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Cancers
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Clinical PET Studies in Neuro-Oncology
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Clinical PET Studies in Neuro-Oncology

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Clinical Research of Cancer".

Deadline for manuscript submissions: closed (1 March 2023) | Viewed by 18588

Special Issue Editor

Prof. Dr. Antoine Verger

E-Mail Website
Guest Editor
1. Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France
2. IADI UMR 1254, INSERM, Université de Lorraine, F-54000 Nancy, France
Interests: PET imaging; amino-acid radiotracers; neuro-oncology; glioma
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

PET imaging is currently recommended as an adjunct to MRI for the assessment of brain tumors. The present Special Issue will focus on PET brain tumor assessment at different stages of the disease, including initial diagnosis, treatment planification, and follow-up studies in clinical practice. All types of brain tumors will be covered, including glioma, brain metastases, meningioma, and primary cerebral lymphoma. Specific attention will be paid to clinical studies with translational research to monitor peptide receptor radionuclide therapy. All the available PET radiotracers that are useful in  neuro-oncology clinical practice will be welcome, including FDG, amino acid radiotracers, DOTATOC PET imaging, and TSPO imaging. The objective of this Special Issue is to provide a complete and comprehensive overview of the potential of PET imaging in neuro-oncology to neuro-oncologists, neurosurgeons, radiologists, and nuclear physicians.

Prof. Dr. Antoine Verger
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • PET
  • neuro-oncology
  • glioma
  • meningioma
  • lymphoma
  • brain metastasis
  • amino acid radiotracer
  • peptide receptor radionuclide therapy
  • DOTATOC
  • FDG
  • TSPO

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Published Papers (6 papers)

