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European Journal of Nuclear Medicine and Molecular Imaging
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 3/2019

05.01.2019 | Original Article

18F-DOPA PET/CT in brain tumors: impact on multidisciplinary brain tumor board decisions

verfasst von: Olivier Humbert, Véronique Bourg, Lydiane Mondot, Jocelyn Gal, Pierre-Yves Bondiau, Denys Fontaine, Esma Saada-Bouzid, Marie Paquet, David Chardin, Fabien Almairac, Fanny Vandenbos, Jacques Darcourt

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 3/2019

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Abstract

Purpose

This study aimed to assess the therapeutic impact and diagnostic accuracy of 18F-DOPA PET/CT in patients with glioblastoma or brain metastases.

Methods

Patients with histologically proven glioblastoma or brain metastases were prospectively included in this monocentric clinical trial (IMOTEP). Patients were included either due to a clinical suspicion of relapse or to assess residual tumor infiltration after treatment. Multimodality brain MRI and 18F-DOPA PET were performed. Patients’ data were discussed during a Multidisciplinary Neuro-oncology Tumor Board (MNTB) meeting. The discussion was first based on clinical and MRI data, and an initial diagnosis and treatment plan were proposed. Secondly, a new discussion was conducted based on the overall imaging results, including 18F-DOPA PET. A second diagnosis and therapeutic plan were proposed. A retrospective and definitive diagnosis was obtained after a 3-month follow-up and considered as the reference standard.

Results

One hundred six cases were prospectively investigated by the MNTB. All patients with brain metastases (N = 41) had a clinical suspicion of recurrence. The addition of 18F-DOPA PET data changed the diagnosis and treatment plan in 39.0% and 17.1% of patients’ cases, respectively. Concerning patients with a suspicion of recurrent glioblastoma (N = 12), the implementation of 18F-DOPA PET changed the diagnosis and treatment plan in 33.3% of cases. In patients evaluated to assess residual glioblastoma infiltration after treatment (N = 53), 18F-DOPA PET data had a lower impact with only 5.7% (3/53) of diagnostic changes and 3.8% (2/53) of therapeutic plan changes. The definitive reference diagnosis was available in 98/106 patients. For patients with tumor recurrence suspicion, the adjunction of 18F-DOPA PET increased the Younden’s index from 0.44 to 0.53 in brain metastases and from 0.2 to 1.0 in glioblastoma, reflecting an increase in diagnostic accuracy.

Conclusion

18F-DOPA PET has a significant impact on the management of patients with a suspicion of brain tumor recurrence, either glioblastoma or brain metastases, but a low impact when used to evaluate the residual glioblastoma infiltration after a first-line radio-chemotherapy or second-line bevacizumab.
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Metadaten
Titel
18F-DOPA PET/CT in brain tumors: impact on multidisciplinary brain tumor board decisions
verfasst von
Olivier Humbert
Véronique Bourg
Lydiane Mondot
Jocelyn Gal
Pierre-Yves Bondiau
Denys Fontaine
Esma Saada-Bouzid
Marie Paquet
David Chardin
Fabien Almairac
Fanny Vandenbos
Jacques Darcourt
Publikationsdatum
05.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 3/2019
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-018-4240-8

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