The value of 11 C-methionine PET in the early differentiation between tumor recurrence and radionecrosis in patients treated for a high-grade glioma and indeterminate MRI

García, J.R.; Cozar, M.; Baquero, Miguel; Barrionuevo, J.M. Fernández; Jaramillo, A.; Rubio, J.; Maida, Giuseppe; Solèr, M.; Riera, E.

doi:10.1016/j.remnie.2016.11.006

Cited by 7 publications

(7 citation statements)

References 25 publications

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Section: Discussionmentioning

confidence: 99%

“…The 11 C-methionine uptake is directly related to L-type amino acid transporter 1 expression ( 41 ); high 11 C-methionine uptake characteristically occurs in tumors with a high degree of neoangiogenesis and cellular proliferation ( 8 , 41 ). Previous studies have found 11 C-methionine PET to have high sensitivity and specificity for diagnosing high-grade tumors ( 8 , 42 ). In our study, we found that the sensitivity and accuracy of 11 C-methionine PET for correctly differentiating true tumor progression from treatment-related effects were 100% and 93%, respectively, compared with the reported 70%–80% sensitivity and 75% accuracy in previous studies ( 37 , 38 , 40 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, the diagnosis of recurrence is not always straightforward with magnetic resonance imaging (MRI), which is the clinical standard of care test for assessing responses to treatments. Indeed, treatment-related effects including pseudoprogression frequently mimics tumor recurrence, thereby leading to misdiagnosis and incorrect management (8,9).…”

Section: Introductionmentioning

confidence: 99%

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[¹¹C]-Methionine PET for Identification of Pediatric High-Grade Glioma Recurrence

et al. 2021

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Rationale: Differentiating tumor recurrence or progression from pseudoprogression during surveillance of pediatric high-grade gliomas (PHGGs) using magnetic resonance imaging (MRI), the primary imaging modality for evaluation of brain tumors, can be challenging. The aim of this study was to evaluate whether [11]Cmethionine positron emission tomography ([11C]MET -PET), a molecular imaging technique that detects functionally active tumors, is useful for further evaluating MRI changes concerning for tumor recurrence during routine surveillance. Methods:We evaluated 27 lesions in 26 patients with new or worsening MRI abnormalities, where PHGG tumor recurrence was of concern during follow-up visits with [11C]MET -PET. We performed quantitative and qualitative assessments of both [11C]MET-PET and MRI data to predict the presence of tumor recurrence.Further, to assess for an association with overall survival we plotted the time from development of the imaging changes against survival.Results: Qualitative evaluation of [11C]MET-PET achieved 100% sensitivity, 60% specificity, and 93% accuracy to correctly predict the presence of tumors in 27 new or worsening MRI abnormalities. Qualitative MRI evaluation achieved sensitivity ranging from 86% to 95%, specificity ranging from 40% to 60%, and accuracy ranging from 85% to 89%. The interobserver agreement for [11C]MET-PET assessment was 100%, whereas the interobserver agreement was only 50% for MRI (P = <0.01). Quantitative MRI and [11C]MET-PET evaluation using receiver operating characteristics demonstrated higher specificity (80%) than qualitative evaluations (40-60%). Postcontrast enhancement volume, metabolic tumor volume, tumor-to-brain ratio and presence of tumor as determined by consensus MRI assessment were inversely associated with overall survival. Conclusion:[11C]MET-PET has slightly higher sensitivity, and accuracy for correctly predicting presence of tumor recurrence, with excellent interobserver agreement, than does MRI. Quantitative [11C]MET-PET can also predict overall survival. These findings suggest [11C]MET-PET can be useful for further evaluation of MRI changes during surveillance of previously treated PHGG.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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[¹¹C]-Methionine PET for Identification of Pediatric High-Grade Glioma Recurrence

et al. 2021

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“…In order to differentiate between tumor recurrence and RN, Garcia et al quantified 11C-MET-PET data (SUV max/SUV mean background) in patients affected by high-grade glioma and treated with post-operative radiotherapy. They found that SUV lesion/background was 2.79 ± 1.35 in tumor recurrence, and 1.53 ± 0.39 in radionecrosis (p < 05) [26]. However, MET-PET might also give false positive and false negative.…”