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Research

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13 pages, 1707 KiB  
Article
Implementing the Point Spread Function Deconvolution for Better Molecular Characterization of Newly Diagnosed Gliomas: A Dynamic 18F-FDOPA PET Radiomics Study
by Shamimeh Ahrari, Timothée Zaragori, Marie Bros, Julien Oster, Laetitia Imbert and Antoine Verger
Cancers 2022, 14(23), 5765; https://doi.org/10.3390/cancers14235765 - 23 Nov 2022
Cited by 2 | Viewed by 1464
Abstract
Purpose: This study aims to investigate the effects of applying the point spread function deconvolution (PSFd) to the radiomics analysis of dynamic L-3,4-dihydroxy-6-[18F]-fluoro-phenyl-alanine (18F-FDOPA) positron emission tomography (PET) images, to non-invasively identify isocitrate dehydrogenase (IDH) mutated and/or 1p/19q codeleted [...] Read more.
Purpose: This study aims to investigate the effects of applying the point spread function deconvolution (PSFd) to the radiomics analysis of dynamic L-3,4-dihydroxy-6-[18F]-fluoro-phenyl-alanine (18F-FDOPA) positron emission tomography (PET) images, to non-invasively identify isocitrate dehydrogenase (IDH) mutated and/or 1p/19q codeleted gliomas. Methods: Fifty-seven newly diagnosed glioma patients underwent dynamic 18F-FDOPA imaging on the same digital PET system. All images were reconstructed with and without PSFd. An L1-penalized (Lasso) logistic regression model, with 5-fold cross-validation and 20 repetitions, was trained with radiomics features extracted from the static tumor-to-background-ratio (TBR) and dynamic time-to-peak (TTP) parametric images, as well as a combination of both. Feature importance was assessed using Shapley additive explanation values. Results: The PSFd significantly modified 95% of TBR, but only 79% of TTP radiomics features. Applying the PSFd significantly improved the ability to identify IDH-mutated and/or 1p/19q codeleted gliomas, compared to PET images not processed with PSFd, with respective areas under the curve of 0.83 versus 0.79 and 0.75 versus 0.68 for a combination of static and dynamic radiomics features (p < 0.001). Without the PSFd, four and eight radiomics features contributed to 50% of the model for detecting IDH-mutated and/or 1p/19q codeleted gliomas, respectively. Application of the PSFd reduced this to three and seven contributive radiomics features. Conclusion: Application of the PSFd to dynamic 18F-FDOPA PET imaging significantly improves the detection of molecular parameters in newly diagnosed gliomas, most notably by modifying TBR radiomics features. Full article
(This article belongs to the Special Issue Clinical PET Studies in Neuro-Oncology)
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11 pages, 1528 KiB  
Article
Impact of SSTR PET on Inter-Observer Variability of Target Delineation of Meningioma and the Possibility of Using Threshold-Based Segmentations in Radiation Oncology
by Florian Kriwanek, Leo Ulbrich, Wolfgang Lechner, Carola Lütgendorf-Caucig, Stefan Konrad, Cora Waldstein, Harald Herrmann, Dietmar Georg, Joachim Widder, Tatjana Traub-Weidinger and Ivo Rausch
Cancers 2022, 14(18), 4435; https://doi.org/10.3390/cancers14184435 - 13 Sep 2022
Cited by 9 | Viewed by 1425
Abstract
Aim: The aim of this study was to assess the effects of including somatostatin receptor agonist (SSTR) PET imaging in meningioma radiotherapy planning by means of changes in inter-observer variability (IOV). Further, the possibility of using threshold-based delineation approaches for semiautomatic tumor [...] Read more.
Aim: The aim of this study was to assess the effects of including somatostatin receptor agonist (SSTR) PET imaging in meningioma radiotherapy planning by means of changes in inter-observer variability (IOV). Further, the possibility of using threshold-based delineation approaches for semiautomatic tumor volume definition was assessed. Patients and Methods: Sixteen patients with meningioma undergoing fractionated radiotherapy were delineated by five radiation oncologists. IOV was calculated by comparing each delineation to a consensus delineation, based on the simultaneous truth and performance level estimation (STAPLE) algorithm. The consensus delineation was used to adapt a threshold-based delineation, based on a maximization of the mean Dice coefficient. To test the threshold-based approach, seven patients with SSTR-positive meningioma were additionally evaluated as a validation group. Results: The average Dice coefficients for delineations based on MRI alone was 0.84 ± 0.12. For delineation based on MRI + PET, a significantly higher dice coefficient of 0.87 ± 0.08 was found (p < 0.001). The Hausdorff distance decreased from 10.96 ± 11.98 mm to 8.83 ± 12.21 mm (p < 0.001) when adding PET for the lesion delineation. The best threshold value for a threshold-based delineation was found to be 14.0% of the SUVmax, with an average Dice coefficient of 0.50 ± 0.19 compared to the consensus delineation. In the validation cohort, a Dice coefficient of 0.56 ± 0.29 and a Hausdorff coefficient of 27.15 ± 21.54 mm were found for the threshold-based approach. Conclusions: SSTR-PET added to standard imaging with CT and MRI reduces the IOV in radiotherapy planning for patients with meningioma. When using a threshold-based approach for PET-based delineation of meningioma, a relatively low threshold of 14.0% of the SUVmax was found to provide the best agreement with a consensus delineation. Full article
(This article belongs to the Special Issue Clinical PET Studies in Neuro-Oncology)
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11 pages, 1050 KiB  
Article
Two Decades of Brain Tumour Imaging with O-(2-[18F]fluoroethyl)-L-tyrosine PET: The Forschungszentrum Jülich Experience
by Alexander Heinzel, Daniela Dedic, Norbert Galldiks, Philipp Lohmann, Gabriele Stoffels, Christian P. Filss, Martin Kocher, Filippo Migliorini, Kim N. H. Dillen, Stefanie Geisler, Carina Stegmayr, Antje Willuweit, Michael Sabel, Marion Rapp, Michael J. Eble, Marc Piroth, Hans Clusmann, Daniel Delev, Elena K. Bauer, Garry Ceccon, Veronika Dunkl, Jurij Rosen, Caroline Tscherpel, Jan-Michael Werner, Maximilian I. Ruge, Roland Goldbrunner, Jürgen Hampl, Carolin Weiss Lucas, Ulrich Herrlinger, Gabriele D. Maurer, Joachim P. Steinbach, Jörg Mauler, Wieland A. Worthoff, Bernd N. Neumaier, Christoph Lerche, Gereon R. Fink, Nadim Jon Shah, Felix M. Mottaghy and Karl-Josef Langenadd Show full author list remove Hide full author list
Cancers 2022, 14(14), 3336; https://doi.org/10.3390/cancers14143336 - 8 Jul 2022
Cited by 12 | Viewed by 2462
Abstract
O-(2-[18F]fluoroethyl)-L-tyrosine (FET) is a widely used amino acid tracer for positron emission tomography (PET) imaging of brain tumours. This retrospective study and survey aimed to analyse our extensive database regarding the development of FET PET investigations, indications, and the [...] Read more.
O-(2-[18F]fluoroethyl)-L-tyrosine (FET) is a widely used amino acid tracer for positron emission tomography (PET) imaging of brain tumours. This retrospective study and survey aimed to analyse our extensive database regarding the development of FET PET investigations, indications, and the referring physicians’ rating concerning the role of FET PET in the clinical decision-making process. Between 2006 and 2019, we performed 6534 FET PET scans on 3928 different patients against a backdrop of growing demand for FET PET. In 2019, indications for the use of FET PET were as follows: suspected recurrent glioma (46%), unclear brain lesions (20%), treatment monitoring (19%), and suspected recurrent brain metastasis (13%). The referring physicians were neurosurgeons (60%), neurologists (19%), radiation oncologists (11%), general oncologists (3%), and other physicians (7%). Most patients travelled 50 to 75 km, but 9% travelled more than 200 km. The role of FET PET in decision-making in clinical practice was evaluated by a questionnaire consisting of 30 questions, which was filled out by 23 referring physicians with long experience in FET PET. Fifty to seventy per cent rated FET PET as being important for different aspects of the assessment of newly diagnosed gliomas, including differential diagnosis, delineation of tumour extent for biopsy guidance, and treatment planning such as surgery or radiotherapy, 95% for the diagnosis of recurrent glioma, and 68% for the diagnosis of recurrent brain metastases. Approximately 50% of the referring physicians rated FET PET as necessary for treatment monitoring in patients with glioma or brain metastases. All referring physicians stated that the availability of FET PET is essential and that it should be approved for routine use. Although the present analysis is limited by the fact that only physicians who frequently referred patients for FET PET participated in the survey, the results confirm the high relevance of FET PET in the clinical diagnosis of brain tumours and support the need for its approval for routine use. Full article
(This article belongs to the Special Issue Clinical PET Studies in Neuro-Oncology)
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Review

