FET PET to differentiate between post-treatment changes and recurrence in high-grade gliomas: a single center multidisciplinary clinic controlled study

期刊论文
出版模式：

开放获取
发表日期：

2024年11月11日

查看全文

Ameya D. Puranik,
Indraja D. Dev,
Venkatesh Rangarajan,
Yash Jain,
Sukriti Patra,
Nilendu C. Purandare,
Arpita Sahu,
Amitkumar Choudhary,
Kajari Bhattacharya,
Tejpal Gupta,
Abhishek Chatterjee,
Archya Dasgupta,
Aliasgar Moiyadi,
Prakash Shetty,
Vikas Singh,
Epari Sridhar,
Ayushi Sahay,
Aekta Shah,
Nandini Menon,
Suchismita Ghosh,
Sayak Choudhury,
Sneha Shah,
Archi Agrawal,
N. Lakshminarayanan,
Amit Kumar,
Arjun Gopalakrishna

摘要

Purpose

The clinico-radiological dilemma in post-treatment high-grade gliomas, between disease recurrence (TR) and treatment-related changes (TRC), still persists. FET (Fluoro-ethyl-tyrosine) PET has been extensively used as problem-solving modality for cases where MR imaging is inconclusive. We incorporated a systematic imaging and clinical follow-up algorithm in a multi-disciplinary clinic (MDC) setting to analyse our cohort of FET PET in post-treatment gliomas.

Methods

We retrospectively analyzed 171 patients of post-treatment grade III and IV glioma with equivocal findings on MRI. 185–222 MBq of 18 F-FET was injected and dedicated static imaging of brain was performed at 20 min. TBR (Tumor to background ratio) was used as semi-quantitative parameter. Cutoff of 2.5 was used for image interpretation. Imaging findings were confirmed with histopathological diagnosis, wherever available or in a multidisciplinary joint clinic based on serial imaging.

Results

121 of 171 patients showed recurrent disease on FET PET, on follow up, 109 were confirmed with recurrence; 7 patients showed TRC, whereas 5 were treated with bevacizumab, with no further clinico-radiological deterioration, thus confirming TRC. 50 patients showed TRC on FET PET, on follow up on follow up, 40 were confirmed as true-negative. 10 patients who showed TBR less than 2.5 had confirmed TR on subsequent MR imaging. The overall sensitivity and specificity was 91.6 and 76.9% respectively, with a diagnostic accuracy of 87.13%.

Conclusion

There is potential for FET PET to be used along with MRI in the post treatment algorithm of high-grade glial tumors.