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Erschienen in: Annals of Nuclear Medicine 10/2018

07.09.2018 | Original Article

Preliminary feasibility study on differential diagnosis between radiation-induced cerebral necrosis and recurrent brain tumor by means of [18F]fluoro-borono-phenylalanine PET/CT

verfasst von: Rouaa Beshr, Kayako Isohashi, Tadashi Watabe, Sadahiro Naka, Genki Horitsugi, Victor Romanov, Hiroki Kato, Shin-Ichi Miyatake, Eku Shimosegawa, Jun Hatazawa

Erschienen in: Annals of Nuclear Medicine | Ausgabe 10/2018

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Abstract

Objectives

A previous study reported that a differential diagnosis between glioblastoma progression and radiation necrosis by 4-borono-2-[18F]-fluoro-phenylalanine ([18F]FBPA) PET can be made based on lesion-to-normal ratio of [18F]FBPA accumulation. Two-dimensional data acquisition mode PET alone system, with in-plane resolution of 7.9 mm and axial resolution of 13.9 mm, was used. In the current study, we aimed to confirm the differential diagnostic capability of [18F]FBPA PET/CT with higher PET spatial resolution by three-dimensional visual inspection and by measuring mean standardized uptake value (SUVmean), maximum SUV (SUVmax), metabolic tumor volume (MTV), and total lesion (TL) [18F]FBPA uptake.

Methods

Twelve patients of glioma (9), malignant meningioma (1), hemangiopericytoma (1), and metastatic brain tumor (1) were enrolled. All had preceding radiotherapy. High-resolution three-dimensional data acquisition mode PET/CT with in-plane resolution of 4.07 mm and axial resolution of 5.41 mm was employed for imaging. Images were three-dimensionally analyzed using the PMOD software. SUVmean and SUVmax of lesion and normal brain were measured. Lesion MTV and TL FBPA uptake were calculated. The diagnostic accuracy of [18F]FBPA PET/CT in detecting recurrence (n = 6) or necrosis (n = 6) was verified by clinical follow-up.

Results

All parameters showed significantly higher values for tumor recurrence than for necrosis. SUVmean in recurrence was 2.95 ± 0.84 vs 1.18 ± 0.24 in necrosis (P = 0.014); SUVmax in recurrence was 4.63 ± 1.23 vs 1.93 ± 0.44 in necrosis (P = 0.014); MTV in recurrence was 44.92 ± 28.93 mL vs 10.66 ± 8.46 mL in necrosis (P = 0.032); and mean TL FBPA uptake in recurrence was 121.01 ± 50.48 g vs 12.36 ± 9.70 g in necrosis (P = 0.0029).

