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

Humbert, Olivier; Bourg, V.; Mondot, Lydiane; Gal, Jocelyn; Bondiau, Pierre‐Yves; Fontaine, Denys; Sâada-Bouzid, Esma; Paquet, M.; Chardin, David; Almairac, Fabien; Vandenbos, Fanny; Darcourt, Jacques

doi:10.1007/s00259-018-4240-8

Cited by 33 publications

(26 citation statements)

References 45 publications

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“…The authors demonstrated that this technique was able to modify the diagnosis or the therapeutic strategy in up to 33.3% of cases when considering patients with glioblastomas. The main limitation was the lack of correlation with pathological data (9.4% of patients) [50]. Youland et al correlated 37 stereotactic biopsies and histological results from 13 patients according to areas of increased 18 F-FDOPA uptake and areas of MRI contrast enhancement.…”

Section: Diagnosis Between Recurrence and Post-therapeutic Changesmentioning

confidence: 99%

Usefulness of 18F-FDOPA PET for the management of primary brain tumors: a systematic review of the literature

et al. 2020

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Contrast-enhanced magnetic resonance imaging is currently the standard of care in the management of primary brain tumors, although certain limitations remain. Metabolic imaging has proven useful for an increasing number of indications in oncology over the past few years, most particularly 18F-FDG PET/CT. In neuro-oncology, 18F-FDG was insufficient to clearly evaluate brain tumors. Amino-acid radiotracers such as 18F-FDOPA were then evaluated in the management of brain diseases, notably tumoral diseases. Even though European guidelines on the use of amino-acid PET in gliomas have been published, it is crucial that future studies standardize acquisition and interpretation parameters. The aim of this article was to systematically review the potential effect of this metabolic imaging technique in numerous steps of the disease: primary and recurrence diagnosis, grading, local and systemic treatment assessment, and prognosis. A total of 41 articles were included and analyzed in this review. It appears that 18F-FDOPA PET holds promise as an effective additional tool in the management of gliomas. More consistent prospective studies are still needed.

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Section: Diagnosis Between Recurrence and Post-therapeutic Changesmentioning

confidence: 99%

Usefulness of 18F-FDOPA PET for the management of primary brain tumors: a systematic review of the literature

et al. 2020

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“…More recently, 18 F-labelled DOPA is a more widely used amino acid tracer than 11 C-MET because it has a longer half-life of up to 110 minutes, whereas that of 11 C-MET is only 20 minutes. Humbert O. et al [8] found that 18 F-FDOPA PET has a signi cant impact on the management of patients with a suspicion of brain tumour recurrence, either glioblastoma or brain metastases, but a low impact when used to evaluate residual glioblastoma in ltration after rst-line radiochemotherapy or second-line bevacizumab. 18 F-FDOPA has been increasingly used in glioma and exhibits potential value in the identi cation of TrE and TuR [21].…”

Section: Discussionmentioning

confidence: 99%

“…Positron emission tomography/computed tomography (PET/CT) is a molecular imaging technique allowing in vivo quantitative measurement of biological processes noninvasively, which has become an integral supplemental imaging tool for differential diagnosis of brain lesions beyond MR [7]. Some PET tracers, such as 18 F-uorodeoxyglucose ( 18 F-FDG), 13 N-ammonia ( 13 N-NH 3 ), 11 C-methylmethionine ( 11 C-MET), 18 F-uoroethyl-L-tyrosine ( 18 F-FET), and 18 F-uoro-L-dihydroxy-phenylalanine ( 18 F-FDOPA), have been used for imaging gliomas [7][8][9][10]. The Response Assessment in Neuro-Oncology working group and European Association for Neuro-Oncology have also recommended the clinical use of PET/CT imaging in gliomas, and they emphasize that PET/CT exhibits increased diagnostic accuracy than MR when differentiating TuR from TrE [11].…”

