Diagnostic accuracy of 11C-methionine PET in detecting neuropathologically confirmed recurrent brain tumor after radiation therapy

Kits, Annika; Martin, Heather; Sánchez-Crespo, Alejandro; Delgado, Anna Falk

doi:10.1007/s12149-017-1227-7

Cited by 12 publications

(19 citation statements)

References 27 publications

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“…The forest plot for 11 C-MET PET (9 studies, 164 PET scans) shows a consistently high sensitivity without any major outliers. Two outliers on the low end of specificity (7,30) can again be explained by their low number of patients with treatment-related changes and have broad confidence intervals. Pooled sensitivity and specificity for 11 C-MET PET (excluding one study that did not include patients without tumor progression (48) are 93% (95%CI, 80%-98%) and 82% (95%CI, 68%-91%), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Pooled sensitivity and specificity for 11 C-MET PET (excluding one study that did not include patients without tumor progression (48) are 93% (95%CI, 80%-98%) and 82% (95%CI, 68%-91%), respectively. A sensitivity analysis with the exclusion of the 2 small studies (21,30) leads to a pooled sensitivity and specificity of 91% (95%CI, 78%-97%) and 83% (95%CI, 68%-92%), respectively.…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic Accuracy of PET Tracers for the Differentiation of Tumor Progression from Treatment-Related Changes in High-Grade Glioma: A Systematic Review and Metaanalysis

et al. 2019

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Posttreatment high-grade gliomas are usually monitored with contrast-enhanced MRI, but its diagnostic accuracy is limited as it cannot adequately distinguish between true tumor progression and treatment-related changes. According to recent Response Assessment in Neuro-Oncology recommendations, PET overcomes this limitation. However, it is currently unknown which tracer yields the best results. Therefore, a systematic review and metaanalysis were performed to compare the diagnostic accuracy of the different PET tracers in differentiating tumor progression from treatment-related changes in high-grade glioma patients. Methods: PubMed, Web of Science, and Embase were searched systematically. Study selection, data extraction, and quality assessment were performed independently by 2 authors. Metaanalysis was performed using a bivariate random-effects model when at least 5 studies were included. Results: The systematic review included 39 studies (11 tracers). 18 F-FDG (12 studies, 171 lesions) showed a pooled sensitivity and specificity of 84% (95% confidence interval, 72%-92%) and 84% (95% confidence interval, 69%-93%), respectively. O-(2-18 F-fluoroethyl)-L-tyrosine (18 F-FET) (7 studies, 172 lesions) demonstrated a sensitivity of 90% (95% confidence interval, 81%-95%) and specificity of 85% (95% confidence interval, 71%-93%). For S-11 C-methyl)-L-methionine (11 C-MET) (8 studies, 151 lesions), sensitivity was 93% (95% confidence interval, 80%-98%) and specificity was 82% (95% confidence interval, 68%-91%). The numbers of included studies for the other tracers were too low to combine, but sensitivity and specificity ranged between 93%-100% and 0%-100%, respectively, for 18 F-FLT; 85%-100% and 72%-100%, respectively, for 3,4-dihydroxy-6-18 F-fluoro-L-phenylalanine (18 F-FDOPA); and 100% and 70%-88%, respectively, for 11 C-choline. Conclusion: 18 F-FET and 11 C-MET, both amino-acid tracers, showed a comparably higher sensitivity than 18 F-FDG in the differentiation between tumor progression and treatment-related changes in high-grade glioma patients. The evidence for other tracers is limited; thus, 18 F-FET and 11 C-MET are preferred when available. Our results support the incorporation of amino-acid PET tracers for the treatment evaluation of high-grade gliomas.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Diagnostic Accuracy of PET Tracers for the Differentiation of Tumor Progression from Treatment-Related Changes in High-Grade Glioma: A Systematic Review and Metaanalysis

