Métastases cérébrales : apport de l’acquisition tardive en TEP/TDM au 18F-FDG pour le diagnostic différentiel entre récurrence tumorale et radionécrose

Matuszak, J; Waissi, Waisse; Clavier, J.; Noël, G.; Namer, Izzie Jacques

doi:10.1016/j.mednuc.2016.02.001

Cited by 7 publications

(9 citation statements)

References 31 publications

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“…19 To date, 2 studies investigating such delayed [ 18 F]-FDG PET images have been published, revealing promising results with 93% to 95% sensitivity and 94% to 100% specificity. 10,11 Our results are in the line with these data, with 83% sensitivity and 92% specificity provided by visual analysis of delayed [ 18 F]-FDG PET images alone, significantly higher than with, respectively, standard and dual-time-point [ 18 F]-FDG PET. Such results can be explained by the significant increase in TBR over time for viable metastases but not for RN, which significantly enhanced the sensitivity without loss of specificity.…”

Section: Discussionsupporting

confidence: 88%

“…Delayed brain PET images started between 240 and 300 minutes postinjection (p.i.). 10,11 Patients were allowed to eat between the standard-and late-phase scans. Unenhanced CT scans were used for attenuation correction.…”

Section: Patientsmentioning

confidence: 99%

“…For visual analysis, lesions were regarded as viable tumors if the [ 18 F]-FDG uptake intensity was higher than the contralateral normal gray matter on the same slice, respectively, on standard and delayed images. 11 Otherwise, lesions were regarded as pure RN. The semiquantitative dual-time-point analysis was performed using the index over time of tumor-to-brain SUV max ratios (TBR = lesion SUVmax / healthy contralateral gray matter SUVmax ), as published by Horky et al 10 : [(TBR delayed − TBR standard )/(TBR standard )].…”

Section: Image Analysismentioning

confidence: 99%

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Delayed [18F]-FDG PET Imaging Increases Diagnostic Performance and Reproducibility to Differentiate Recurrence of Brain Metastases From Radionecrosis

et al. 2022

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PurposeDifferentiating brain metastasis recurrence from radiation necrosis can be challenging during MRI follow-up after stereotactic radiotherapy. [18F]-FDG is the most available PET tracer, but standard images performed 30 to 60 minutes postinjection provide insufficient accuracy. We compared the diagnostic performance and interobserver agreement of [18F]-FDG PET with delayed images (4–5 hours postinjection) with the ones provided by standard and dual-time-point imaging.MethodsConsecutive patients referred for brain [18F]-FDG PET after inconclusive MRI were retrospectively included between 2015 and 2020 in 3 centers. Two independent nuclear medicine physicians interpreted standard (visually), delayed (visually), and dual-time-point (semiquantitatively) images, respectively. Adjudication was applied in case of discrepancy. The final diagnosis was confirmed histologically or after 6 months of MRI follow-up. Areas under the receiver operating characteristic curves were pairwise compared.ResultsForty-eight lesions from 46 patients were analyzed. Primary tumors were mostly located in the lungs (57%) and breast (23%). The median delay between radiotherapy and PET was 15.7 months. The final diagnosis was tumor recurrence in 24 of 48 lesions (50%), with histological confirmation in 19 of 48 lesions (40%). Delayed images provided a larger area under the receiver operating characteristic curve (0.88; 95% confidence interval [CI], 0.75–0.95) than both standard (0.69; 95% CI, 0.54–0.81; P = 0.0014) and dual-time-point imaging (0.77; 95% CI, 0.63–0.88; P = 0.045), respectively. Interobserver agreement was almost perfect with delayed images (κ = 0.83), whereas it was moderate with both standard (κ = 0.48) and dual-time-point images (κ = 0.61).Conclusions[18F]-FDG PET with delayed images is an accurate and reliable alternative to differentiate metastasis recurrence from radiation necrosis in case of inconclusive MRI after brain stereotactic radiotherapy.