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18 pages, 2107 KiB  
Review
Role of Positron Emission Tomography in Primary Central Nervous System Lymphoma
by Laura Rozenblum, Caroline Houillier, Carole Soussain, Marc Bertaux, Sylvain Choquet, Damien Galanaud, Khê Hoang-Xuan and Aurélie Kas
Cancers 2022, 14(17), 4071; https://doi.org/10.3390/cancers14174071 - 23 Aug 2022
Cited by 10 | Viewed by 2480
Abstract
The incidence of primary central nervous system lymphoma has increased over the past two decades in immunocompetent patients and the prognosis remains poor. A diagnosis and complete evaluation of the patient is needed without delay, but histologic evaluation is not always available and [...] Read more.
The incidence of primary central nervous system lymphoma has increased over the past two decades in immunocompetent patients and the prognosis remains poor. A diagnosis and complete evaluation of the patient is needed without delay, but histologic evaluation is not always available and PCNSL can mimic a variety of brain lesions on MRI. In this article, we review the potential role of 18F-FDG PET for the diagnosis of PCNSL in immunocompetent and immunocompromised patients. Its contribution to systemic assessment at the time of diagnosis has been well established by expert societies over the past decade. In addition, 18F-FDG provides valuable information for differential diagnosis and outcome prediction. The literature also shows the potential role of 18F-FDG as a therapeutic evaluation tool during the treatment and the end of the treatment. Finally, we present several new radiotracers that may have a potential role in the management of PCNSL in the future. Full article
(This article belongs to the Special Issue Clinical PET Studies in Neuro-Oncology)
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19 pages, 1291 KiB  
Review
PET Imaging in Neuro-Oncology: An Update and Overview of a Rapidly Growing Area
by Antoine Verger, Aurélie Kas, Jacques Darcourt and Eric Guedj
Cancers 2022, 14(5), 1103; https://doi.org/10.3390/cancers14051103 - 22 Feb 2022
Cited by 39 | Viewed by 7179
Abstract
PET plays an increasingly important role in the management of brain tumors. This review outlines currently available PET radiotracers and their respective indications. It specifically focuses on 18F-FDG, amino acid and somatostatin receptor radiotracers, for imaging gliomas, meningiomas, primary central nervous system [...] Read more.
PET plays an increasingly important role in the management of brain tumors. This review outlines currently available PET radiotracers and their respective indications. It specifically focuses on 18F-FDG, amino acid and somatostatin receptor radiotracers, for imaging gliomas, meningiomas, primary central nervous system lymphomas as well as brain metastases. Recent advances in radiopharmaceuticals, image analyses and translational applications to therapy are also discussed. The objective of this review is to provide a comprehensive overview of PET imaging’s potential in neuro-oncology as an adjunct to brain MRI for all medical professionals implicated in brain tumor diagnosis and care. Full article
(This article belongs to the Special Issue Clinical PET Studies in Neuro-Oncology)
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Other

