PET Imaging in Neuro-Oncology: An Update and Overview of a Rapidly Growing Area

Verger, Antoine; Kas, Aurélie; Darcourt, Jacques; Guedj, Éric

doi:10.3390/cancers14051103

Cited by 44 publications

(23 citation statements)

References 153 publications

(190 reference statements)

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“…Although multiparametric MRI represents the current imaging gold standard in primary and metastatic brain neoplasms, PET studies have the unique and complementary ability to evaluate and characterize the metabolic patterns within the tumor and non-tumor tissues through the use of selected radiolabeled tracers [ 84 , 85 , 86 ]. The roles of different PET tracers in tumor diagnosis and post-treatment response assessment have been largely discussed and validated by international consensuses and recommendations [ 87 , 88 , 89 , 90 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of [68Ga]Ga-DOTA-SSTR PET Radiotracers in Brain Tumors: A Systematic Review of the Literature and Ongoing Clinical Trials

Palmisciano

Watanabe

Conching

et al. 2022

Cancers

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Background: The development of [68Ga]Ga-DOTA-SSTR PET tracers has garnered interest in neuro-oncology, to increase accuracy in diagnostic, radiation planning, and neurotheranostics protocols. We systematically reviewed the literature on the current uses of [68Ga]Ga-DOTA-SSTR PET in brain tumors. Methods: PubMed, Scopus, Web of Science, and Cochrane were searched in accordance with the PRISMA guidelines to include published studies and ongoing trials utilizing [68Ga]Ga-DOTA-SSTR PET in patients with brain tumors. Results: We included 63 published studies comprising 1030 patients with 1277 lesions, and 4 ongoing trials. [68Ga]Ga-DOTA-SSTR PET was mostly used for diagnostic purposes (62.5%), followed by treatment planning (32.7%), and neurotheranostics (4.8%). Most lesions were meningiomas (93.6%), followed by pituitary adenomas (2.8%), and the DOTATOC tracer (53.2%) was used more frequently than DOTATATE (39.1%) and DOTANOC (5.7%), except for diagnostic purposes (DOTATATE 51.1%). [68Ga]Ga-DOTA-SSTR PET studies were mostly required to confirm the diagnosis of meningiomas (owing to their high SSTR2 expression and tracer uptake) or evaluate their extent of bone invasion, and improve volume contouring for better radiotherapy planning. Some studies reported the uncommon occurrence of SSTR2-positive brain pathology challenging the diagnostic accuracy of [68Ga]Ga-DOTA-SSTR PET for meningiomas. Pre-treatment assessment of tracer uptake rates has been used to confirm patient eligibility (high somatostatin receptor-2 expression) for peptide receptor radionuclide therapy (PRRT) (i.e., neurotheranostics) for recurrent meningiomas and pituitary carcinomas. Conclusion: [68Ga]Ga-DOTA-SSTR PET studies may revolutionize the routine neuro-oncology practice, especially in meningiomas, by improving diagnostic accuracy, delineation of radiotherapy targets, and patient eligibility for radionuclide therapies.

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Section: Discussionmentioning

confidence: 99%

The Role of [68Ga]Ga-DOTA-SSTR PET Radiotracers in Brain Tumors: A Systematic Review of the Literature and Ongoing Clinical Trials

Palmisciano

Watanabe

Conching

et al. 2022

Cancers

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“…As described above, the application of AI-based MRI shows excellent outcomes in glioma. However, MRI may not always be able to answer three essential questions: evaluation of the initial characterization of the brain lesion, monitoring of therapies to clear changes induced by recurrence/progression and treatment, and evaluation of treatment efficacy ( 92 ). Furthermore, one of the main advantages of PET is that the radiotracers used for PET are in most cases independent of disruption of the blood-brain barrier (BBB) as opposed to MRI, which is especially useful in LDH ( 92 , 93 ).…”

Section: Applications Of Ai-based On Medical Imaging In Gliomamentioning

confidence: 99%

Applications of Artificial Intelligence Based on Medical Imaging in Glioma: Current State and Future Challenges

Meng

Qiu

et al. 2022

Front. Oncol.

