nach oben

Erschienen in:

21.10.2020 | Original Communication

¹⁸F-FDOPA-PET in pseudotumoral brain lesions

verfasst von: Dimitri Renard, Laurent Collombier, Sabine Laurent-Chabalier, Thibault Mura, Anne Le Floch, Hassan El Fertit, Eric Thouvenot, Jean Sebastien Guillamo

Erschienen in: Journal of Neurology | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Introduction

3,4-Dihydroxy-6-[¹⁸F]-fluoro-l-phenylalanine (FDOPA) positron emission tomography (PET) is sensitive for identifying primary brain tumors. However, increased FDOPA uptake has been reported in pseudotumoral brain lesions. Our aim was to analyse FDOPA-PET in patients with pseudotumoral brain lesions and to compare them with patients with brain tumors.

Methods

We retrospectively analysed consecutively recruited patients with suspected primary brain tumor (based on clinical and magnetic resonance imaging findings) referred for FDOPA-PET in our centre between November 2013 and June 2019 (n = 74). FDOPA-PET parameters (maximum and mean lesion standardised uptake values [SUV] and ratios comparing lesion with different background uptake SUV) and thresholds were evaluated to determine which offered optimal discrimination between pseudotumoral and tumoral lesions.

Results

Overlapping PET values were observed between pseudotumoral (n = 26) and tumoral (n = 48) lesion, particularly for low-grade tumors. Based on receiver operating characteristic (ROC) analyses, the optimal PET parameters to discriminate pseudotumoral from tumoral lesions were SUV_max lesion/basal ganglia, SUV_max lesion/grey matter, SUV_mean lesion/grey matter, and SUV_max lesion/mirror area in contralateral hemisphere (all ratios showing area under the curve [AUC] 0.85, 95% CI). The narrowest 95% sensitivity–95% specificity window was observed for SUV_max lesion/basal ganglia ratio, with ratio values of 0.79 and 1.35 corresponding to 95% sensitivity and 95% specificity, respectively.

Conclusion

FDOPA-PET uptake should be interpreted with caution in patients with suspected primary brain tumor, especially in patients showing low or intermediate SUV values and ratios.

Clinical Trial Registration-URL

https://www.clinicaltrials.gov. Unique identifier: NCT04306484

Nur mit Berechtigung zugänglich

Albert NL, Weller M, Suchorska B et al (2016) Response assessment in neuro-oncology working group and european association for neuro-oncology recommendations for the clinical use of PET imaging in gliomas. Neuro Oncol 18:1199–1208CrossRef

Filss CP, Cicone F, Shah NJ, Galldiks N, Langen KJ (2017) Amino acid PET and MR perfusion imaging in brain tumours. Clin Transl Imaging 5:209–223CrossRef

Lapa C, Linsenmann T, Monoranu CM et al (2014) Comparison of the amino acid tracers 18F-FET and 18F-DOPA in high-grade glioma patients. J Nucl Med 55:1611–1616CrossRef

Becherer A, Karanikas G, Szabó M et al (2003) Brain tumour imaging with PET: a comparison between [18F]fluorodopa and [11C]methionine. Eur J Nucl Med Mol Imaging 30:1561–1567CrossRef

Kratochwil C, Combs SE, Leotta K et al (2014) Intra-individual comparison of ¹⁸F-FET and ¹⁸F-DOPA in PET imaging of recurrent brain tumors. Neuro Oncol 16:434–440CrossRef

Bund C, Heimburger C, Imperiale A et al (2017) FDOPA PET-CT of nonenhancing brain tumors. Clin Nucl Med 42:250–257CrossRef

Morana G, Bottoni G, Mancardi MM, Verrico A, Piccardo A (2018) Seizure-induced increased 18F-DOPA uptake in a child with diffuse astrocytoma and transient brain mri abnormalities related to status epilepticus. Clin Nucl Med 43:e149–e150CrossRef

Rapp M, Heinzel A, Galldiks N et al (2013) Diagnostic performance of 18F-FET PET in newly diagnosed cerebral lesions suggestive of glioma. J Nucl Med 54:229–235CrossRef

Hutterer M, Nowosielski M, Putzer D et al (2013) [18F]-fluoro-ethyl-L-tyrosine PET: a valuable diagnostic tool in neuro-oncology, but not all that glitters is glioma. Neuro Oncol 15:341–351CrossRef

10.

Xiao J, Jin Y, Nie J, Chen F, Ma X (2019) Diagnostic and grading accuracy of ₁₈F-FDOPA PET and PET/CT in patients with gliomas: a systematic review and meta-analysis. BMC Cancer 19:767CrossRef

11.

Giammarile F, Cinotti LE, Jouvet A et al (2004) High and low grade oligodendrogliomas (ODG): correlation of amino-acid and glucose uptakes using PET and histological classifications. J Neurooncol 68:263–274CrossRef

12.

Fortin D, Cairncross GJ, Hammond RR (1999) Oligodendroglioma: an appraisal of recent data pertaining to diagnosis and treatment. Neurosurgery 45:1279–1291CrossRef

13.

Ogawa T, Hatazawa J, Inugami A et al (1995) Carbon-11-methionine PET evaluation of intracerebral hematoma: distinguishing neoplastic from non-neoplastic hematoma. J Nucl Med 36:2175–2179PubMed

14.

Calabria FF, Chiaravalloti A, Jaffrain-Rea ML et al (2016) 18F-DOPA PET/CT physiological distribution and pitfalls: experience in 215 patients. Clin Nucl Med 41:753–760CrossRef

15.

