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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 10/2018

01-12-2018 | Original Article

Preliminary feasibility study on differential diagnosis between radiation-induced cerebral necrosis and recurrent brain tumor by means of [18F]fluoro-borono-phenylalanine PET/CT

Authors: Rouaa Beshr, Kayako Isohashi, Tadashi Watabe, Sadahiro Naka, Genki Horitsugi, Victor Romanov, Hiroki Kato, Shin-Ichi Miyatake, Eku Shimosegawa, Jun Hatazawa

Published in: Annals of Nuclear Medicine | Issue 10/2018

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Abstract

Objectives

A previous study reported that a differential diagnosis between glioblastoma progression and radiation necrosis by 4-borono-2-[18F]-fluoro-phenylalanine ([18F]FBPA) PET can be made based on lesion-to-normal ratio of [18F]FBPA accumulation. Two-dimensional data acquisition mode PET alone system, with in-plane resolution of 7.9 mm and axial resolution of 13.9 mm, was used. In the current study, we aimed to confirm the differential diagnostic capability of [18F]FBPA PET/CT with higher PET spatial resolution by three-dimensional visual inspection and by measuring mean standardized uptake value (SUVmean), maximum SUV (SUVmax), metabolic tumor volume (MTV), and total lesion (TL) [18F]FBPA uptake.

Methods

Twelve patients of glioma (9), malignant meningioma (1), hemangiopericytoma (1), and metastatic brain tumor (1) were enrolled. All had preceding radiotherapy. High-resolution three-dimensional data acquisition mode PET/CT with in-plane resolution of 4.07 mm and axial resolution of 5.41 mm was employed for imaging. Images were three-dimensionally analyzed using the PMOD software. SUVmean and SUVmax of lesion and normal brain were measured. Lesion MTV and TL FBPA uptake were calculated. The diagnostic accuracy of [18F]FBPA PET/CT in detecting recurrence (n = 6) or necrosis (n = 6) was verified by clinical follow-up.

Results

All parameters showed significantly higher values for tumor recurrence than for necrosis. SUVmean in recurrence was 2.95 ± 0.84 vs 1.18 ± 0.24 in necrosis (P = 0.014); SUVmax in recurrence was 4.63 ± 1.23 vs 1.93 ± 0.44 in necrosis (P = 0.014); MTV in recurrence was 44.92 ± 28.93 mL vs 10.66 ± 8.46 mL in necrosis (P = 0.032); and mean TL FBPA uptake in recurrence was 121.01 ± 50.48 g vs 12.36 ± 9.70 g in necrosis (P = 0.0029).