Conclusion

In this preliminary feasibility study, we confirmed the possibility of differentiating tumor recurrence from radiation necrosis in patients with irradiated brain tumors by [18F]FBPA PET/CT using indices of SUVmean, SUVmax, MTV, and TL 18FBPA uptake.
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Literatur
1.
Zurück zum Zitat Saris S. Multidisciplinary approach to malignant gliomas. Med Health R I. 1996;79(6):210–3.PubMed Saris S. Multidisciplinary approach to malignant gliomas. Med Health R I. 1996;79(6):210–3.PubMed
2.
Zurück zum Zitat Jeon YS, Young-Cho K, Song SW, Cho J, Lim SD. Palliative resection of metastatic brain tumors previously treated by stereotactic radiosurgery. Brain Tumor Res Treat. 2016;4(2):116–23.CrossRef Jeon YS, Young-Cho K, Song SW, Cho J, Lim SD. Palliative resection of metastatic brain tumors previously treated by stereotactic radiosurgery. Brain Tumor Res Treat. 2016;4(2):116–23.CrossRef
3.
Zurück zum Zitat Patchell RA. The management of brain metastases. Cancer Treat Rev. 2013;29(6):533–40.CrossRef Patchell RA. The management of brain metastases. Cancer Treat Rev. 2013;29(6):533–40.CrossRef
4.
Zurück zum Zitat Plowman PN. Stereotactic radiosurgery. VIII. The classification of postradiation reactions. Br J Neurosurg. 1999;13(3):256–64.CrossRef Plowman PN. Stereotactic radiosurgery. VIII. The classification of postradiation reactions. Br J Neurosurg. 1999;13(3):256–64.CrossRef
5.
Zurück zum Zitat Rane N, Quaghebeur G. CNS effects following the treatment of malignancy. Clin Radiol. 2012;67:61–8.CrossRef Rane N, Quaghebeur G. CNS effects following the treatment of malignancy. Clin Radiol. 2012;67:61–8.CrossRef
6.
Zurück zum Zitat Verma N, Cowperthwaite MC, Burnett MG, Markey MK. Differentiating tumor recurrence from treatment necrosis: a review of neuro-oncologic imaging strategies. Neuro-Oncology. 2013;15:515–34.CrossRef Verma N, Cowperthwaite MC, Burnett MG, Markey MK. Differentiating tumor recurrence from treatment necrosis: a review of neuro-oncologic imaging strategies. Neuro-Oncology. 2013;15:515–34.CrossRef
7.
Zurück zum Zitat Dooms GC, Hecht S, Brant-Zawadzki M, Berthiaume Y, Norman D, Newton TH. Brain radiation lesions: MR imaging. Radiology. 1986;158:149–55.CrossRef Dooms GC, Hecht S, Brant-Zawadzki M, Berthiaume Y, Norman D, Newton TH. Brain radiation lesions: MR imaging. Radiology. 1986;158:149–55.CrossRef
8.
Zurück zum Zitat Parvez K, Parvez A, Zadeh G. The diagnosis and treatment of pseudoprogression, radiation necrosis and brain tumor recurrence. Int J Mol Sci. 2014;15(7):11832–46.CrossRef Parvez K, Parvez A, Zadeh G. The diagnosis and treatment of pseudoprogression, radiation necrosis and brain tumor recurrence. Int J Mol Sci. 2014;15(7):11832–46.CrossRef
9.
Zurück zum Zitat Van Laere K, Ceyssens S, Van Calenbergh F, de Groot T, Menten J, Flamen P, Bormans G, Mortelmans L. Direct comparison of 18F-FDG and 11C-methionine PET in suspected recurrence of glioma: sensitivity, inter-observer variability and prognostic value. Eur J Nucl Med Mol Imaging. 2015;32(1):39–51.CrossRef Van Laere K, Ceyssens S, Van Calenbergh F, de Groot T, Menten J, Flamen P, Bormans G, Mortelmans L. Direct comparison of 18F-FDG and 11C-methionine PET in suspected recurrence of glioma: sensitivity, inter-observer variability and prognostic value. Eur J Nucl Med Mol Imaging. 2015;32(1):39–51.CrossRef
10.
