Added value of [(18)F]FDOPA PET to the management of high-grade glioma patients after their initial treatment: a prospective multicentre study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue European Journal of Nuclear Medicine and Molecular Imaging Année : 2023

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

Veronique Bourg
  • Fonction : Auteur
Marie Blonski
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  • IdRef : 155605712
Fabien Almairac
  • Fonction : Auteur
Lydiane Mondot
Laurent Collombier
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Aurélie Kas
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  • PersonId : 1140273
Luc Taillandier
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  • PersonId : 1032141
Antoine Verger
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  • PersonId : 1103015

Résumé

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.

Dates et versions

hal-04088513 , version 1 (04-05-2023)

Identifiants

Citer

Jacques Darcourt, David Chardin, Veronique Bourg, Jocelyn Gal, Renaud Schiappa, et al.. Added value of [(18)F]FDOPA PET to the management of high-grade glioma patients after their initial treatment: a prospective multicentre study. European Journal of Nuclear Medicine and Molecular Imaging, 2023, 50 (9), pp.2727-2735. ⟨10.1007/s00259-023-06225-0⟩. ⟨hal-04088513⟩
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