Accuracy of distinguishing between dysembryoplastic neuroepithelial tumour and other epileptogenic brain neoplasms with [11C]methionine PET - CNRS - Centre national de la recherche scientifique Accéder directement au contenu
Article Dans Une Revue Neuro-Oncology Année : 2014

Accuracy of distinguishing between dysembryoplastic neuroepithelial tumour and other epileptogenic brain neoplasms with [11C]methionine PET

Résumé

Background Dysembryoplastic neuroepithelial tumors (DNTs) represent a prevalent cause of epileptogenic brain tumors, the natural evolution of which is much more benign than that of most gliomas. Previous studies have suggested that [11C]methionine positron emission tomography (MET-PET) could help to distinguish DNTs from other epileptogenic brain tumors, and hence optimize the management of patients. Here, we reassessed the diagnostic accuracy of MET-PET for the differentiation between DNT and other epileptogenic brain neoplasms in a larger population. Methods We conducted a retrospective study of 77 patients with focal epilepsy related to a nonrapidly progressing brain tumor on MRI who underwent MET-PET, including 52 with a definite histopathology. MET-PET data were assessed by a structured visual analysis that distinguished normal, moderately abnormal, and markedly abnormal tumor methionine uptake and by semiquantitative ratio measurements. Results Pathology showed 21 DNTs (40%), 10 gangliogliomas (19%), 19 low-grade gliomas (37%), and 2 high-grade gliomas (4%). MET-PET visual findings significantly differed among the various tumor types (P < .001), as confirmed by semiquantitative analyses (P < .001 for all calculated ratios), regardless of gadolinium enhancement on MRI. All gliomas and gangliogliomas were associated with moderately or markedly increased tumor methionine uptake, whereas 9/21 DNTs had normal methionine uptake. Receiver operating characteristics analysis of the semiquantitative ratios showed an optimal cutoff threshold that distinguished DNTs from other tumor types with 90% specificity and 89% sensitivity. Conclusions Normal MET-PET findings in patients with an epileptogenic nonrapidly progressing brain tumor are highly suggestive of DNT, whereas a markedly increased tumor methionine uptake makes this diagnosis unlikely.

Dates et versions

hal-00975967 , version 1 (09-04-2014)

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Citer

S. Rheims, S. Rubi, S. Bouvard, E. Bernard, N. Streichenberger, et al.. Accuracy of distinguishing between dysembryoplastic neuroepithelial tumour and other epileptogenic brain neoplasms with [11C]methionine PET. Neuro-Oncology, 2014, 16 (10), pp.1417-1426. ⟨10.1093/neuonc/nou022⟩. ⟨hal-00975967⟩
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