Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Ampronix

Molecular Imaging Tracers Help Determine Brain Metastases Treatment Strategies

By Medimaging International staff writers
Posted on 17 Dec 2013
Print article
Imaging with the molecular imaging tracer 18F-FDOPA (L-3,4-dihydroxy-6-[18F]fluoro-phenylalanine) can help differentiate radiation-induced lesions from new tumor growth in patients who have been treated with radiotherapy for brain metastases, according to new research.

Using this amino acid tracer, researchers discovered that physicians could effectively differentiate the two types of lesions 83% of the time. Progression-free survival could also be predicted through evaluating the 18F-FDOPA imaging findings.

Brain metastases occur in 20%–40% of all cancer patients, especially in those with melanoma, non-small-cell lung cancer, and breast cancer. They account for 170,000 new cases yearly in the United States alone, and prognosis is poor. Treatment for brain metastases usually includes a combination of surgery, radiation treatment, and chemotherapy.

“Histopathological changes in neural tissue treated with radiation could trigger clinical and imaging manifestations which are very similar to those caused by tumor growth,” said Karlo J. Lizarraga, MD, MS, from the department of neurology, Miller School of Medicine, University of Miami (FL, USA), and lead author of the study. “The challenge is then to differentiate whether these manifestations are due to radiation or to tumor progression or recurrence. Accurate and timely distinction between these two possibilities can significantly affect patient care, and outcome for treatment modalities are completely different for each case.”

In the retrospective study, published ahead of print October 28, 2013, and slated for the January 1, 2014, issue of the Journal of Nuclear Medicine, researchers analyzed images from 32 patients who had 83 earlier irradiated brain metastases and who underwent 18F-FDOPA positron emission tomography (PET). The studies were analyzed both semi-quantitatively and visually to determine whether lesions were caused by radiation injury or were recurrent or progressive brain metastases. Results were verified by histopathologic analysis or clinical follow-up. The prognostic ability of 18F-FDOPA in predicting progression-free survival and overall survival was also studied with the Kaplan-Meier and Cox regression techniques.

The best overall accuracy for differentiating between the two types of lesions was achieved using visual scoring, which had a sensitivity of 81.3%, a specificity of 84.3%, and an overall accuracy of 83.1%. The semi-quantitative analysis resulted in a sensitivity of 81.3%, a specificity of 72.5% and an overall accuracy of 75.9%.

Researchers also discovered that evaluations with 18F-FDOPA PET was highly prognostic of progression-free survival, as lesions with a negative PET result had a mean time to progression that was 4.6 times longer than lesions with positive 18F-FDOPA PET findings. Moreover, a trend toward predicting overall survival was also seen.

18F-FDOPA PET imaging is currently available in few centers. The longer physical half-life of 18F-FDOPA, when compared to other amino acid tracers, gives it the advantage of potential automated production and transport to PET centers for widespread use,” noted Dr. Lizarraga.

Related Links:

Miller School of Medicine, University of Miami



Print article
Radcal

Channels

Radiography

view channel

Innovation Initiative to Develop Artificial Intelligence X-Ray Engine

Imaging Advantage (IA; Phoenix, AZ, USA), the largest platform provider of cloud based radiology service in the United States, has announced the launch of a research initiative to develop an artificial intelligence engine that will be seamlessly incorporated into its proprietary exam routing technology. The Singularity... Read more

General/Advanced Imaging

view channel

Early Intervention with Stent Retrievers Improves Outcomes for Ischemic Stroke Patients

New research has shown that restoration of blood flow to the brain within two and a half hours from the onset of the first signs of acute ischemic stroke resulted in none, or only minimal disability in 91% of patients. Endovascular therapy in the early stages of the onset of stroke symptoms significantly improved functional... Read more

Imaging IT

view channel

World Medical VR Technology Company Unveils First-of-Its-Kind Neurosurgery Surgical Visualization Platform

A novel neurosurgery Virtual Reality (VR) visualization platform has been demonstrated at the NVIDIA GPU Technology Conference (GTC) 2016 in California (USA). The enterprise-wide solution is intended to help clinicians plan, prepare, and perform neurosurgery, and enable the surgeon to empower and engage their patients... Read more

Industry News

view channel
Image: Mazor Robotics\' Renaissance Image Guidance Robot in the Hand of a Surgeon (Photo courtesy of Mazor Robotics).

Medical Image Guidance Systems Developer Reports Demand for Systems in Q1 2016

The developer of an innovative guidance system that can improve the accuracy and clinical outcomes for spine and brain surgery procedures, has announced demand for its systems during the first quarter of 2016.... Read more
Copyright © 2000-2016 Globetech Media. All rights reserved.