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Article Dans Une Revue Neurochirurgie Année : 2019

Diagnostic value of fusion of metabolic and structural images for stereotactic biopsy of brain tumors without enhancement after contrast medium injection

Résumé

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 and methods 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.

Domaines

Génétique
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Dates et versions

hal-03683807 , version 1 (31-05-2022)

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Citer

Julien Todeschi, Caroline Bund, Hélène Cebula, Salvatore Chibbaro, Benoît Lhermitte, et al.. Diagnostic value of fusion of metabolic and structural images for stereotactic biopsy of brain tumors without enhancement after contrast medium injection. Neurochirurgie, 2019, 65 (6), pp.357-364. ⟨10.1016/j.neuchi.2019.08.002⟩. ⟨hal-03683807⟩
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