Diagnostic value of fusion of metabolic and structural images for stereotactic biopsy of brain tumors without enhancement after contrast medium injection.
Neurochirurgie
; 65(6): 357-364, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-31560911
ABSTRACT
BACKGROUND:
The heterogeneous nature of glioma makes it difficult to select a target for stereotactic biopsy that will be representative of grade severity on non-contrast-enhanced lesion imaging. The objective of this study was to evaluate the benefit of fusion of metabolic images (PET 18F-DOPA) with magnetic resonance imaging (MRI) morphological images for cerebral biopsy under stereotactic conditions of glioma without contrast enhancement. PATIENTS ANDMETHODS:
This single-center prospective observational study conducted between January 2016 and April 2018 included 20 consecutive patients (mean age 45±19.5 years; range, 9-80 years) who underwent cerebral biopsy for a tumor without MRI enhancement but with hypermetabolism on 18F-FDOPA PET (positron emission tomography). Standard 18F-FDOPA uptake value (SUVmax) was determined for diagnosis of high-grade glioma, with comparison to histomolecular results.RESULTS:
Histological diagnosis was made in all patients (100%). Samples from hypermetabolism areas revealed high-grade glial tumor in 16 patients (80%). For a SUVmax threshold of 1.75, sensitivity was 81.2%, specificity 50%, PPV 86.7% and VPN 40% for diagnosis of high-grade glioma. No significant association between SUVmax and histomolecular mutation was found.CONCLUSION:
18F-FDOPA metabolic imaging is an aid in choosing the target to be biopsied under stereotactic conditions in tumors without MR enhancement. Nevertheless, despite good sensitivity, 18F-FDOPA PET is insufficient for definitive diagnosis of high-grade tumor.Palavras-chave
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MEDLINE
Assunto principal:
Biópsia
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Processamento de Imagem Assistida por Computador
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Neoplasias Encefálicas
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Técnicas Estereotáxicas
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Glioma
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article