{"title":"FET PET用于区分高级别胶质瘤的治疗后变化和复发：一项单中心多学科临床对照研究。","authors":"Ameya D Puranik, Indraja D Dev, Venkatesh Rangarajan, Yash Jain, Sukriti Patra, Nilendu C Purandare, Arpita Sahu, Amitkumar Choudhary, Kajari Bhattacharya, Tejpal Gupta, Abhishek Chatterjee, Archya Dasgupta, Aliasgar Moiyadi, Prakash Shetty, Vikas Singh, Epari Sridhar, Ayushi Sahay, Aekta Shah, Nandini Menon, Suchismita Ghosh, Sayak Choudhury, Sneha Shah, Archi Agrawal, N Lakshminarayanan, Amit Kumar, Arjun Gopalakrishna","doi":"10.1007/s00234-024-03495-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The clinico-radiological dilemma in post-treatment high-grade gliomas, between disease recurrence (TR) and treatment-related changes (TRC), still persists. FET (Fluoro-ethyl-tyrosine) PET has been extensively used as problem-solving modality for cases where MR imaging is inconclusive. We incorporated a systematic imaging and clinical follow-up algorithm in a multi-disciplinary clinic (MDC) setting to analyse our cohort of FET PET in post-treatment gliomas.</p><p><strong>Methods: </strong>We retrospectively analyzed 171 patients of post-treatment grade III and IV glioma with equivocal findings on MRI. 185-222 MBq of 18 F-FET was injected and dedicated static imaging of brain was performed at 20 min. TBR (Tumor to background ratio) was used as semi-quantitative parameter. Cutoff of 2.5 was used for image interpretation. Imaging findings were confirmed with histopathological diagnosis, wherever available or in a multidisciplinary joint clinic based on serial imaging.</p><p><strong>Results: </strong>121 of 171 patients showed recurrent disease on FET PET, on follow up, 109 were confirmed with recurrence; 7 patients showed TRC, whereas 5 were treated with bevacizumab, with no further clinico-radiological deterioration, thus confirming TRC. 50 patients showed TRC on FET PET, on follow up on follow up, 40 were confirmed as true-negative. 10 patients who showed TBR less than 2.5 had confirmed TR on subsequent MR imaging. The overall sensitivity and specificity was 91.6 and 76.9% respectively, with a diagnostic accuracy of 87.13%.</p><p><strong>Conclusion: </strong>There is potential for FET PET to be used along with MRI in the post treatment algorithm of high-grade glial tumors.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"FET PET to differentiate between post-treatment changes and recurrence in high-grade gliomas: a single center multidisciplinary clinic controlled study.\",\"authors\":\"Ameya D Puranik, Indraja D Dev, Venkatesh Rangarajan, Yash Jain, Sukriti Patra, Nilendu C Purandare, Arpita Sahu, Amitkumar Choudhary, Kajari Bhattacharya, Tejpal Gupta, Abhishek Chatterjee, Archya Dasgupta, Aliasgar Moiyadi, Prakash Shetty, Vikas Singh, Epari Sridhar, Ayushi Sahay, Aekta Shah, Nandini Menon, Suchismita Ghosh, Sayak Choudhury, Sneha Shah, Archi Agrawal, N Lakshminarayanan, Amit Kumar, Arjun Gopalakrishna\",\"doi\":\"10.1007/s00234-024-03495-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The clinico-radiological dilemma in post-treatment high-grade gliomas, between disease recurrence (TR) and treatment-related changes (TRC), still persists. FET (Fluoro-ethyl-tyrosine) PET has been extensively used as problem-solving modality for cases where MR imaging is inconclusive. We incorporated a systematic imaging and clinical follow-up algorithm in a multi-disciplinary clinic (MDC) setting to analyse our cohort of FET PET in post-treatment gliomas.