Visual and semi-quantitative analysis of 6-[18F]FDOPA PET/CT in patients with brain tumors and suspected tumor recurrence versus radionecrosis

Revista espanola de medicina nuclear e imagen molecular Pub Date : 2024-01-01 DOI:10.1016/j.remnie.2023.10.003

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 umour 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 SUVmax and SUVmaxlesion/SUVmaxstriatum (L/S) and SUVmaxlesion/SUVmaxcortex (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.

查看原文本刊更多论文

6-[18F]FDOPA PET/CT在脑肿瘤和疑似肿瘤复发与放射性坏死患者中的视觉和半定量分析。

引言：氨基酸PET是主要神经影像学学会推荐的一种用于鉴别诊断脑肿瘤放射性坏死（RNC）和肿瘤复发（TR）的工具，但在我国的应用仍然有限。这项工作的目的是展示我们在6-[18 F] 脑肿瘤（原发性和M1）的FDOPA PET/CT（FDOPA），将这些结果与其他已发表的结果进行比较。材料和方法：对62例疑似肿瘤复发（TR）患者进行回顾性研究：42例脑转移（M1），20例原发性，接受FDOPA。对图像进行视觉和半定量分析，获得SUVmax和SUVmax病变/SUV最大纹状体（L/S）以及SUVmax损伤/SUV最大皮层（L/C）比率。对PET的诊断有效性进行了分析，并计算了最佳诊断临界点。将PET结果与临床放射学随访和/或组织病理学进行比较。结果：在49%的M1和76%的原发性脑中发现TR。表现最好的FDOPA解释是视觉和半定量的，原发性的敏感性和特异性分别为94%和80%，M1的敏感性和特异度分别为96%和72%。诊断性能最好的分界点是M1的L/C1.44和原发的L/C1.55。结果与其他已发表的结果不一致。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FDOPA结果在中心间水平上的均匀化。

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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Revista espanola de medicina nuclear e imagen molecular

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