18F-Fluorocholine PET/CT as a complementary tool in the follow-up of low-grade glioma: diagnostic accuracy and clinical utility

Gómez-Río, Manuel; Dardel, Nathalie Testart; Chinchilla, A. Santiago; Rodrı́guez-Fernández, Antonio; Granados, Gonzalo Olivares; Luque, Raquel; Herrera, M. Zurita; Santos, Clara E. Chamorro; Lardelli-Claret, Pablo; Elvira, J.M. Llamas

doi:10.1007/s00259-015-2997-6

Cited by 22 publications

(11 citation statements)

References 31 publications

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“…Using TBR, the reported diagnostic accuracy is even higher because TBR is significantly higher in patients with TP with respect to negative cases 9,20,21 . On the other hand, 18 F-fluorocholine seems to offer the same results, based on its capability to predict therapy response 10,22 . Similarly to the previously reported results by Montes et al, 20 our mean SUV max and TBR values significantly differed between TP and negative cases.…”

Section: Discussionsupporting

confidence: 75%

Early Recurrence Detection of Glioma Using 18F-Fluorocholine PET/CT

Vicente¹,

Amo-Salas

Valencia³

et al. 2022

Clin Nucl Med

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ObjectiveThe aim of this study was to analyze the usefulness of 18F-fluorocholine PET/CT in the early diagnosis of tumor recurrence, increasing the diagnosis confidence of MRI.MethodsPatients with a previous gross total resection of glioma and the first suspicious or doubtful for recurrence MRI were prospectively included and subjected to 18F-fluorocholine PET/CT. An independent and combined assessment of 18F-fluorocholine PET/CT and multimodal MRI was performed classifying the studies as positive or negative for tumor recurrence. Final diagnosis (recurrence or not) was obtained by histological confirmation or clinical and imaging follow-up. The relation of SUVmax and tumor-to-background ratio with progression, the diagnostic performance of imaging techniques, and their concordance (κ Cohen) were analyzed.ResultsTwenty-four studies on 21 patients were assessed. Recurrence was diagnosed in 20 cases. PET/CT was positive in 23 cases (3 false positive), whereas MRI was positive in 15 cases (1 false positive). MRI was false negative in 6 cases. There was no false negative on 18F-fluorocholine PET/CT. Accuracy of PET/CT versus MRI was 87.5% and 70.8%, respectively. The combined evaluation of both techniques did not show any advantage with respect to PET/CT results alone. The concordance between both imaging techniques was low (κ = 0.135; P = 0.375). SUVmax and tumor-to-background ratio were related to recurrence (areas under the curve of 0.844 [P = 0.033] and 0.869 [P = 0.022], respectively).Conclusions18F-fluorocholine PET/CT was helpful for increasing the diagnostic confidence in the cases of MRI doubtful for recurrence in order to avoid a delayed diagnosis.

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Section: Discussionsupporting

confidence: 75%

Early Recurrence Detection of Glioma Using 18F-Fluorocholine PET/CT

Vicente¹,

Amo-Salas

Valencia³

et al. 2022

Clin Nucl Med

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“…It is worth noting that no such false positive being observed in Ref. [ 12 ] based on patient-specific studies. This difference may be caused by the in vivo environment of each patient, the location, growth stage and dimension of the tumor, and PET scanner, etc.…”

Section: Discussionmentioning

confidence: 91%

“…Only 18 F-FCH provides a clear contrast between tumor and normal cerebral tissues ( Fig 1D ). It is observed that normal cerebral tissues typically represent low 18 F-FCH uptake [ 12 ] as shown in Fig 2A . However, in some of the control animals, 18 F-FCH uptake is unexpectedly observed in normal brain tissue ( Fig 2B ), resulting in potential false-positive findings.…”

Section: Resultsmentioning

confidence: 99%

“…Clinical experiments represented that 18 F-FCH accumulates significantly in high grade glioma [ 11 ], but little is known about its distribution into low grade gliomas. Recent clinical studies demonstrated a high sensitivity of 18 F-FCH PET/CT detection for low-grade glioma based on experiments involving 18 patients [ 12 ], with no false positive being observed. However, it still has been reported that 18 F-FCH can accumulate in normal brain cells [ 6 , 10 ] to result in false positive.…”

Section: Introductionmentioning

confidence: 99%

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A Dual Tracer 18F-FCH/18F-FDG PET Imaging of an Orthotopic Brain Tumor Xenograft Model

Ong

Ranganath

et al. 2016

PLoS ONE

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Early diagnosis of low grade glioma has been a challenge to clinicians. Positron Emission Tomography (PET) using 18F-FDG as a radio-tracer has limited utility in this area because of the high background in normal brain tissue. Other radiotracers such as 18F-Fluorocholine (18F-FCH) could provide better contrast between tumor and normal brain tissue but with high incidence of false positives. In this study, the potential application of a dual tracer 18F-FCH/18F-FDG-PET is investigated in order to improve the sensitivity of PET imaging for low grade glioma diagnosis based on a mouse orthotopic xenograft model. BALB/c nude mice with and without orthotopic glioma xenografts from U87 MG-luc2 glioma cell line are used for the study. The animals are subjected to 18F-FCH and 18F-FDG PET imaging, and images acquired from two separate scans are superimposed for analysis. The 18F-FCH counts are subtracted from the merged images to identify the tumor. Micro-CT, bioluminescence imaging (BLI), histology and measurement of the tumor diameter are also conducted for comparison. Results show that there is a significant contrast in 18F-FCH uptake between tumor and normal brain tissue (2.65 ± 0.98), but with a high false positive rate of 28.6%. The difficulty of identifying the tumor by 18F-FDG only is also proved in this study. All the tumors can be detected based on the dual tracer technique of 18F-FCH/ 18F-FDG-PET imaging in this study, while the false-positive caused by 18F-FCH can be eliminated. Dual tracer 18F-FCH/18F-FDG PET imaging has the potential to improve the visualization of low grade glioma. 18F-FCH delineates tumor areas and the tumor can be identified by subtracting the 18F-FCH counts. The sensitivity was over 95%. Further studies are required to evaluate the possibility of applying this technique in clinical trials.

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“…The study by Gómez-Río and colleagues demonstrated that 18 F-fluorocholine PET/CT is useful to detect a recurrence of posttreatment LGG [3]. The value of this study is that the study was prospectively done in comparison with standard/ advanced radiological examinations performed with clinically available procedures at present.…”

mentioning

confidence: 98%