</p><p><strong>Methods: </strong>We retrospectively analyzed 171 patients of post-treatment grade III and IV glioma with equivocal findings on MRI. 185-222 MBq of 18 F-FET was injected and dedicated static imaging of brain was performed at 20 min. TBR (Tumor to background ratio) was used as semi-quantitative parameter. Cutoff of 2.5 was used for image interpretation. Imaging findings were confirmed with histopathological diagnosis, wherever available or in a multidisciplinary joint clinic based on serial imaging.</p><p><strong>Results: </strong>121 of 171 patients showed recurrent disease on FET PET, on follow up, 109 were confirmed with recurrence; 7 patients showed TRC, whereas 5 were treated with bevacizumab, with no further clinico-radiological deterioration, thus confirming TRC. 50 patients showed TRC on FET PET, on follow up on follow up, 40 were confirmed as true-negative. 10 patients who showed TBR less than 2.5 had confirmed TR on subsequent MR imaging. The overall sensitivity and specificity was 91.6 and 76.9% respectively, with a diagnostic accuracy of 87.13%.</p><p><strong>Conclusion: </strong>There is potential for FET PET to be used along with MRI in the post treatment algorithm of high-grade glial tumors.</p>\",\"PeriodicalId\":19422,\"journal\":{\"name\":\"Neuroradiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00234-024-03495-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-024-03495-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：治疗后高级别胶质瘤在疾病复发（TR）和治疗相关变化（TRC）之间的临床放射学难题依然存在。FET（氟乙基酪氨酸）正电子发射计算机断层扫描已被广泛应用于核磁共振成像不确定的病例中，作为解决问题的方式。我们在多学科诊所（MDC）中采用了系统的成像和临床随访算法，对治疗后胶质瘤的 FET PET 进行了分析：我们回顾性分析了171例磁共振成像结果不明确的治疗后III级和IV级胶质瘤患者。注射 185-222 MBq 18 F-FET，并在 20 分钟内对大脑进行专门的静态成像。TBR（肿瘤与背景比率）被用作半定量参数。图像解读的临界值为 2.5。在有组织病理学诊断的情况下，或在多学科联合诊所根据连续成像结果确认成像结果：171 例患者中有 121 例在 FET PET 上显示疾病复发，经随访，109 例被证实为复发；7 例患者显示为 TRC，其中 5 例接受贝伐单抗治疗后，临床放射学情况没有进一步恶化，因此证实为 TRC。50 名患者在 FET PET 上显示出 TRC，在随访中，40 名患者被确认为真阴性。10 名显示 TBR 小于 2.5 的患者在随后的磁共振成像中证实了 TR。总体敏感性和特异性分别为 91.6% 和 76.9%，诊断准确率为 87.13%：结论：在高级别胶质瘤的治疗后算法中，FET PET 有可能与 MRI 一起使用。
FET PET to differentiate between post-treatment changes and recurrence in high-grade gliomas: a single center multidisciplinary clinic controlled study.
Purpose: The clinico-radiological dilemma in post-treatment high-grade gliomas, between disease recurrence (TR) and treatment-related changes (TRC), still persists. FET (Fluoro-ethyl-tyrosine) PET has been extensively used as problem-solving modality for cases where MR imaging is inconclusive. We incorporated a systematic imaging and clinical follow-up algorithm in a multi-disciplinary clinic (MDC) setting to analyse our cohort of FET PET in post-treatment gliomas.
Methods: We retrospectively analyzed 171 patients of post-treatment grade III and IV glioma with equivocal findings on MRI. 185-222 MBq of 18 F-FET was injected and dedicated static imaging of brain was performed at 20 min. TBR (Tumor to background ratio) was used as semi-quantitative parameter. Cutoff of 2.5 was used for image interpretation. Imaging findings were confirmed with histopathological diagnosis, wherever available or in a multidisciplinary joint clinic based on serial imaging.
Results: 121 of 171 patients showed recurrent disease on FET PET, on follow up, 109 were confirmed with recurrence; 7 patients showed TRC, whereas 5 were treated with bevacizumab, with no further clinico-radiological deterioration, thus confirming TRC. 50 patients showed TRC on FET PET, on follow up on follow up, 40 were confirmed as true-negative. 10 patients who showed TBR less than 2.5 had confirmed TR on subsequent MR imaging. The overall sensitivity and specificity was 91.6 and 76.9% respectively, with a diagnostic accuracy of 87.13%.
Conclusion: There is potential for FET PET to be used along with MRI in the post treatment algorithm of high-grade glial tumors.
期刊介绍：
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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