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18F-Fluorocholine PET/CT as a complementary tool in the follow-up of low-grade glioma: diagnostic accuracy and clinical utility

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The follow-up of treated low-grade glioma (LGG) requires the evaluation of subtle clinical changes and MRI results. When the result is inconclusive, additional procedures are required to assist decision-making, such as the use of advanced MRI (aMRI) sequences and nuclear medicine scans (SPECT and PET). The aim of this study was to determine whether incorporating 18F-fluorocholine PET/CT in the follow-up protocol for treated LGG improves diagnostic accuracy and clinical utility.

Methods

This was a prospective case-series study in patients with treated LGG during standard follow-up with indeterminate clinical and/or radiological findings of tumour activity. All patients underwent clinical evaluation, aMRI, 201Tl-SPECT and 18F-fluorocholine PET/CT. Images were interpreted by visual evaluation complemented with semiquantitative analysis.

Results

Between January 2012 and December 2013, 18 patients were included in this study. The final diagnosis was established by histology (five surgical specimens, one biopsy specimen) or by consensus of the Neuro-Oncology Group (11 patients) after a follow-up of >6 months (mean 14.9 ± 2.72 months). The global diagnostic accuracies were 90.9 % for aMRI (38.8 % inconclusive), 69.2 % for 201Tl-SPECT (11.1 % inconclusive), and 100 % for 18F-fluorocholine PET/CT. 201Tl-SPECT led correctly to a change in the initial approach in 38.9 % of patients but might have led to error in 27.8 %. The use of 18F-fluorocholine PET/CT alone rather than 201Tl-SPECT led correctly to a change in the approach suggested by routine follow-up in 72.2 % of patients and endorsed the approach in the remaining 27.8 %.

Conclusion

Our results support the need to complement structural MRI with aMRI and nuclear medicine procedures in selected patients. 18F-Fluorocholine PET/CT can be useful in the individualized management of patients with treated LGG with uncertain clinical and/or radiological evidence of tumour activity.

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Authors contribution

All authors made a substantial intellectual contribution, assume responsibility for publication of this article and are in a position to explain and defend why and how the observations were made, the theoretical framework, the data and results obtained, and to participate in critical discussions in related scientific meetings. All authors collected and analysed the data, reviewed the draft, provided comments and approved the final version of the report.

Conflicts of interest

None.

Funding

This project was supported by FIS-Instituto de Salud Carlos III (PI 09/90737), Consejería de Igualdad, Salud y Políticas Sociales de la Junta de Andalucía (PI: 06/0342), and Instituto de Investigación Biosanitaria de Granada, Spain.

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Authors and Affiliations

  1. Instituto de Investigación Biosanitaria de Granada, Granada, Spain

    Manuel Gómez-Río, Antonio Rodríguez-Fernández, Pablo Lardelli-Claret & José M. Llamas-Elvira

  2. Department of Nuclear Medicine, University Hospital “Virgen de las Nieves”, Avda. Fuerzas Armadas, 2, 18014, Granada, Spain

    Manuel Gómez-Río, Nathalie Testart Dardel, Antonio Rodríguez-Fernández & José M. Llamas-Elvira

  3. Department of Radiology, University Hospital “Virgen de las Nieves”, 18014, Granada, Spain

    Alicia Santiago Chinchilla

  4. Department of Neurosurgery, University Hospital “Virgen de las Nieves”, 18014, Granada, Spain

    Gonzalo Olivares Granados

  5. Department of Medical Oncology, University Hospital “Virgen de las Nieves”, 18014, Granada, Spain

    Raquel Luque Caro

  6. Department of Radiotherapy Oncology, University Hospital “Virgen de las Nieves”, 18014, Granada, Spain

    Mercedes Zurita Herrera

  7. Department of Pathology, University Hospital “Virgen de las Nieves”, 18014, Granada, Spain

    Clara E. Chamorro Santos

  8. Centros de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Granada, Spain

    Pablo Lardelli-Claret

  9. Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, 18012, Granada, Spain

    Pablo Lardelli-Claret

Authors
  1. Manuel Gómez-Río
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  2. Nathalie Testart Dardel
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Correspondence to Manuel Gómez-Río.

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Gómez-Río, M., Testart Dardel, N., Santiago Chinchilla, A. et al. 18F-Fluorocholine PET/CT as a complementary tool in the follow-up of low-grade glioma: diagnostic accuracy and clinical utility. Eur J Nucl Med Mol Imaging 42, 886–895 (2015). https://doi.org/10.1007/s00259-015-2997-6

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  • DOI: https://doi.org/10.1007/s00259-015-2997-6

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