Section: Read Full Licensementioning

confidence: 99%

Identify glioma recurrence and treatment effects with triple-tracer PET/CT

Liu

Chen

et al. 2021

Preprint

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Purpose: Differential diagnosis of tumour recurrence (TuR) from treatment effects (TrE), mostly induced by radiotherapy and chemotherapy, is still difficult by using conventional computed tomography (CT) or magnetic resonance (MR) imaging. We have investigated the diagnostic performance of PET/CT with 3 tracers, 13N-NH3, 18F-FDOPA, and 18F-FDG, to identify TuR and TrE in glioma patients following treatment. Methods: Forty-three patients with MR-suspected recurrent glioma were included. The maximum and mean standardized uptake values (SUVmax and SUVmean) of the lesion and the lesion-to-normal grey-matter cortex uptake (L/G) ratio were obtained from each tracer PET/CT. TuR or TrE was determined by histopathology or clinical MR follow-up for at least 6 months. Results: In this cohort, 34 patients were confirmed to have TuR, and 9 patients met the diagnostic standard of TrE. The SUVmax and SUVmean of 13N-NH3 and 18F-FDOPA PET/CT at TuR lesions were significantly higher compared with normal brain tissue (13N-NH3 0.696±0.558, 0.625±0.507 vs 0.486±0.413; 18F-FDOPA 0.455±0.518, 0.415±0.477 vs 0.194±0.203; both P<0.01), but there was no significant difference in 18F-FDG (6.918±3.190, 6.016±2.807 vs 6.356±3.104, P=0.290 and 0.493). L/G ratios of 13N-NH3 and 18F-FDOPA were significantly higher in TuR than in TrE group (13N-NH3, 1.573±0.099 vs 1.025±0.128, P=0.008; 18F-FDOPA, 2.729±0.131 vs 1.514±0.141, P<0.001). The sensitivity, specificity and AUC (area under the curve) by ROC (receiver operating characteristic) analysis were 57.7%, 100% and 0.803, for 13N-NH3; 84.6%, 100% and 0.938, for 18F-FDOPA; and 80.8%, 100%, and 0.952, for the combination, respectively.Conclusion: Our results suggest that although multiple tracer PET/CT may improve differential diagnosis efficacy, for glioma TuR from TrE, 18F-FDOPA PET-CT is the most reliable. The combination of 18F-FDOPA and 13N-NH3 does not increase the diagnostic efficiency, while 18F-FDG is not worthy for differential diagnosis of glioma TuR and TrE.

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“…Recently, 18F-FDOPA it is studied in the imaging of brain tumors. In this scenario, one of the main pros of 18F-FDOPA lays in the crossing of the BBB thanks to a specific neutral amino acid transporter, which grants a better uptake ratio also because tracer accumulation does not depend on BBB breakdown [78]. In a non-conventional meta-analysis, Yu et al evaluated the accuracy of 18F-FDOPA and compared it to 18F-FET for differentiating RN from brain tumor recurrence going through 48 separate studies (18F-FDOPA, n = 21; 18F-FET, n = 27), in which both tracer showed comparable results in terms of pooled sensitivity (85%), specificity (82%) and diagnostic odds ratio (21.7); in particular, 18F-FDOPA showed better diagnostic accuracy in patients with glioma compared with patients with brain metastases and proved to be better than 18F-FET in diagnosing glioma recurrence.…”

Section: Figure 2 (A) Post-surgical Right Parietal Changes Due To Rementioning

confidence: 99%

Diagnosis and Management of Radiation Necrosis in Patients with Brain Metastases and Primary Tumors

García-Robledo¹,

Ruíz-Patiño²,

Sotelo³

et al. 2022

Central Nervous System Tumors

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The incidence of radiation necrosis has increased secondary to combined modality therapy for brain tumors and stereotactic radiosurgery. The pathology of progressive brain radiation necrosis (RN) primarily includes inflammation and angiogenesis in which cytokines, chemokines, and vascular endothelial growth factors are upregulated. Combined multiparametric imaging, including lesional metabolism, spectroscopy, and blood flow, could enhance diagnostic accuracy compared with a single imaging study. Nevertheless, a substantial risk of bias restricts firm conclusions about the best imaging technique for diagnosing brain RN. Bevacizumab shows promising results of improving radiographic edema and post-gadolinium enhancement with associated symptomatic improvement. However, this was based on small double-blinded randomized controlled trials, which introduces a high risk of bias due to the small sample size despite the high-quality trial design. Edaravone combined with corticosteroids also resulted in a more significant reduction in radiographic edema than corticosteroids alone but had no impact on reducing the enhancing lesion. There is a great need for further prospective randomized controlled trials (RCTs) to treat brain RN.

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

Cited by 33 publications

References 45 publications

Usefulness of 18F-FDOPA PET for the management of primary brain tumors: a systematic review of the literature

Usefulness of 18F-FDOPA PET for the management of primary brain tumors: a systematic review of the literature

Identify glioma recurrence and treatment effects with triple-tracer PET/CT

Diagnosis and Management of Radiation Necrosis in Patients with Brain Metastases and Primary Tumors

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