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Section: Discussionsupporting

confidence: 88%

Section: Patientsmentioning

confidence: 99%

Section: Image Analysismentioning

confidence: 99%

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Delayed [18F]-FDG PET Imaging Increases Diagnostic Performance and Reproducibility to Differentiate Recurrence of Brain Metastases From Radionecrosis

et al. 2022

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“…Recent MRI techniques, such as perfusion-and diffusion-weighted scans or MR spectroscopy may help distinguish the lesion (3) . 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been proposed as a diagnostic alternative, particularly when co-registered with MRI wich appears to improve the sensitivity of FDG PET from 65 to 86%, with the same specificity (14,15) . The general characteresitics of CRN and tumors are summerized in table 2.…”

Section: Discussionmentioning

confidence: 99%

Brain Radionecrosis in Patients Irradiated for Nasopharngeal Carcinoma : About Four Cases

Lahlali

Echchikhi²,

Chbili³

et al. 2017

IAM

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Purpose: to study the clinical, radiological, therapeutic and progressive aspects of brain radionecrosis after treatment for nasopharyngel carcinoma. Patients and methods: four patients ( two men and two women) of mean age 53.5 years were treated for UCNT( undifferentiated carcinoma of the nasopharynx), between 2009and 2014, and developed cerebral radionecrosis. All patients were treated with radical radiotherapy. The mean dose was 70 Gy. Dose per fraction was 2 Gy, one fraction daily. All patients received chemotherapy. Result: patients presented non specific neurological signs, and one case was discovered fortuitously. The mean latent periode was 46 months, brain radionecrosis was authetificated by brain imaging. The localisation was temporal in two patients and bulbomedullar in two patients. After a mean follow-up period of 14 months, clinical outcomes were favorable in one case, stabilisation in two cases and one patient died. Conclusion: brain radionecrosis is a rare iatrogenic complication for patients irradiated for UCNT. Imaging techniques play a major role in the diagnosis. Corticotherapy is the main treatment.

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“…To overcome this issue, some authors performed additional delayed PET images 4 to 5 h after [ 18 F]FDG injection. With such protocols, [ 18 F]FDG PET reached sensitivity of 93–95% and specificity of 94–100% [ 76 , 77 ] ( Figure 3 ).…”

Section: Metastasesmentioning

confidence: 99%

What Does PET Imaging Bring to Neuro-Oncology in 2022? A Review

Zhang-Yin

Girard

Bertaux

2022

Cancers

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PET imaging is being increasingly used to supplement MRI in the clinical management of brain tumors. The main radiotracers implemented in clinical practice include [18F]FDG, radiolabeled amino acids ([11C]MET, [18F]FDOPA, [18F]FET) and [68Ga]Ga-DOTA-SSTR, targeting glucose metabolism, L-amino-acid transport and somatostatin receptors expression, respectively. This review aims at addressing the current place and perspectives of brain PET imaging for patients who suffer from primary or secondary brain tumors, at diagnosis and during follow-up. A special focus is given to the following: radiolabeled amino acids PET imaging for tumor characterization and follow-up in gliomas; the role of amino acid PET and [18F]FDG PET for detecting brain metastases recurrence; [68Ga]Ga-DOTA-SSTR PET for guiding treatment in meningioma and particularly before targeted radiotherapy.

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Métastases cérébrales : apport de l’acquisition tardive en TEP/TDM au 18F-FDG pour le diagnostic différentiel entre récurrence tumorale et radionécrose

Cited by 7 publications

References 31 publications

Delayed [18F]-FDG PET Imaging Increases Diagnostic Performance and Reproducibility to Differentiate Recurrence of Brain Metastases From Radionecrosis

Delayed [18F]-FDG PET Imaging Increases Diagnostic Performance and Reproducibility to Differentiate Recurrence of Brain Metastases From Radionecrosis

Brain Radionecrosis in Patients Irradiated for Nasopharngeal Carcinoma : About Four Cases

What Does PET Imaging Bring to Neuro-Oncology in 2022? A Review

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