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20 pages, 1141 KiB  
Systematic Review
The Role of [68Ga]Ga-DOTA-SSTR PET Radiotracers in Brain Tumors: A Systematic Review of the Literature and Ongoing Clinical Trials
by Paolo Palmisciano, Gina Watanabe, Andie Conching, Christian Ogasawara, Gianluca Ferini, Othman Bin-Alamer, Ali S. Haider, Maria Gabriella Sabini, Giacomo Cuttone, Sebastiano Cosentino, Massimo Ippolito and Giuseppe E. Umana
Cancers 2022, 14(12), 2925; https://doi.org/10.3390/cancers14122925 - 14 Jun 2022
Cited by 19 | Viewed by 2926
Abstract
Background: The development of [68Ga]Ga-DOTA-SSTR PET tracers has garnered interest in neuro-oncology, to increase accuracy in diagnostic, radiation planning, and neurotheranostics protocols. We systematically reviewed the literature on the current uses of [68Ga]Ga-DOTA-SSTR PET in brain tumors. Methods: PubMed, [...] Read more.
Background: The development of [68Ga]Ga-DOTA-SSTR PET tracers has garnered interest in neuro-oncology, to increase accuracy in diagnostic, radiation planning, and neurotheranostics protocols. We systematically reviewed the literature on the current uses of [68Ga]Ga-DOTA-SSTR PET in brain tumors. Methods: PubMed, Scopus, Web of Science, and Cochrane were searched in accordance with the PRISMA guidelines to include published studies and ongoing trials utilizing [68Ga]Ga-DOTA-SSTR PET in patients with brain tumors. Results: We included 63 published studies comprising 1030 patients with 1277 lesions, and 4 ongoing trials. [68Ga]Ga-DOTA-SSTR PET was mostly used for diagnostic purposes (62.5%), followed by treatment planning (32.7%), and neurotheranostics (4.8%). Most lesions were meningiomas (93.6%), followed by pituitary adenomas (2.8%), and the DOTATOC tracer (53.2%) was used more frequently than DOTATATE (39.1%) and DOTANOC (5.7%), except for diagnostic purposes (DOTATATE 51.1%). [68Ga]Ga-DOTA-SSTR PET studies were mostly required to confirm the diagnosis of meningiomas (owing to their high SSTR2 expression and tracer uptake) or evaluate their extent of bone invasion, and improve volume contouring for better radiotherapy planning. Some studies reported the uncommon occurrence of SSTR2-positive brain pathology challenging the diagnostic accuracy of [68Ga]Ga-DOTA-SSTR PET for meningiomas. Pre-treatment assessment of tracer uptake rates has been used to confirm patient eligibility (high somatostatin receptor-2 expression) for peptide receptor radionuclide therapy (PRRT) (i.e., neurotheranostics) for recurrent meningiomas and pituitary carcinomas. Conclusion: [68Ga]Ga-DOTA-SSTR PET studies may revolutionize the routine neuro-oncology practice, especially in meningiomas, by improving diagnostic accuracy, delineation of radiotherapy targets, and patient eligibility for radionuclide therapies. Full article
(This article belongs to the Special Issue Clinical PET Studies in Neuro-Oncology)
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