et al. 2019

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“…Our result was in line with the Kits et al retrospective study. 29 An appropriate assessment method for tracer uptake is also an option that is under discussion. In this study, we adopted visual assessment to determine whether 11 C-MET and 18 F-FDG were taken up in the targeted lesions because visual assessment may be pertinent to daily clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Determination of brain tumor recurrence using ¹¹C‐methionine positron emission tomography after radiotherapy

et al. 2021

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“…The PET radiotracer [ 11 C-methyl]- l -methionine ( 11 C-MET) is the most well-established and utilized amino acid probe. 11 C-MET PET has been shown to be useful in delineating ependymomas, medulloblastoma, and astrocytomas in pediatric patients and can also effectively differentiate between radiation-induced brain tissue injury and tumor recurrence [40,41,42,43]. It is superior to MRI in differentiating tumor necrosis following gamma knife radiosurgery from recurrent tumor [44] and offers accurate tumor size correlation of WHO grades II and III meningiomas [45].…”

Section: Positron Emission Tomography Of Cns Tumorsmentioning

confidence: 99%

The Emerging Role of Amino Acid PET in Neuro-Oncology

2018

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Imaging plays a critical role in the management of the highly complex and widely diverse central nervous system (CNS) malignancies in providing an accurate diagnosis, treatment planning, response assessment, prognosis, and surveillance. Contrast-enhanced magnetic resonance imaging (MRI) is the primary modality for CNS disease management due to its high contrast resolution, reasonable spatial resolution, and relatively low cost and risk. However, defining tumor response to radiation treatment and chemotherapy by contrast-enhanced MRI is often difficult due to various factors that can influence contrast agent distribution and perfusion, such as edema, necrosis, vascular alterations, and inflammation, leading to pseudoprogression and pseudoresponse assessments. Amino acid positron emission tomography (PET) is emerging as the method of resolving such equivocal lesion interpretations. Amino acid radiotracers can more specifically differentiate true tumor boundaries from equivocal lesions based on their specific and active uptake by the highly metabolic cellular component of CNS tumors. These therapy-induced metabolic changes detected by amino acid PET facilitate early treatment response assessments. Integrating amino acid PET in the management of CNS malignancies to complement MRI will significantly improve early therapy response assessment, treatment planning, and clinical trial design.

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Diagnostic accuracy of 11C-methionine PET in detecting neuropathologically confirmed recurrent brain tumor after radiation therapy

Abstract: Based on neuropathologically confirmed cases, the DTA of SURmirror and SURcortex from C-methionine PET was high when discriminating recurrent tumor from radiation injury.

Cited by 12 publications

References 27 publications

Diagnostic Accuracy of PET Tracers for the Differentiation of Tumor Progression from Treatment-Related Changes in High-Grade Glioma: A Systematic Review and Metaanalysis

Diagnostic Accuracy of PET Tracers for the Differentiation of Tumor Progression from Treatment-Related Changes in High-Grade Glioma: A Systematic Review and Metaanalysis

Determination of brain tumor recurrence using ¹¹C‐methionine positron emission tomography after radiotherapy

The Emerging Role of Amino Acid PET in Neuro-Oncology

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Diagnostic accuracy of 11C-methionine PET in detecting neuropathologically confirmed recurrent brain tumor after radiation therapy

Abstract: Based on neuropathologically confirmed cases, the DTA of SURmirror and SURcortex from C-methionine PET was high when discriminating recurrent tumor from radiation injury.

Cited by 12 publications

References 27 publications

Diagnostic Accuracy of PET Tracers for the Differentiation of Tumor Progression from Treatment-Related Changes in High-Grade Glioma: A Systematic Review and Metaanalysis

Diagnostic Accuracy of PET Tracers for the Differentiation of Tumor Progression from Treatment-Related Changes in High-Grade Glioma: A Systematic Review and Metaanalysis

Determination of brain tumor recurrence using 11C‐methionine positron emission tomography after radiotherapy

The Emerging Role of Amino Acid PET in Neuro-Oncology

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Determination of brain tumor recurrence using ¹¹C‐methionine positron emission tomography after radiotherapy