqueplo
- Université de Paris Cité, PARCC INSERM UMR970, Paris, France
- Plateforme d'Imageries du Vivant, Université de Paris Cité, Faculté de Médecine, Paris, France
| | - Bertrand Tavitian
- Université de Paris Cité, PARCC INSERM UMR970, Paris, France
- Sorbonne Université, Service de Médecine Nucléaire, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France
| | - Charlotte Lussey-Lepoutre
- PARCC INSERM UMR970, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Radiologie, Paris, France
| | - Judith Favier
- Université de Paris Cité, PARCC INSERM UMR970, Paris, France
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Mairot K, Sahakian N, Salgues B, Levy N, Gascon P, Denis D. Somatostatin receptor PET/CT scan as a helpful diagnostic tool for optic nerve sheath meningioma. J Fr Ophtalmol 2021; 44:e619-e621. [PMID: 34229893 DOI: 10.1016/j.jfo.2021.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/04/2021] [Accepted: 01/04/2021] [Indexed: 11/24/2022]
Affiliation(s)
- K Mairot
- Service d'ophtalmologie, centre hospitalier universitaire de l'hôpital Nord, Chemin des Bourrely, 13015 Marseille, France.
| | - N Sahakian
- Médecine nucléaire, centre hospitalier universitaire de l'hôpital Nord, Chemin des Bourrely, 13015 Marseille, France
| | - B Salgues
- Médecine nucléaire, groupe hospitalier Pitié-Salpêtrière-Charles Foix, Sorbonne université, Paris, France
| | - N Levy
- Service d'ophtalmologie, centre hospitalier universitaire de l'hôpital Nord, Chemin des Bourrely, 13015 Marseille, France
| | - P Gascon
- Service d'ophtalmologie, centre hospitalier universitaire de l'hôpital Nord, Chemin des Bourrely, 13015 Marseille, France
| | - D Denis
- Service d'ophtalmologie, centre hospitalier universitaire de l'hôpital Nord, Chemin des Bourrely, 13015 Marseille, France
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Salgues B, Guerin C, Amodru V, Pattou F, Brunaud L, Lifante JC, Mirallié E, Sahakian N, Castinetti F, Loundou A, Baumstarck K, Sebag F, Taïeb D. Risk stratification of adrenal masses by [ 18 F]FDG PET/CT: Changing tactics. Clin Endocrinol (Oxf) 2021; 94:133-140. [PMID: 32978795 DOI: 10.1111/cen.14338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/30/2022]
Abstract
CONTEXT [18 F]FDG PET/CT improves adrenal tumour characterization. However, there is still no consensus regarding the optimal imaging biomarkers of malignancy. OBJECTIVES To assess the performance of Tumour standardized uptake value (SUV)max :Liver SUVmax for malignancy-risk and to build and evaluate a prediction model. DESIGN/METHODS The cohort consisted of consecutive patients with adrenal masses evaluated by [18 F]FDG PET/CT. The gold standard for malignancy was based on histology or a multidisciplinary consensus in nonoperated cases. The performance of the previously reported cut-off for Tumour SUVmax :Liver SUVmax (>1.5) was evaluated in this independent cohort. Additionally, a predictive model of malignancy was built from the training cohort (previous study) and evaluated in the validation cohort (current study). RESULTS Sixty-four patients were evaluated; 28% of them had a Cushing's syndrome. Fifty-four adrenal masses were classified as benign and 10 as malignant (including 7 adrenocortical carcinomas). Compared to benign masses, malignant lesions were larger in size, had higher unenhanced densities and higher [18 F]FDG uptake. CT-derived anthropometric parameters did not differ between benign and malignant masses. A tumour SUVmax :Liver SUVmax > 1.5 showed a good diagnostic performance: Se = 90.0%/Sp = 92.6%/PPV = 69.2%/NPV = 98.0% and accuracy = 92.2%. A predictive model based on tumour size and tumour-to-liver uptake SUVmax ratio for malignancy-risk was validated and provides a complementary approach to the ratio. CONCLUSIONS Tumour SUVmax :Liver SUVmax uptake ratio is a useful biomarker for diagnosis of adrenal masses. Another tactic would be to calculate with the model an individual risk of malignancy and integrate this information into a shared decision-making process.
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Affiliation(s)
- Betty Salgues
- Service de Médecine Nucléaire, Centre Hospitalo-Universitaire de la Timone, APHM, Centre Européen de Recherche en Imagerie Médicale, Aix Marseille Univ, Marseille, France
| | - Carole Guerin
- Service de Chirurgie Générale et Endocrinienne, Centre Hospitalier Conception, APHM, Aix Marseille Univ, Marseille, France
| | - Vincent Amodru
- Service d'Enodrinologie, Centre hospitalier Conception, APHM, Aix Marseille Univ, Marseille, France
| | - François Pattou
- Service de Chirurgie Endocrinienne, Centre Hospitalier Régional Universitaire de Lille, Lille, France
- Université Lille nord de France, INSERM, Lille, France
| | - Laurent Brunaud
- Université de Lorraine, Service de Chirurgie et unité multidisciplinaire de Chirurgie Endocrinienne, Métabolique et Thyroïdienne, Centre hospitalo-universitaire Nancy Brabois, Nancy, France
| | | | - Eric Mirallié
- Chirurgie Cancérologique, Digestive et Endocrinienne, CHU Nantes, Nantes, France
| | - Nicolas Sahakian
- Service de Médecine Nucléaire, Centre Hospitalo-Universitaire de la Timone, APHM, Centre Européen de Recherche en Imagerie Médicale, Aix Marseille Univ, Marseille, France
| | - Frédéric Castinetti
- Service d'Enodrinologie, Centre hospitalier Conception, APHM, Aix Marseille Univ, Marseille, France
| | - Anderson Loundou
- Service de Santé Publique, Faculté de Médecine de la Timone, Aix Marseille Univ, Marseille, France
| | - Karine Baumstarck
- Service de Santé Publique, Faculté de Médecine de la Timone, Aix Marseille Univ, Marseille, France
| | - Fréderic Sebag
- Service de Chirurgie Générale et Endocrinienne, Centre Hospitalier Conception, APHM, Aix Marseille Univ, Marseille, France
| | - David Taïeb
- Service de Médecine Nucléaire, Centre Hospitalo-Universitaire de la Timone, APHM, Centre Européen de Recherche en Imagerie Médicale, Aix Marseille Univ, Marseille, France
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Abstract
We present a 42-year-old woman with primary central nervous system lymphoma (PCNSL) and strong F-FDOPA PET uptake. F-FDOPA PET has high diagnostic accuracy in gliomas and brain metastases. The L-type amino acid transporter 1, targeted by F-FDOPA and C-MET PET, is a cell-type transporter usually upregulated in malignant tumors, including PCNSL. In this line, strong uptake was already shown with C-MET in PCNSL. We report the same findings with F-FDOPA. Consequently, PCNSL is a possible differential neoplastic diagnosis of F-FDOPA uptake among neoplastic lesions.
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Affiliation(s)
| | | | | | - Gilles Brun
- Neuroradiology Department, APHM, Timone Hospital, Marseille, France
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