Hsieh HJ, Lin SH, Chu YK, Chang CP, Wang SJ (2005) F-18 FDG and F-18 FDOPA PET brain imaging in subacute sclerosing panencephalitis. Clin Nucl Med 30:519–520CrossRef

16.

Condon L, Blazak J (2018) Focal 18F-DOPA uptake in brain parenchyma surrounding developmental venous anomalies. Clin Nucl Med 43:e37–e38CrossRef

17.

Floeth FW, Pauleit D, Sabel M et al (2006) 18F-FET PET differentiation of ring-enhancing brain lesions. J Nucl Med 47:776–782PubMed

18.

Kebir S, Gaertner FC, Mueller M et al (2016) ₁₈F-fluoroethyl-L-tyrosine positron emission tomography for the differential diagnosis of tumefactive multiple sclerosis versus glioma: a case report. Oncol Lett 11:2195–2198CrossRef

19.

Lizarraga KJ, Allen-Auerbach M, Czernin J et al (2014) (18)F-FDOPA PET for differentiating recurrent or progressive brain metastatic tumors from late or delayed radiation injury after radiation treatment. J Nucl Med 55:30–36CrossRef

20.

Cicone F, Minniti G, Romano A et al (2015) Accuracy of F-DOPA PET and perfusion-MRI for differentiating radionecrotic from progressive brain metastases after radiosurgery. Eur J Nucl Med Mol Imaging 42:103–111CrossRef

21.

Hernández Pinzón J, Mena D, Aguilar M, Biafore F, Recondo G, Bastianello M (2016) Radionecrosis versus disease progression in brain metastasis. Value of (18)F-DOPA PET/CT/MRI. Rev Esp Med Nucl Imagen Mol 35:332–325PubMed

22.

Sala Q, Metellus P, Taieb D, Kaphan E, Figarella-Branger D, Guedj E (2014) 18F-DOPA, a clinically available PET tracer to study brain inflammation? Clin Nucl Med 39:e283-285CrossRef

23.

Hanley JA, McNeil BJ (1982) The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143:29–36CrossRef

24.

DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845CrossRef

25.

Papin-Michault C, Bonnetaud C, Dufour M et al (2016) Study of LAT1 expression in brain metastases: towards a better understanding of the results of positron emission tomography using amino acid tracers. PLoS ONE 11:e0157139CrossRef

26.

Piroth MD, Prasath J, Willuweit A et al (2013) Uptake of O-(2-[18F]fluoroethyl)-L-tyrosine in reactive astrocytosis in the vicinity of cerebral gliomas. Nucl Med Biol 40:795–800CrossRef

27.

Salber D, Stoffels G, Oros-Peusquens AM et al (2010) Comparison of O-(2–18F-fluoroethyl)-L-tyrosine and L-3H-methionine uptake in cerebral hematomas. J Nucl Med 51:790–797CrossRef

28.

Salber D, Stoffels G, Pauleit D et al (2006) Differential uptake of [18F]FET and [3H]l-methionine in focal cortical ischemia. Nucl Med Biol 33:1029–1035CrossRef

29.

Hutterer M, Bumes E, Riemenschneider MJ et al (2017) AIDS-related central nervous system toxoplasmosis with increased 18F-Fluoroethyl-L-Tyrosine amino acid pet uptake due to LAT1/2 expression of inflammatory cells. Clin Nucl Med 4:e506–e508CrossRef

30.

Lohmann P, Piroth MD, Sellhaus B et al (2018) Correlation of dynamic O-(2-[¹⁸F]Fluoroethyl) L-tyrosine positron emission tomography, conventional magnetic resonance imaging, and whole-brain histopathology in a pretreated glioblastoma: a postmortem study. World Neurosurg 119:e653–e660CrossRef

31.

Pichler R, Wurm G, Nussbaumer K, Kalev O, Silyé R, Weis S (2010) Sarcoidois and radiation-induced astrogliosis causes pitfalls in neuro-oncologic positron emission tomography imaging by O-(2-[18F]fluoroethyl)-L-tyrosine. J Clin Oncol 28:e753-755CrossRef

32.

Munk OL, Tolbod LP, Hansen SB, Bogsrud TV (2017) Point-spread function reconstructed PET images of sub-centimeter lesions are not quantitative. EJNMMI Phys 4:5CrossRef

33.

Law I, Albert NL, Arbizu J et al (2019) Joint EANM/EANO/RANO practice guidelines/SNMMI procedure standards for imaging of gliomas using PET with radiolabelled amino acids and [(18)F]FDG: version 1.0. Eur J Nucl Med Mol Imaging 46:540–557CrossRef

34.

Kumakura Y, Vernaleken I, Buchholz HG et al (2010) Age-dependent decline of steady state dopamine storage capacity of human brain: an FDOPA PET study. Neurobiol Aging 31:447–463CrossRef

Titel: 18F-FDOPA-PET in pseudotumoral brain lesions
verfasst von: Dimitri Renard
Laurent Collombier
Sabine Laurent-Chabalier
Thibault Mura
Anne Le Floch
Hassan El Fertit
Eric Thouvenot
Jean Sebastien Guillamo
Publikationsdatum: 21.10.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 4/2021
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10269-9

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Introduction

Methods

Results

Conclusion

Clinical Trial Registration-URL

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2021

Serum neurofilament light chain as outcome marker for intensive care unit patients

Giovanni Mingazzini (1859–1929)

One nerve suffices: A clinically guided nerve ultrasound protocol for the differentiation of multifocal motor neuropathy (MMN) and amyotrophic lateral sclerosis (ALS)

Management of Parkinson's disease patients after DBS by remote programming: preliminary application of single center during quarantine of 2019-nCoV

Should I stop or should I go on? Disease modifying therapy after the first clinical episode of multiple sclerosis