Zurück zum Zitat Minamimoto R, Saginoya T, Kondo C, Tomura N, Ito K, Matsuo Y, Matsunaga S, Shuto T, Akabane A, Miyata Y, Sakai S, Kubota K. Differentiation of brain tumor recurrence from post-radiotherapy necrosis with 11C-methionine PET: visual assessment versus quantitative assessment. PLoS One. 2015;13(7):e0132515. 10).CrossRef Minamimoto R, Saginoya T, Kondo C, Tomura N, Ito K, Matsuo Y, Matsunaga S, Shuto T, Akabane A, Miyata Y, Sakai S, Kubota K. Differentiation of brain tumor recurrence from post-radiotherapy necrosis with 11C-methionine PET: visual assessment versus quantitative assessment. PLoS One. 2015;13(7):e0132515. 10).CrossRef
11.
Zurück zum Zitat Okamoto S, Shiga T, Hattori N, Kubo N, Takei T, Katoh N, Sawamura Y, Nishijima K, Kuge Y, Tamaki N. Semiquantitative analysis of C-11 methionine PET may distinguish brain tumor recurrence from radiation necrosis even in small lesions. Ann Nucl Med. 2011;25:213–20.CrossRef Okamoto S, Shiga T, Hattori N, Kubo N, Takei T, Katoh N, Sawamura Y, Nishijima K, Kuge Y, Tamaki N. Semiquantitative analysis of C-11 methionine PET may distinguish brain tumor recurrence from radiation necrosis even in small lesions. Ann Nucl Med. 2011;25:213–20.CrossRef
12.
Zurück zum Zitat Iwai Y, Yamanaka K, Oda J, Tsuyuguchi N, Ochi H. Tracer accumulation in radiation necrosis of the brain after thallium-201 SPECT and [11C]methionine PET: case report. Neurol Med Chir (Tokyo). 2001;41(8):415–8.CrossRef Iwai Y, Yamanaka K, Oda J, Tsuyuguchi N, Ochi H. Tracer accumulation in radiation necrosis of the brain after thallium-201 SPECT and [11C]methionine PET: case report. Neurol Med Chir (Tokyo). 2001;41(8):415–8.CrossRef
13.
Zurück zum Zitat Lizarraga KJ, Allen-Auerbach M, Czernin J, DeSalles AA, Yong WH, Phelps ME, Chen W. 18F-FDOPA PET for differentiating recurrent or progressive brain metastatic tumors from late or delayed radiation injury after radiation treatment. J Nucl Med. 2014;55:30–6.CrossRef Lizarraga KJ, Allen-Auerbach M, Czernin J, DeSalles AA, Yong WH, Phelps ME, Chen W. 18F-FDOPA PET for differentiating recurrent or progressive brain metastatic tumors from late or delayed radiation injury after radiation treatment. J Nucl Med. 2014;55:30–6.CrossRef
14.
Zurück zum Zitat Morana G, Piccardo A, Puntoni M, Nozza P, Cama A, Raso A, Mascelli S, Massollo M, Milanaccio C, Garre ML, Rossi A. Diagnostic and prognostic value of 18F-DOPA PET and 1H-MR spectroscopy in pediatric supratentorial infiltrative gliomas: a comparative study. Neuro Oncol. 2015;17(12):1637–47.CrossRef Morana G, Piccardo A, Puntoni M, Nozza P, Cama A, Raso A, Mascelli S, Massollo M, Milanaccio C, Garre ML, Rossi A. Diagnostic and prognostic value of 18F-DOPA PET and 1H-MR spectroscopy in pediatric supratentorial infiltrative gliomas: a comparative study. Neuro Oncol. 2015;17(12):1637–47.CrossRef
15.
Zurück zum Zitat Ceccon G, Lohmann Ph, Stoffels G, Judov N, Filss CP, Rapp M, Bauer E, Hamisch C, et al. Dynamic O-(2-18F-fluoroethyl)-l-tyrosine positron emission tomography differentiates brain metastasis recurrence from radiation injury after radiotherapy. Neuro-oncology. 2017;19(2):281–8.PubMed Ceccon G, Lohmann Ph, Stoffels G, Judov N, Filss CP, Rapp M, Bauer E, Hamisch C, et al. Dynamic O-(2-18F-fluoroethyl)-l-tyrosine positron emission tomography differentiates brain metastasis recurrence from radiation injury after radiotherapy. Neuro-oncology. 2017;19(2):281–8.PubMed
16.
