| Autor: |
Cailleteau A; Department of Radiotherapy, ICO René Gauducheau, 44800 Saint Herblain, France., Ferrer L; Department of Nuclear Medicine, ICO René Gauducheau, 44800 Saint Herblain, France.; Nantes Université, Univ Angers, INSERM, CNRS, CRCI2NA, F-44000 Nantes, France., Geffroy D; Department of Radiology, ICO René Gauducheau, 44800 Saint Herblain, France., Fleury V; Department of Nuclear Medicine, ICO René Gauducheau, 44800 Saint Herblain, France., Lalire P; Department of Nuclear Medicine, ICO René Gauducheau, 44800 Saint Herblain, France., Doré M; Department of Radiotherapy, ICO René Gauducheau, 44800 Saint Herblain, France., Rousseau C; Department of Nuclear Medicine, ICO René Gauducheau, 44800 Saint Herblain, France.; Nantes Université, Univ Angers, INSERM, CNRS, CRCI2NA, F-44000 Nantes, France. |
| Abstrakt: |
Brain metastases or primary brain tumours had poor prognosis until the use of high dose radiotherapy. However, radionecrosis is a complex challenge in the post-radiotherapy management of these patients due to the difficulty of distinguishing this complication from local tumour recurrence. MRI alone has a variable specificity and sensibility, as does PET-CT imaging. We aimed to investigate the diagnostic performance of dual-phase 18 F-FDG PET-mpMRI to distinguish cerebral radionecrosis from local tumour recurrence after cranial radiotherapy. A retrospective analysis was conducted between May 2021 and September 2022. Inclusion criteria encompassed patients with inconclusive MRI findings post-radiotherapy and history of cerebral radiotherapy for primary or metastatic brain lesions. Lesions are assessed qualitatively and semi-quantitatively. The gold standard to assess radionecrosis was histopathology or a composite criterion at three months. The study evaluated 24 lesions in 23 patients. Qualitative analysis yielded 85.7% sensitivity and 75% specificity. Semi-quantitative analysis, based on contralateral background noise, achieved 100% sensitivity and 50% specificity. Moreover, using contralateral frontal lobe background noise resulted in higher performances with 92% sensitivity and 63% specificity. Stratification by lesion type demonstrated 100% sensitivity and specificity rates for metastatic lesions. The diagnostic performance of dual-phase 18 F-FDG PET-mpMRI shows promising results for metastatic lesions. |