Section: Nuclear Medicine Imagingmentioning

confidence: 99%

Stereotactic Radiotherapy for Brain Metastases: Imaging Tools and Dosimetric Predictive Factors for Radionecrosis

Lupattelli

Alì

Ingrosso

et al. 2020

JPM

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Radionecrosis (RN) is the most important side effect after stereotactic radiotherapy (SRT) for brain metastases, with a reported incidence ranging from 3% to 24%. To date, there are no unanimously accepted criteria for iconographic diagnosis of RN, as well as no definitive dose-constraints correlated with the onset of this late effect. We reviewed the current literature and gave an overview report on imaging options for the diagnosis of RN and on dosimetric parameters correlated with the onset of RN. We performed a PubMed literature search according to the preferred reporting items and meta-analysis (PRISMA) guidelines, and identified articles published within the last ten years, up to 31 December 2019. When analyzing data on diagnostic tools, perfusion magnetic resonance imaging (MRI) seems to be very useful allowing evaluation of the blood flow in the lesion using the relative cerebral blood volume (rCBV) and blood vessel integrity using relative peak weight (rPH). It is necessary to combine morphological with functional imaging in order to match information about lesion morphology, metabolism and blood-flow. Eventually, serial imaging follow-up is needed. Regarding dosimetric parameters, in radiosurgery (SRS) V12 < 8 cm3 and V10 < 10.5 cm3 of normal brain are the most reliable prognostic factors, whereas in hypo-fractionated stereotactic radiotherapy (HSRT) V18 and V21 are considered the main predictive independent risk factors of RN.

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“…The isolation of circulating tumor cells [180] could be useful during follow-up [177,[180][181][182][183] as a complement to radiographic features [184]. Circulating microRNA analysis could be interesting for identifying TP versus PsP because miRNA accurately identifies cancer tissues [177,185] via circulating tumor stem cells [186,187], circulating cell-free nucleic acids [176] or circulating tumor cell clusters [188].…”

Section: Blood-based Biomarkersmentioning

confidence: 99%

Pseudoprogression versus true progression in glioblastoma patients: A multiapproach literature review

Fèvre

Lhermitte

Ahle

et al. 2021

Critical Reviews in Oncology/Hematology

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The value of 11 C-methionine PET in the early differentiation between tumor recurrence and radionecrosis in patients treated for a high-grade glioma and indeterminate MRI

Cited by 7 publications

References 25 publications

[¹¹C]-Methionine PET for Identification of Pediatric High-Grade Glioma Recurrence

[¹¹C]-Methionine PET for Identification of Pediatric High-Grade Glioma Recurrence

Stereotactic Radiotherapy for Brain Metastases: Imaging Tools and Dosimetric Predictive Factors for Radionecrosis

Pseudoprogression versus true progression in glioblastoma patients: A multiapproach literature review

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The value of 11 C-methionine PET in the early differentiation between tumor recurrence and radionecrosis in patients treated for a high-grade glioma and indeterminate MRI

Cited by 7 publications

References 25 publications

[11C]-Methionine PET for Identification of Pediatric High-Grade Glioma Recurrence

[11C]-Methionine PET for Identification of Pediatric High-Grade Glioma Recurrence

Stereotactic Radiotherapy for Brain Metastases: Imaging Tools and Dosimetric Predictive Factors for Radionecrosis

Pseudoprogression versus true progression in glioblastoma patients: A multiapproach literature review

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[¹¹C]-Methionine PET for Identification of Pediatric High-Grade Glioma Recurrence

[¹¹C]-Methionine PET for Identification of Pediatric High-Grade Glioma Recurrence