Zurück zum Zitat Shimosegawa E, Isohashi K, Naka S, Horitsugi G, Hatazawa J. Assessment of 10B concentration in boron neutron capture therapy: potential of image-guided therapy using 18FBPA PET. Ann Nucl Med. 2016;30(10):749–55.CrossRef Shimosegawa E, Isohashi K, Naka S, Horitsugi G, Hatazawa J. Assessment of 10B concentration in boron neutron capture therapy: potential of image-guided therapy using 18FBPA PET. Ann Nucl Med. 2016;30(10):749–55.CrossRef
17.
Zurück zum Zitat Isohashi K, Shimosegawa K, Naka S, Kanai Y, Horitsugi G, Mochida I, Matsunaga K, Watabe T, Kato H, Tatsumi M, Hatazawa J. Comparison of the image-derived radioactivity and blood-sample radioactivity for estimating the clinical indicators of the efficacy of boron neutron capture therapy (BNCT): 4-borono-2-18F-fluoro-phenylalanine (FBPA) PET study. EJNMMI Res. 2016;6(1):75.CrossRef Isohashi K, Shimosegawa K, Naka S, Kanai Y, Horitsugi G, Mochida I, Matsunaga K, Watabe T, Kato H, Tatsumi M, Hatazawa J. Comparison of the image-derived radioactivity and blood-sample radioactivity for estimating the clinical indicators of the efficacy of boron neutron capture therapy (BNCT): 4-borono-2-18F-fluoro-phenylalanine (FBPA) PET study. EJNMMI Res. 2016;6(1):75.CrossRef
18.
Zurück zum Zitat Yoshimoto M, Kurihara H, Honda N, Kawai K, Ohe K, Fujii H, Itami J, Arai Y. Predominant contribution of l-type amino acid transporter to 4-borono-2-(18)F-fluoro-phenylalanine uptake in human glioblastoma cells. Nucl Med Biol. 2013;40(5):625–9.CrossRef Yoshimoto M, Kurihara H, Honda N, Kawai K, Ohe K, Fujii H, Itami J, Arai Y. Predominant contribution of l-type amino acid transporter to 4-borono-2-(18)F-fluoro-phenylalanine uptake in human glioblastoma cells. Nucl Med Biol. 2013;40(5):625–9.CrossRef
19.
Zurück zum Zitat Watabe T, Ikeda H, Nagamori Sh, Wiriyasermkul P, Tanaka Y, Naka S, Kanai Y, Hagiwara K, Aoki M, Shimosegawa E, Kanai Y, Hatazawa J. 18F-FBPA as a tumor-specific probe of l-type amino acid transporter 1 (LAT1): a comparison study with 18F-FDG and 11C-methionine PET. Eur J Nucl Med Mol Imaging. 2017;44(2):321–31.CrossRef Watabe T, Ikeda H, Nagamori Sh, Wiriyasermkul P, Tanaka Y, Naka S, Kanai Y, Hagiwara K, Aoki M, Shimosegawa E, Kanai Y, Hatazawa J. 18F-FBPA as a tumor-specific probe of l-type amino acid transporter 1 (LAT1): a comparison study with 18F-FDG and 11C-methionine PET. Eur J Nucl Med Mol Imaging. 2017;44(2):321–31.CrossRef
20.
Zurück zum Zitat Kanai Y, Segawa H, Miyamoto K, Uchino H, Takeda E, Endou H. Expression cloning and characterization of a transporter for large neutral amino acids activated by the heavy chain of 4F2 antigen (CD98). J Biol Chem. 1998;273(37):23629–32.CrossRef Kanai Y, Segawa H, Miyamoto K, Uchino H, Takeda E, Endou H. Expression cloning and characterization of a transporter for large neutral amino acids activated by the heavy chain of 4F2 antigen (CD98). J Biol Chem. 1998;273(37):23629–32.CrossRef
21.
Zurück zum Zitat Koshi H, Sano T, Handa T, Yanagawa T, Saitou K, Nagamori S, Kanai Y, Takagishi K, Oyama T. l-Type amino acid transporter-1 and CD98 expression in bone and soft tissue tumors. Pathol Int. 2015;65(9):460–7.CrossRef Koshi H, Sano T, Handa T, Yanagawa T, Saitou K, Nagamori S, Kanai Y, Takagishi K, Oyama T. l-Type amino acid transporter-1 and CD98 expression in bone and soft tissue tumors. Pathol Int. 2015;65(9):460–7.CrossRef
22.
