Accuracy of 18F-DOPA PET and 18F-FET PET for Differentiating Radiation Necrosis From Brain Tumor Recurrence.

Accuracy of 18F-DOPA PET and 18F-FET PET for Differentiating Radiation Necrosis From Brain Tumor Recurrence.

World Neurosurg. 2018 Apr 03;:

Authors: Yu J, Zheng J, Xu W, Weng J, Gao L, Tao L, Liang F, Zhang J

Abstract
INTRODUCTION: It remains a great challenge to distinguish radiation necrosis from brain tumor recurrence. The meta-analysis was performed to assess the diagnostic accuracy of two different amino acid tracers of PET/CT.
METHODS: We searched for studies in 3 databases: PubMed, Chinese Biomedical databases (CBM), Embase. The data were extracted from eligible studies and then processed with heterogeneity test, threshold effect test, and calculation of sensitivity (SEN), specificity (SPE) and areas under summary receiver operating characteristic curve (SROC). Meta-regression and subgroup analysis were performed to explore the source of heterogeneity.
RESULTS: A Total of 48 studies (18F-FDOPA: 21; 18F-FET: 27) were included. Quantitative synthesis showed pooled weight values in 18F-FDOPA and 18F-FET groups: SEN: 0.85 vs 0.82; SPE: 0.77 vs 0.80; DOR: 21.7 vs 23.03; AUC values: 0.8771 vs 0.8976, P = 0.46. Moreover, the "types of tumors" was determined as the possible source of significant heterogeneity (I2 = 52%, P = 0.003) found in 18F-FDOPA group. In meta-regression and subgroup analysis, 18F-FDOPA revealed better diagnostic accuracy in patients with glioma instead of brain metastases (AUC values: 0.9691 vs 0.837, P < 0.01). 18F-FDOPA also showed overwhelming advantages in diagnosis of glioma recurrence compared with 18F-FET (AUC values: 0.9691 vs 0.9124; P = 0.015).
CONCLUSION: Both 18F-FDOPA and 18F-FET display moderate overall accuracy in diagnosing brain tumor recurrence from radiation necrosis. Moreover, 18F-FDOPA is more adept at diagnosing glioma recurrence instead of brain metastases, and it is more effective in diagnosing glioma recurrence than 18F-FET.

PMID: 29625311 [PubMed - as supplied by publisher]

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