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Titre : | Quelle est la meilleure méthode de délimitation du volume tumoral total des gliomes avant traitement en TEP à la [18F]-FDOPA ? Une étude contrôlée par biopsie[Compte rendu de Communication orale] (2023) |
Auteurs : | P. Meneret ; X. Palard Novello ; J. Farce ; P.J. Le Reste ; A. Metais ; D.C. Chiforeanu ; L. Riffaud ; A. Devillers ; F. Le Jeune ; A. Girard |
Type de document : | Article |
Dans : | Médecine nucléaire (Vol. 47, n°2, mars 2023) |
Article en page(s) : | p. 45 |
Langues: | Anglais |
Mots-clés: | 18F-FDOPA ; Gliomes ; Volume tumoral |
Résumé : |
Purpose
The definition of tumor boundaries in newly diagnosed glioma is crucial for optimal local therapies and/or non-invasive tumor characterization. The widespread use of [18F]FDOPA PET in this setting is hampered by the lack of a histologically validated standardized method. This study aimed to determine the best way to delineate the overall tumor volume in untreated gliomas regarding diagnostic performance and reliability. Methods We retrospectively analyzed 33 biopsy sites and 33 biopsy sites and 33 contralateral virtual biopsies, from fourteen patients. Six sets of 10minutes images were reconstructed starting at three different time points (10, 20, and 30minutes post-injection) using two sets of features for the iterative algorithm. Four reference regions (hemispheric, banana-shaped, striatum and white matter) were drawn independently by four readers. A step-by-step selection was applied based on areas under the ROC curve (AUC) for the identification of tumor tissue, intraclass correlation coefficients (ICC) across reconstruction features, and inter-reader agreement. The best cut-off value was calculated as maximizing Youden's index. Results Tumor infiltration was confirmed in all biopsy samples. TargetSUVmax-to-StriatumSUVmean (TSRmean) and TargetSUVmax-to-StriatumSUVmax (TSRmax) on images performed at 20minutes provided the best overall performances with AUCs = 0.91, inter-algorithm ICCs = 0.99 and inter-reader Fleiss kappas = 0.99 for both. Optimal threshold values of TSRmean2030 = 0.90 and TSRmax2030 = 0.68 provided sensitivities of 85% and 83%, respectively, and specificities of 86% for both. Conclusion This study completes the current EANM guidelines and is a step forward in standardizing the delineation methods in untreated glioma patients. TSRmean2030 or TSRmax2030 provided the best combination of accuracy and reliability. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.em-premium.com/revue/mednuc/47/2 |