Zurück zum Zitat Yoshino E, Ohmori Y, Imahori Y, Higuchi T, Furuya S, Naruse S, Mori T, Suzuki K, Yamaki T, Ueda S, Tsuzuki T, Takai S. Irradiation effects on the metabolism of metastatic brain tumors: analysis by positron emission tomography and 1H-magnetic resonance spectroscopy. Stereotact Funct Neurosurg. 1996;66(Suppl 1):240–59.CrossRef Yoshino E, Ohmori Y, Imahori Y, Higuchi T, Furuya S, Naruse S, Mori T, Suzuki K, Yamaki T, Ueda S, Tsuzuki T, Takai S. Irradiation effects on the metabolism of metastatic brain tumors: analysis by positron emission tomography and 1H-magnetic resonance spectroscopy. Stereotact Funct Neurosurg. 1996;66(Suppl 1):240–59.CrossRef
23.
Zurück zum Zitat Miyashita M, Miyatake S, Imahori Y, Yokoyama K, Kawabata S, Kajimoto Y, Shibata MA, Otsuki Y, Kirihata M, Ono K, Kuroiwa T. Evaluation of fluoride-labeled boronophenylalanine-PET imaging for the study of radiation effects in patients with glioblastomas. J Neurooncol. 2008;89(2):239–46.CrossRef Miyashita M, Miyatake S, Imahori Y, Yokoyama K, Kawabata S, Kajimoto Y, Shibata MA, Otsuki Y, Kirihata M, Ono K, Kuroiwa T. Evaluation of fluoride-labeled boronophenylalanine-PET imaging for the study of radiation effects in patients with glioblastomas. J Neurooncol. 2008;89(2):239–46.CrossRef
24.
Zurück zum Zitat Kanno I, Miura S, Yamamoto S, Iida H, Murakami M, Takahashi K, Uemura K. Design and evaluation of a positron emission tomograph:HEADTOME III. J Comput Assist Tomogr. 1985;9(5):931–9.CrossRef Kanno I, Miura S, Yamamoto S, Iida H, Murakami M, Takahashi K, Uemura K. Design and evaluation of a positron emission tomograph:HEADTOME III. J Comput Assist Tomogr. 1985;9(5):931–9.CrossRef
25.
Zurück zum Zitat Ishiwata K, Ido T, Mejia AA, Ichihashi M, Mishima Y. Synthesis and radiation dosimetry of 4-borono-2-[18F]fluoro-d,l-phenylalanine: a target compound for PET and boron neutron capture therapy. Int J Rad Appl Instrum A. 1991;42(4):325–8.CrossRef Ishiwata K, Ido T, Mejia AA, Ichihashi M, Mishima Y. Synthesis and radiation dosimetry of 4-borono-2-[18F]fluoro-d,l-phenylalanine: a target compound for PET and boron neutron capture therapy. Int J Rad Appl Instrum A. 1991;42(4):325–8.CrossRef
26.
Zurück zum Zitat Matsumoto K, Kitamura K, Mizuta T, Tanaka K, Yamamoto S, Sakamoto S, et al. Performance characteristics of a new 3-dimensional continuous-emission and spiral-transmission high sensitivity and high-resolution PET camera evaluated with the NEMA NU 2-2001 standard. J Nucl Med. 2006;47(1):83–90.PubMed Matsumoto K, Kitamura K, Mizuta T, Tanaka K, Yamamoto S, Sakamoto S, et al. Performance characteristics of a new 3-dimensional continuous-emission and spiral-transmission high sensitivity and high-resolution PET camera evaluated with the NEMA NU 2-2001 standard. J Nucl Med. 2006;47(1):83–90.PubMed
27.
Zurück zum Zitat Bishop A, Satyamurthy N, Gerald B, George H, Ph M, Jorge B. Proton irradiation of [18O]O2: production of [18F]F2 and [18F]F2 + [18F]OF2. Nucl Med Biol. 1996;23(3):189–99.CrossRef Bishop A, Satyamurthy N, Gerald B, George H, Ph M, Jorge B. Proton irradiation of [18O]O2: production of [18F]F2 and [18F]F2 + [18F]OF2. Nucl Med Biol. 1996;23(3):189–99.CrossRef
Metadaten
Titel
Preliminary feasibility study on differential diagnosis between radiation-induced cerebral necrosis and recurrent brain tumor by means of [18F]fluoro-borono-phenylalanine PET/CT
verfasst von
Rouaa Beshr
Kayako Isohashi
Tadashi Watabe
Sadahiro Naka
Genki Horitsugi
Victor Romanov
Hiroki Kato
Shin-Ichi Miyatake
Eku Shimosegawa
Jun Hatazawa
Publikationsdatum
07.09.2018
Verlag
Springer Japan
Erschienen in
Annals of Nuclear Medicine / Ausgabe 10/2018
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-018-1296-2

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