Impact of 3,4-Dihydroxy-6-18F-Fluoro-l-Phenylalanine PET/CT on Managing Patients with Brain Tumors: The Referring Physician's Perspective

Journal of Nuclear Medicine

Michael E. Phelps¹  Johannes Czernin¹  Albert Lai¹  Phioanh Nghiemphu¹  Nagichettiar Satyamurthy¹  Barbara Fueger¹  Franziska Walter¹  Naveed Wagle¹  Timothy Cloughesy¹  Martin A. Walter¹ 

关键词: ¹⁸F-DOPA PET/CT;    glioma;    glioblastoma;    amino acid transport;    management;    outcome;   

DOI  :  10.2967/jnumed.111.095711

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

We investigated the impact of 18F-DOPA brain PET/CT on the clinical management of patients with known or suspected brain tumors. Methods: A prospective survey of referring physicians was conducted. A pre-PET questionnaire inquired about indication, tumor histology or grade, level of suspicion for tumor recurrence, and planned management. Early post-PET questionnaires asked referring physicians to categorize PET findings as negative, equivocal, or positive; assessed the level of suspicion for primary or recurrent brain tumor; and recorded intended management changes prompted by PET findings. A late follow-up questionnaire 6 mo after the scan aimed at determining patient outcome (recurrence, survival). In addition, all referring physicians were contacted to determine whether management changes intended after 18F-DOPA PET/CT were implemented. Results: Fifty-eight consecutive patients were included. The clinical suspicion for recurrence increased in 33%, remained unchanged in 50%, and decreased in 17% of patients after adding the PET/CT result to the available diagnostic data. The late post-PET questionnaire confirmed recurrence in 26 patients whereas 32 had stable disease or remained disease-free. 18F-DOPA PET/CT resulted in intended management changes in 41% of patients. Changes in intended management from wait and watch to chemotherapy (6 patients [25%]) and from chemotherapy to wait and watch (4 patients [17%]) occurred most frequently. Clinical follow-up revealed that 75% of intended treatment changes were implemented. Conclusion: 18F-DOPA PET/CT changed the intended management of 41% of patients with brain tumors, and intended management changes were implemented in 75% of these. These changes suggest a potentially important clinical role of imaging amino acid transport in the management of brain tumor patients.

【 授权许可】

Unknown