18 F-FDOPA-PET in pseudotumoral brain lesions
- PDF / 1,872,059 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 101 Downloads / 199 Views
ORIGINAL COMMUNICATION
18
F‑FDOPA‑PET in pseudotumoral brain lesions
Dimitri Renard1 · Laurent Collombier2 · Sabine Laurent‑Chabalier3 · Thibault Mura3 · Anne Le Floch1 · Hassan El Fertit4 · Eric Thouvenot1,5 · Jean Sebastien Guillamo1 Received: 29 June 2020 / Revised: 8 October 2020 / Accepted: 10 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction 3,4-Dihydroxy-6-[18F]-fluoro-l-phenylalanine (FDOPA) positron emission tomography (PET) is sensitive for identifying primary brain tumors. However, increased FDOPA uptake has been reported in pseudotumoral brain lesions. Our aim was to analyse FDOPA-PET in patients with pseudotumoral brain lesions and to compare them with patients with brain tumors. Methods We retrospectively analysed consecutively recruited patients with suspected primary brain tumor (based on clinical and magnetic resonance imaging findings) referred for FDOPA-PET in our centre between November 2013 and June 2019 (n = 74). FDOPA-PET parameters (maximum and mean lesion standardised uptake values [SUV] and ratios comparing lesion with different background uptake SUV) and thresholds were evaluated to determine which offered optimal discrimination between pseudotumoral and tumoral lesions. Results Overlapping PET values were observed between pseudotumoral (n = 26) and tumoral (n = 48) lesion, particularly for low-grade tumors. Based on receiver operating characteristic (ROC) analyses, the optimal PET parameters to discriminate pseudotumoral from tumoral lesions were S UVmax lesion/basal ganglia, S UVmax lesion/grey matter, S UVmean lesion/grey matter, and S UVmax lesion/mirror area in contralateral hemisphere (all ratios showing area under the curve [AUC] 0.85, 95% CI). The narrowest 95% sensitivity–95% specificity window was observed for SUVmax lesion/basal ganglia ratio, with ratio values of 0.79 and 1.35 corresponding to 95% sensitivity and 95% specificity, respectively. Conclusion FDOPA-PET uptake should be interpreted with caution in patients with suspected primary brain tumor, especially in patients showing low or intermediate SUV values and ratios. Clinical Trial Registration‑URL https://www.clinicaltrials.gov. Unique identifier: NCT04306484 Keywords Tumor · Pseudotumor · 3,4-dihydroxy-6-[18f]-fluoro-l-phenylalanine · FDOPA · PET
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00415-020-10269-9) contains supplementary material, which is available to authorized users. * Dimitri Renard [email protected] 1
Department of Neurology, CHU Nîmes, University Montpellier, Nîmes, France
2
Department of Nuclear Medicine, CHU Nîmes, University Montpellier, Nîmes, France
3
Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, CHU Nîmes, University Montpellier, Nîmes, France
4
Department of Neurosurgery, CHU Nîmes, University Montpellier, Nîmes, France
5
Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, University Montpelli
Data Loading...
