Added value of [ 18 F]FDOPA PET to the management of high-grade glioma patients after their initial treatment: a prospective multicentre study.

Autor: Darcourt J; Department of Nuclear Medicine, Centre Antoine Lacassagne and UMR 4320 CEA-UCA, Université Côte d'Azur, Nice, France. Jacques.darcourt@univ-cotedazur.fr., Chardin D; Department of Nuclear Medicine, Centre Antoine Lacassagne and UMR 4320 CEA-UCA, Université Côte d'Azur, Nice, France., Bourg V; Department of Neurology, CHU, Nice, Université Cote d'Azur, Nice, France., Gal J; Epidemiology and Biostatistics Department, Centre Antoine Lacassagne and Université Côte d'Azur, Nice, France., Schiappa R; Epidemiology and Biostatistics Department, Centre Antoine Lacassagne and Université Côte d'Azur, Nice, France., Blonski M; Department of Neuro-Oncology, CHU, Nancy and CNRS, UMR 7039, Université de Lorraine, Nancy, France., Koulibaly PM; Department of Nuclear Medicine, Centre Antoine Lacassagne and UMR 4320 CEA-UCA, Université Côte d'Azur, Nice, France., Almairac F; Department of Neurosurgery, CHU Nice and UR2CA Team PIN, Université Côte d'Azur, Nice, France., Mondot L; Department of Radiology, CHU Nice, Université Côte d'Azur, Nice, France., Le Jeune F; Department of Nuclear Medicine, Centre Eugène Marquis, Rennes and LTSI INSERM 1099, Université de Rennes 1, Rennes, France., Collombier L; Department of Nuclear Medicine, CHU Nîmes, Université de Montpellier, Nîmes, France., Kas A; Department of Nuclear Medicine, AP-HP Hôpitaux Universitaires Pitié-Salpétrière Charles Foix and LIB INSERM U1146, Sorbonne University, Paris, France., Taillandier L; Department of Neuro-Oncology, CHU, Nancy and CNRS, UMR 7039, Université de Lorraine, Nancy, France., Verger A; Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHU Nancy and IADI INSERM UMR 1254, Université de Lorraine, Nancy, France.
Jazyk: angličtina
Zdroj: European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2023 Jul; Vol. 50 (9), pp. 2727-2735. Date of Electronic Publication: 2023 Apr 22.
DOI: 10.1007/s00259-023-06225-0
Abstrakt: Background: Diagnostic value of 3,4-dihydroxy-6-[ 18 F]fluoro-L-phenylalanine ([ 18 F]FDOPA) PET in patients with suspected recurrent gliomas is recognised. We conducted a multicentre prospective study to assess its added value in the practical management of patients suspected of recurrence of high grade gliomas (HGG).
Methods: Patients with a proven HGG (WHO grade III and IV) were referred to the multidisciplinary neuro-oncology board (MNOB) during their follow-up after initial standard of care treatment and when MRI findings were not fully conclusive. Each case was discussed in 2 steps. For step 1, a diagnosis and a management proposal were made only based on the clinical and the MRI data. For step 2, the same process was repeated taking the [ 18 F]FDOPA PET results into consideration. A level of confidence for the decisions was assigned to each step. Changes in diagnosis and management induced by [ 18 F]FDOPA PET information were measured. When unchanged, the difference in the confidence of the decisions were assessed. The diagnostic performances of each step were measured.
Results: 107 patients underwent a total of 138 MNOB assessments. The proposed diagnosis changed between step 1 and step 2 in 37 cases (26.8%) and the proposed management changed in 31 cases (22.5%). When the management did not change, the confidence in the MNOB final decision was increased in 87 cases (81.3%). Step 1 had a sensitivity, specificity and accuracy of 83%, 58% and 66% and step 2, 86%, 64% and 71% respectively.
Conclusion: [ 18 F]FDOPA PET adds significant information for the follow-up of HGG patients in clinical practice. When MRI findings are not straightforward, it can change the management for more than 20% of the patients and increases the confidence level of the multidisciplinary board decisions.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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