18F-FDOPA-PET in pseudotumoral brain lesions

Renard, Dimitri; Collombier, Laurent; Laurent‐Chabalier, Sabine; Mura, Thibault; Floch, Anne Le; Fertit, Hassan El; Thouvenot, Éric; Guillamo, J.S.

doi:10.1007/s00415-020-10269-9

Cited by 6 publications

(11 citation statements)

References 33 publications

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“…However, it should be noted that the diagnostic accuracy of both the specialists and the optimal cut-off values for the low 11C-MET tracer uptake lesions were not high, indicating the limitations of using 11C-MET tracer uptake for diagnosis at the rst visit. It was recently reported that it is easy to mistake non-neoplastic lesions for brain tumors on F-DOPAPET imaging [24]. It may be necessary to inform the attending physician planning the next strategy of the limitations of 11C-METPET.…”

Section: Discussionmentioning

confidence: 99%

Usability of 11C-methionine positron emission tomography for differentiation of intracranial brain tumor from non-neoplastic lesions before treatment

Yamaki¹,

Higuchi²,

Iwadate³

et al. 2021

Preprint

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We investigated the usability of 11C-methionine positron emission tomography (11C-METPET) for the differentiation of intracranial brain tumors from non-neoplastic lesions before treatment. Among 425 consecutive patients who underwent 11C-METPET imaging, 113 pretreatment patients were analyzed. Quantitative data including mean, peak, and maximum standardized uptake values and the ratios of lesion uptake to mean and maximum contralateral normal frontal lobe gray matter uptake (Lmax/Nmean and Lmax/Nmax), were analyzed. Next, the optimal cut-off for the differential diagnosis of brain tumors from non-neoplastic lesions were determined using receiver-operating characteristics curves. Finally, positive and negative predictive value were calculated. The final diagnoses for brain tumors included central nervous system tumor, lymphoma, and metastatic brain tumor, whereas the non-neoplastic lesions included neurovascular disease, dysplasia, encephalopathy, and inflammatory disease. An Lmax/Nmax of greater than 2.01 and an Lmax/Nmean of greater than 2.23 provided the best sensitivity and specificity for the differential diagnosis of brain tumor. However, the positive and negative predictive value were 96.5% and 47.4%, respectively, for Lmax/Nmax, and 93.7% and 50%, respectively, for Lmax/Nmean. Considering high positive predictive value and low negative predictive value in relation to the diagnosis based on the optimal cut-off, the utilization of 11C-METPET imaging before treatment requires careful attention.

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Section: Discussionmentioning

confidence: 99%

Usability of 11C-methionine positron emission tomography for differentiation of intracranial brain tumor from non-neoplastic lesions before treatment

Yamaki¹,

Higuchi²,

Iwadate³

et al. 2021

Preprint

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“…FDOPA PET uptake should be interpreted with caution in patients with suspected primary brain tumors, especially in patients showing low or intermediate SUV values and ratios 6 . Renard et al 7 observed overlapping PET values between pseudotumoral (n = 26) and tumoral (n = 48) lesions, particularly for low-grade tumors. 18 F-DOPA uptake may be enhanced in inflammatory tissues, as described by Calabria et al 8 …”

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confidence: 99%

18F-FDOPA and MRI Findings in a Case of Multiple Sclerosis

et al. 2022

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A 39-year-old woman with no significant medical history underwent a brain MRI because of headaches and dysarthria having lasted 3 weeks. A tumor lesion was suspected. PET imaging was decided. She underwent FDG and FDOPA PET, leading to the diagnosis of low-grade glioma. Three months later, a new imaging assessment was organized. It showed a decrease in the hypermetabolism of the lesion and the appearance of a second lesion questioning the diagnosis. Further assessment led to the conclusion of a multiple sclerosis. This case illustrates that FDOPA PET uptake should be interpreted with caution in patients with suspected primary brain tumors.

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“…In differential diagnoses, brain tumors, brain inflammatory lesions, ischemia, or primary central nervous system lymphomas are typically "do not touch" lesions (12), with correspondingly very low rates of available histologic analyses, which restricts their inclusion in these types of retrospective studies. In their study, Renard et al (13) underline that less than one third of their pseudotumor patients had available histology.…”

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confidence: 99%

“…These improvements in MRI-based brain lesion characterizations will allow more specific identification of the best candidate brain lesions to refer for amino acid PET imaging. Moreover, conventional static analysis of 18 F-FDOPA PET imaging is also useful in discriminating between pseudotumoral and tumoral lesions (13).…”

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confidence: 99%

“…Other dynamic amino acid PET studies also suggest that lymphomas (18) and benign lesions (19) show dynamic patterns similar to the ones observed in less aggressive gliomas. Dynamic PET imaging of brain lesions at the initial diagnosis, in addition to conventional static analysis (13), should therefore help identify nonglioma brain lesions. This possibility will, of course, need to be further confirmed by well-designed prospective studies.…”

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confidence: 99%

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Reply to Letter to the Editor: “¹⁸F-FDOPA PET for the Noninvasive Prediction of Glioma Molecular Parameters: A Radiomics Study”

Zaragori

Verger

2022

J Nucl Med

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TO THE EDITOR: We have read with interest the paper by Zaragori et al. about the role of PET using 6-18 F-fluoro-L-DOPA ( 18 F-FDOPA) in the prediction of molecular parameters by radiomics (1). We agree that radiomics is a promising approach to improve the accuracy of amino acid PET (2). This has been demonstrated, for example, for the differentiation of recurrent tumor from treatment-related changes (3,4).Zaragori et al. report that radiomics features of static and dynamic 18

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18F-FDOPA-PET in pseudotumoral brain lesions

Cited by 6 publications

References 33 publications

Usability of 11C-methionine positron emission tomography for differentiation of intracranial brain tumor from non-neoplastic lesions before treatment

Usability of 11C-methionine positron emission tomography for differentiation of intracranial brain tumor from non-neoplastic lesions before treatment

18F-FDOPA and MRI Findings in a Case of Multiple Sclerosis

Reply to Letter to the Editor: “¹⁸F-FDOPA PET for the Noninvasive Prediction of Glioma Molecular Parameters: A Radiomics Study”

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18F-FDOPA-PET in pseudotumoral brain lesions

Cited by 6 publications

References 33 publications

Usability of 11C-methionine positron emission tomography for differentiation of intracranial brain tumor from non-neoplastic lesions before treatment

Usability of 11C-methionine positron emission tomography for differentiation of intracranial brain tumor from non-neoplastic lesions before treatment

18F-FDOPA and MRI Findings in a Case of Multiple Sclerosis

Reply to Letter to the Editor: “18F-FDOPA PET for the Noninvasive Prediction of Glioma Molecular Parameters: A Radiomics Study”

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Reply to Letter to the Editor: “¹⁸F-FDOPA PET for the Noninvasive Prediction of Glioma Molecular Parameters: A Radiomics Study”