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Glioma is one of the most fatal primary brain tumors, and it is well-known for its difficulty in diagnosis and management. Medical imaging techniques such as magnetic resonance imaging (MRI), positron emission tomography (PET), and spectral imaging can efficiently aid physicians in diagnosing, treating, and evaluating patients with gliomas. With the increasing clinical records and digital images, the application of artificial intelligence (AI) based on medical imaging has reduced the burden on physicians treating gliomas even further. This review will classify AI technologies and procedures used in medical imaging analysis. Additionally, we will discuss the applications of AI in glioma, including tumor segmentation and classification, prediction of genetic markers, and prediction of treatment response and prognosis, using MRI, PET, and spectral imaging. Despite the benefits of AI in clinical applications, several issues such as data management, incomprehension, safety, clinical efficacy evaluation, and ethical or legal considerations, remain to be solved. In the future, doctors and researchers should collaborate to solve these issues, with a particular emphasis on interdisciplinary teamwork.

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“…Nonetheless, there has been an expanding role of PET-CT in neuro oncology. In addition to FDG, several radiopharmaceuticals have been developed and used to assess important biologic and physiologic properties of brain tumors including metabolism, proliferation, blood flow/perfusion, hypoxia, amino acid uptake, somatostatin-receptor expression [ 99 , 100 , 101 , 102 , 103 , 104 , 105 ]. Expanded neuro oncologic applications for a variety of radiopharmaceuticals, including those FDA-approved for other indications, is well supported in the literature.…”

Section: Neuro Oncologymentioning

confidence: 99%

“…FDG PET has been used for many years in the evaluation of meningiomas. An excellent review of PET imaging in meningiomas and other brain tumors has been recently published [ 104 ]. Studies have also been published showing the utility of FDG PET in differentiating low from high-grade meningiomas, with higher grade tumors showing increased uptake [ 108 , 153 ].…”

Section: Neuro Oncologymentioning

confidence: 99%

“…For this reason, SSTR (e.g. DOTATATE) PET-CT is preferred in for imaging meningiomas, with detection sensitivities greater than for MRI [ 104 ]. Most meningiomas are markedly positive on SSTR-targeting PET ( Figure 50 and Figure 51 ), although it must be noted that Grade III, poorly differentiated malignant meningiomas may be decreased in uptake of SSTR ligands [ 154 ].…”

Section: Neuro Oncologymentioning

confidence: 99%

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PET-CT in Clinical Adult Oncology—V. Head and Neck and Neuro Oncology

Wiggins

Hoffman

Fine

et al. 2022

Cancers

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PET-CT is an advanced imaging modality with many oncologic applications, including staging, assessment of response to therapy, restaging, and longitudinal surveillance for recurrence. The goal of this series of six review articles is to provide practical information to providers and imaging professionals regarding the best use of PET-CT for specific oncologic indications, and the potential pitfalls and nuances that characterize these applications. In addition, key tumor-specific clinical information and representative PET-CT images are provided to outline the role that PET-CT plays in the management of oncology patients. Hundreds of different types of tumors exist, both pediatric and adult. A discussion of the role of FDG PET for all of these is beyond the scope of this review. Rather, this series of articles focuses on the most common adult malignancies that may be encountered in clinical practice. It also focuses on FDA-approved and clinically available radiopharmaceuticals, rather than research tracers or those requiring a local cyclotron. The fifth review article in this series focuses on PET-CT imaging in head and neck tumors, as well as brain tumors. Common normal variants, key anatomic features, and benign mimics of these tumors are reviewed. The goal of this review article is to provide the imaging professional with guidance in the interpretation of PET-CT for the more common head and neck malignancies and neuro oncology, and to inform the referring providers so that they can have realistic expectations of the value and limitations of PET-CT for the specific type of tumor being addressed.

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PET Imaging in Neuro-Oncology: An Update and Overview of a Rapidly Growing Area

Cited by 44 publications

References 153 publications

The Role of [68Ga]Ga-DOTA-SSTR PET Radiotracers in Brain Tumors: A Systematic Review of the Literature and Ongoing Clinical Trials

The Role of [68Ga]Ga-DOTA-SSTR PET Radiotracers in Brain Tumors: A Systematic Review of the Literature and Ongoing Clinical Trials

Applications of Artificial Intelligence Based on Medical Imaging in Glioma: Current State and Future Challenges

PET-CT in Clinical Adult Oncology—V. Head and Neck and Neuro Oncology

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