Análisis visual y semicuantitativo del 6-[18F]FDOPA PET/TC en pacientes con tumores cerebrales ante la sospecha de recurrencia tumoral versus radionecrosis

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Revista Espanola De Medicina Nuclear E Imagen Molecular Pub Date : 2024-01-01 DOI:10.1016/j.remn.2023.08.004

M. Suárez-Piñera , L. Rodriguez-Bel , M. Alemany , A. Pons-Escoda , M. Pudis , A. Coello , G. Reynes , N. Vidal , M. Cortes-Romera , M. Macia

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Abstract

Introduction

Amino acid PET is a tool recommended by the main neuroimaging societies in the differential diagnosis between radionecrosis (RNC) and tumour recurrence (TR) in brain tumours, but its use in our country is still limited. The aim of this work is to present our experience with 6-[¹⁸F]FDOPA PET/CT (FDOPA) in brain tumours (primary and M1), comparing these results with other published results.

Material and methods

Retrospective study of 62 patients with suspected tumour recurrence (TR): 42 brain metastases (M1) and 20 primary, who underwent FDOPA. Images were analysed visually and semi-quantitatively, obtaining SUV_max and SUV_maxlesion/SUV_maxstriatum (L/S) and SUV_maxlesion/SUV_maxcortex (L/C) ratios. The diagnostic validity of PET was analysed and the best performing cut-off points were calculated. PET results were compared with clinical-radiological follow-up and/or histopathology.

Results

TR was identified in 49% of M1 and 76% of brain primaries. The best performing FDOPA interpretation was visual and semi-quantitative, with a sensitivity and specificity in primaries of 94% and 80% and in M1s of 96% and 72% respectively. The cut-off points with the best diagnostic performance were L/C1.44 in M1 and L/C1.55 in primaries. There are discrepant results with other published results.

Conclusion

FDOPA PET/CT is a useful tool in the differential diagnosis between recurrence and RNC in brain tumours. It is needed a standardization to contribute to homogenise FDOPA results a inter-centre level.

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对疑似肿瘤复发与放射性坏死的脑肿瘤患者进行 6-[18F]FDOPA PET/CT 的可视化和半定量分析

导言：氨基酸 PET 是主要神经影像学协会推荐用于鉴别诊断脑肿瘤放射性坏死（RNC）和肿瘤复发（TR）的一种工具，但在我国的应用仍然有限。本研究旨在介绍我们在脑肿瘤（原发和 M1）中使用 6-[18F]FDOPA PET/CT (FDOPA) 的经验，并将这些结果与其他已发表的结果进行比较。对图像进行视觉和半定量分析，获得 SUVmax 和 SUVmaxlesion/SUVmaxstriatum (L/S) 以及 SUVmaxlesion/SUVmaxcortex (L/C) 比率。对 PET 的诊断有效性进行了分析，并计算出了效果最佳的截断点。PET结果与临床放射学随访和/或组织病理学结果进行了比较。效果最好的 FDOPA 解释是视觉和半定量解释，对原发灶的敏感性和特异性分别为 94% 和 80%，对 M1 的敏感性和特异性分别为 96% 和 72%。诊断效果最好的临界点是 M1 的 L/C1.44，以及初诊的 L/C1.55。结论FDOPA PET/CT 是鉴别诊断脑肿瘤复发和 RNC 的有用工具。需要进行标准化，以促进中心间FDOPA结果的同质化。

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来源期刊

Revista Espanola De Medicina Nuclear E Imagen Molecular RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

1.10

自引率

16.70%

发文量

审稿时长

24 days

期刊介绍： The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles.