A study method using early dynamic acquisition of [¹⁸F]fluorodopa positron emission tomography for the differential diagnosis between progression and radionecrosis of brain metastases after radiotherapy.

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

EJNMMI Research Pub Date : 2024-10-09 DOI:10.1186/s13550-024-01158-7

Ines Barrat, Marc-Etienne Meyer, Alexandre Coutte, Mathieu Boone, Roger Bouzerar, Pascal Bailly

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引用次数: 0

Abstract

Background: It is difficult to distinguish between the brain metastasis progression (BMP) and brain radionecrosis (BRN) on the basis of ¹⁸F-3,4-dihydroxyphenylalanine positron emission tomography/computed-tomography (¹⁸F-FDOPA PET/CT) data. The advent of silicon photomultiplier (SiPM) PET technology makes it possible to study dynamic volumes and potentially improve diagnostic accuracy. We developed a method for processing ¹⁸F-FDOPA PET/CT in the differential diagnosis between BMP and BRN. The method involves a short (3-second) sampling time during a 4-minute acquisition on a SiPM-PET/CT machine. We prospectively included 15 patients and 19 metastases. All acquisitions were performed in list mode acquisition for 25 min on a four-ring SiPM PET/CT system. We calculated the ratios between the maximum activity in the lesion's voxel and the mean activity in the contralateral region (VOImax/CLmean) or the mean activity in the white matter (VOImax/WMmean).

Results: Seven lesions were classified as BMP and twelve were classified as BRN. Statistically significant intergroup differences in the VOImax/CLmean and VOImax/WMmean activity ratios were observed for both the clinical volume and the early acquisition. The best performing quantitative variable was the VOImax/CLmean ratio on early acquisition, with a diagnostic accuracy of 94.7%, a sensitivity of 100%, and a specificity of 91.7%.

Conclusion: The ¹⁸F-FDOPA PET/CT data acquired a few minutes after the bolus injection confirms its value in differentiating between BMP and BRN, compared to the much longer classic clinical protocol.

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利用早期动态采集[18F]氟多巴正电子发射断层扫描鉴别诊断放疗后脑转移瘤进展和放射性坏死的研究方法。

背景：根据18F-3,4-二羟基苯丙氨酸正电子发射断层扫描/计算机断层扫描（18F-FDOPA PET/CT）数据很难区分脑转移进展（BMP）和脑放射性坏死（BRN）。硅光电倍增管（SiPM）PET 技术的出现使研究动态容积成为可能，并有可能提高诊断的准确性。我们开发了一种处理 18F-FDOPA PET/CT 的方法，用于 BMP 和 BRN 的鉴别诊断。该方法是在 SiPM-PET/CT 设备上进行 4 分钟的采集，采样时间很短（3 秒）。我们前瞻性地纳入了 15 名患者和 19 个转移灶。所有采集均在四环 SiPM PET/CT 系统上以列表模式采集 25 分钟。我们计算了病灶体素最大活动度与对侧区域平均活动度（VOImax/CLmean）或白质平均活动度（VOImax/WMmean）之间的比率：七个病灶被归类为 BMP，十二个病灶被归类为 BRN。临床容积和早期采集的 VOImax/CLmean 和 VOImax/WMmean 活性比率在组间差异上有统计学意义。早期采集的VOImax/CLmean比值是表现最好的定量变量，诊断准确率为94.7%，敏感性为100%，特异性为91.7%：18F-FDOPA正电子发射计算机断层成像（PET/CT）数据是在栓剂注射后几分钟采集的，与时间更长的传统临床方案相比，证实了其在区分BMP和BRN方面的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.