Olivier Humbert1,2,3, Véronique Bourg4, Lydiane Mondot5, Jocelyn Gal6, Pierre-Yves Bondiau7, Denys Fontaine8, Esma Saada-Bouzid9, Marie Paquet10,11, David Chardin10, Fabien Almairac8, Fanny Vandenbos12, Jacques Darcourt10,11. 1. Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06100, Nice, France. ohumbert@unice.fr. 2. TIRO-UMR E 4320, UCA/CEA, Nice, France. ohumbert@unice.fr. 3. Clinical Research and Innovation Office, UCA, Nice, France. ohumbert@unice.fr. 4. Department of Neurology, Pasteur 2 University Hospital, UCA, Nice, France. 5. Department of Neuroradiology, Pasteur 2 University Hospital, UCA, Nice, France. 6. Department of Biostatistics, Centre Antoine-Lacassagne, UCA, Nice, France. 7. Department of Radiotherapy, Centre Antoine-Lacassagne, UCA, Nice, France. 8. Department of Neurosurgery, Pasteur 2 University Hospital, UCA, Nice, France. 9. Department of Medical Oncology, Centre Antoine-Lacassagne, UCA, Nice, France. 10. Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06100, Nice, France. 11. TIRO-UMR E 4320, UCA/CEA, Nice, France. 12. Central Laboratory of Pathology, Pasteur I University Hospital, UCA, Nice, France.
Abstract
PURPOSE: This study aimed to assess the therapeutic impact and diagnostic accuracy of 18F-DOPA PET/CT in patients with glioblastoma or brain metastases. METHODS: Patients with histologically proven glioblastoma or brain metastases were prospectively included in this monocentric clinical trial (IMOTEP). Patients were included either due to a clinical suspicion of relapse or to assess residual tumor infiltration after treatment. Multimodality brain MRI and 18F-DOPA PET were performed. Patients' data were discussed during a Multidisciplinary Neuro-oncology Tumor Board (MNTB) meeting. The discussion was first based on clinical and MRI data, and an initial diagnosis and treatment plan were proposed. Secondly, a new discussion was conducted based on the overall imaging results, including 18F-DOPA PET. A second diagnosis and therapeutic plan were proposed. A retrospective and definitive diagnosis was obtained after a 3-month follow-up and considered as the reference standard. RESULTS: One hundred six cases were prospectively investigated by the MNTB. All patients with brain metastases (N = 41) had a clinical suspicion of recurrence. The addition of 18F-DOPA PET data changed the diagnosis and treatment plan in 39.0% and 17.1% of patients' cases, respectively. Concerning patients with a suspicion of recurrent glioblastoma (N = 12), the implementation of 18F-DOPA PET changed the diagnosis and treatment plan in 33.3% of cases. In patients evaluated to assess residual glioblastoma infiltration after treatment (N = 53), 18F-DOPA PET data had a lower impact with only 5.7% (3/53) of diagnostic changes and 3.8% (2/53) of therapeutic plan changes. The definitive reference diagnosis was available in 98/106 patients. For patients with tumor recurrence suspicion, the adjunction of 18F-DOPA PET increased the Younden's index from 0.44 to 0.53 in brain metastases and from 0.2 to 1.0 in glioblastoma, reflecting an increase in diagnostic accuracy. CONCLUSION: 18F-DOPA PET has a significant impact on the management of patients with a suspicion of brain tumor recurrence, either glioblastoma or brain metastases, but a low impact when used to evaluate the residual glioblastoma infiltration after a first-line radio-chemotherapy or second-line bevacizumab.
PURPOSE: This study aimed to assess the therapeutic impact and diagnostic accuracy of 18F-DOPA PET/CT in patients with glioblastoma or brain metastases. METHODS:Patients with histologically proven glioblastoma or brain metastases were prospectively included in this monocentric clinical trial (IMOTEP). Patients were included either due to a clinical suspicion of relapse or to assess residual tumor infiltration after treatment. Multimodality brain MRI and 18F-DOPA PET were performed. Patients' data were discussed during a Multidisciplinary Neuro-oncology Tumor Board (MNTB) meeting. The discussion was first based on clinical and MRI data, and an initial diagnosis and treatment plan were proposed. Secondly, a new discussion was conducted based on the overall imaging results, including 18F-DOPA PET. A second diagnosis and therapeutic plan were proposed. A retrospective and definitive diagnosis was obtained after a 3-month follow-up and considered as the reference standard. RESULTS: One hundred six cases were prospectively investigated by the MNTB. All patients with brain metastases (N = 41) had a clinical suspicion of recurrence. The addition of 18F-DOPA PET data changed the diagnosis and treatment plan in 39.0% and 17.1% of patients' cases, respectively. Concerning patients with a suspicion of recurrent glioblastoma (N = 12), the implementation of 18F-DOPA PET changed the diagnosis and treatment plan in 33.3% of cases. In patients evaluated to assess residual glioblastoma infiltration after treatment (N = 53), 18F-DOPA PET data had a lower impact with only 5.7% (3/53) of diagnostic changes and 3.8% (2/53) of therapeutic plan changes. The definitive reference diagnosis was available in 98/106 patients. For patients with tumor recurrence suspicion, the adjunction of 18F-DOPA PET increased the Younden's index from 0.44 to 0.53 in brain metastases and from 0.2 to 1.0 in glioblastoma, reflecting an increase in diagnostic accuracy. CONCLUSION:18F-DOPA PET has a significant impact on the management of patients with a suspicion of brain tumor recurrence, either glioblastoma or brain metastases, but a low impact when used to evaluate the residual glioblastoma infiltration after a first-line radio-chemotherapy or second-line bevacizumab.
Authors: Corinne Beinat; Chirag B Patel; Tom Haywood; Surya Murty; Lewis Naya; Jessa B Castillo; Samantha T Reyes; Megan Phillips; Pablo Buccino; Bin Shen; Jun Hyung Park; Mary Ellen I Koran; Israt S Alam; Michelle L James; Dawn Holley; Kim Halbert; Harsh Gandhi; Joy Q He; Monica Granucci; Eli Johnson; Daniel Dan Liu; Nobuko Uchida; Rahul Sinha; Pauline Chu; Donald E Born; Geoffrey I Warnock; Irving Weissman; Melanie Hayden-Gephart; Mehdi Khalighi; Tarik F Massoud; Andrei Iagaru; Guido Davidzon; Reena Thomas; Seema Nagpal; Lawrence D Recht; Sanjiv Sam Gambhir Journal: Clin Cancer Res Date: 2021-09-02 Impact factor: 13.801
Authors: Cornelia Brendle; Caroline Maier; Benjamin Bender; Jens Schittenhelm; Frank Paulsen; Mirjam Renovanz; Constantin Roder; Salvador Castaneda-Vega; Ghazaleh Tabatabai; Ulrike Ernemann; Christian la Fougère Journal: J Nucl Med Date: 2021-08-05 Impact factor: 10.057