Conclusion

In this preliminary feasibility study, we confirmed the possibility of differentiating tumor recurrence from radiation necrosis in patients with irradiated brain tumors by [18F]FBPA PET/CT using indices of SUVmean, SUVmax, MTV, and TL 18FBPA uptake.
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Literature
1.
Saris S. Multidisciplinary approach to malignant gliomas. Med Health R I. 1996;79(6):210–3.PubMed
2.
Jeon YS, Young-Cho K, Song SW, Cho J, Lim SD. Palliative resection of metastatic brain tumors previously treated by stereotactic radiosurgery. Brain Tumor Res Treat. 2016;4(2):116–23.CrossRef
3.
Patchell RA. The management of brain metastases. Cancer Treat Rev. 2013;29(6):533–40.CrossRef
4.
Plowman PN. Stereotactic radiosurgery. VIII. The classification of postradiation reactions. Br J Neurosurg. 1999;13(3):256–64.CrossRef
5.
Rane N, Quaghebeur G. CNS effects following the treatment of malignancy. Clin Radiol. 2012;67:61–8.CrossRef
6.
Verma N, Cowperthwaite MC, Burnett MG, Markey MK. Differentiating tumor recurrence from treatment necrosis: a review of neuro-oncologic imaging strategies. Neuro-Oncology. 2013;15:515–34.CrossRef
7.
Dooms GC, Hecht S, Brant-Zawadzki M, Berthiaume Y, Norman D, Newton TH. Brain radiation lesions: MR imaging. Radiology. 1986;158:149–55.CrossRef
8.
Parvez K, Parvez A, Zadeh G. The diagnosis and treatment of pseudoprogression, radiation necrosis and brain tumor recurrence. Int J Mol Sci. 2014;15(7):11832–46.CrossRef
9.
Van Laere K, Ceyssens S, Van Calenbergh F, de Groot T, Menten J, Flamen P, Bormans G, Mortelmans L. Direct comparison of 18F-FDG and 11C-methionine PET in suspected recurrence of glioma: sensitivity, inter-observer variability and prognostic value. Eur J Nucl Med Mol Imaging. 2015;32(1):39–51.CrossRef
10.
Minamimoto R, Saginoya T, Kondo C, Tomura N, Ito K, Matsuo Y, Matsunaga S, Shuto T, Akabane A, Miyata Y, Sakai S, Kubota K. Differentiation of brain tumor recurrence from post-radiotherapy necrosis with 11C-methionine PET: visual assessment versus quantitative assessment. PLoS One. 2015;13(7):e0132515. 10).CrossRef
11.
Okamoto S, Shiga T, Hattori N, Kubo N, Takei T, Katoh N, Sawamura Y, Nishijima K, Kuge Y, Tamaki N. Semiquantitative analysis of C-11 methionine PET may distinguish brain tumor recurrence from radiation necrosis even in small lesions. Ann Nucl Med. 2011;25:213–20.CrossRef
12.
Iwai Y, Yamanaka K, Oda J, Tsuyuguchi N, Ochi H. Tracer accumulation in radiation necrosis of the brain after thallium-201 SPECT and [11C]methionine PET: case report. Neurol Med Chir (Tokyo). 2001;41(8):415–8.CrossRef
13.
Lizarraga KJ, Allen-Auerbach M, Czernin J, DeSalles AA, Yong WH, Phelps ME, Chen W. 18F-FDOPA PET for differentiating recurrent or progressive brain metastatic tumors from late or delayed radiation injury after radiation treatment. J Nucl Med. 2014;55:30–6.CrossRef
14.
Morana G, Piccardo A, Puntoni M, Nozza P, Cama A, Raso A, Mascelli S, Massollo M, Milanaccio C, Garre ML, Rossi A. Diagnostic and prognostic value of 18F-DOPA PET and 1H-MR spectroscopy in pediatric supratentorial infiltrative gliomas: a comparative study. Neuro Oncol. 2015;17(12):1637–47.CrossRef
15.
Ceccon G, Lohmann Ph, Stoffels G, Judov N, Filss CP, Rapp M, Bauer E, Hamisch C, et al. Dynamic O-(2-18F-fluoroethyl)-l-tyrosine positron emission tomography differentiates brain metastasis recurrence from radiation injury after radiotherapy. Neuro-oncology. 2017;19(2):281–8.PubMed
16.
Shimosegawa E, Isohashi K, Naka S, Horitsugi G, Hatazawa J. Assessment of 10B concentration in boron neutron capture therapy: potential of image-guided therapy using 18FBPA PET. Ann Nucl Med. 2016;30(10):749–55.CrossRef
17.
Isohashi K, Shimosegawa K, Naka S, Kanai Y, Horitsugi G, Mochida I, Matsunaga K, Watabe T, Kato H, Tatsumi M, Hatazawa J. Comparison of the image-derived radioactivity and blood-sample radioactivity for estimating the clinical indicators of the efficacy of boron neutron capture therapy (BNCT): 4-borono-2-18F-fluoro-phenylalanine (FBPA) PET study. EJNMMI Res. 2016;6(1):75.CrossRef
18.
Yoshimoto M, Kurihara H, Honda N, Kawai K, Ohe K, Fujii H, Itami J, Arai Y. Predominant contribution of l-type amino acid transporter to 4-borono-2-(18)F-fluoro-phenylalanine uptake in human glioblastoma cells. Nucl Med Biol. 2013;40(5):625–9.CrossRef
19.
Watabe T, Ikeda H, Nagamori Sh, Wiriyasermkul P, Tanaka Y, Naka S, Kanai Y, Hagiwara K, Aoki M, Shimosegawa E, Kanai Y, Hatazawa J. 18F-FBPA as a tumor-specific probe of l-type amino acid transporter 1 (LAT1): a comparison study with 18F-FDG and 11C-methionine PET. Eur J Nucl Med Mol Imaging. 2017;44(2):321–31.CrossRef
20.
Kanai Y, Segawa H, Miyamoto K, Uchino H, Takeda E, Endou H. Expression cloning and characterization of a transporter for large neutral amino acids activated by the heavy chain of 4F2 antigen (CD98). J Biol Chem. 1998;273(37):23629–32.CrossRef
21.
Koshi H, Sano T, Handa T, Yanagawa T, Saitou K, Nagamori S, Kanai Y, Takagishi K, Oyama T. l-Type amino acid transporter-1 and CD98 expression in bone and soft tissue tumors. Pathol Int. 2015;65(9):460–7.CrossRef
22.
Yoshino E, Ohmori Y, Imahori Y, Higuchi T, Furuya S, Naruse S, Mori T, Suzuki K, Yamaki T, Ueda S, Tsuzuki T, Takai S. Irradiation effects on the metabolism of metastatic brain tumors: analysis by positron emission tomography and 1H-magnetic resonance spectroscopy. Stereotact Funct Neurosurg. 1996;66(Suppl 1):240–59.CrossRef
23.
Miyashita M, Miyatake S, Imahori Y, Yokoyama K, Kawabata S, Kajimoto Y, Shibata MA, Otsuki Y, Kirihata M, Ono K, Kuroiwa T. Evaluation of fluoride-labeled boronophenylalanine-PET imaging for the study of radiation effects in patients with glioblastomas. J Neurooncol. 2008;89(2):239–46.CrossRef
24.
Kanno I, Miura S, Yamamoto S, Iida H, Murakami M, Takahashi K, Uemura K. Design and evaluation of a positron emission tomograph:HEADTOME III. J Comput Assist Tomogr. 1985;9(5):931–9.CrossRef
25.
Ishiwata K, Ido T, Mejia AA, Ichihashi M, Mishima Y. Synthesis and radiation dosimetry of 4-borono-2-[18F]fluoro-d,l-phenylalanine: a target compound for PET and boron neutron capture therapy. Int J Rad Appl Instrum A. 1991;42(4):325–8.CrossRef
26.
Matsumoto K, Kitamura K, Mizuta T, Tanaka K, Yamamoto S, Sakamoto S, et al. Performance characteristics of a new 3-dimensional continuous-emission and spiral-transmission high sensitivity and high-resolution PET camera evaluated with the NEMA NU 2-2001 standard. J Nucl Med. 2006;47(1):83–90.PubMed
27.
Bishop A, Satyamurthy N, Gerald B, George H, Ph M, Jorge B. Proton irradiation of [18O]O2: production of [18F]F2 and [18F]F2 + [18F]OF2. Nucl Med Biol. 1996;23(3):189–99.CrossRef
Metadata
Title
Preliminary feasibility study on differential diagnosis between radiation-induced cerebral necrosis and recurrent brain tumor by means of [18F]fluoro-borono-phenylalanine PET/CT
Authors
Rouaa Beshr
Kayako Isohashi
Tadashi Watabe
Sadahiro Naka
Genki Horitsugi
Victor Romanov
Hiroki Kato
Shin-Ichi Miyatake
Eku Shimosegawa
Jun Hatazawa
Publication date
01-12-2018
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 10/2018
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-018-1296-2

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