Features | Partner Sites | Information | LinkXpress
Sign In
Schiller
VIEWORKS
Ampronix

Molecular Imaging Tracers Help Determine Brain Metastases Treatment Strategies

By Medimaging International staff writers
Posted on 17 Dec 2013
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



Channels

Radiography

view channel
Image: Siemens MAMMOMAT FFDM System (Photo courtesy of Siemens Healthcare).

New FFDM Systems Transform Mammography Services Across Northern Ireland

The Northern Ireland Breast Screening Program has been equipped with 14 new mobile and static Full Field Digital Mammography (FFDM) systems. The new systems will replace existing analog ones and enable... Read more

Ultrasound

view channel

Study Suggests Ultrasound Could Eliminate Breast Biopsies in Adolescent Girls

Results of a study published in the Journal of Ultrasound in Medicine in April 2015, indicate that ultrasound examinations could replace invasive excisional tissue biopsies for adolescent girls with breast lumps. The study was carried out by researchers at the Loyola University Health System (Maywood, IL, USA) and included... Read more

General/Advanced Imaging

view channel
Image: Measuring the Magnetic Activity in the Brain of a Child, Using a MEG machine. (Photo courtesy of Children\'s Hospital of Philadelphia).

Study Suggests Language Delay Linked to Chromosome Deletion in Children with Neurological Disorders

A study found that children with neuro-developmental problems born with DNA duplications or deletions on part of chromosome 16, show measurable delays in their ability to process sound and language.... Read more

Industry News

view channel

Partnership to Extend Web and Mobile Image Access to Enterprise Patient Multimedia Manager

A partnership and distribution agreement has been agreed to integrate an enterprise multimedia Picture Archiving and Communication System (PACS) with an enterprise image viewing solution. The partnership will provide extended web and mobile access for clinicians to medical images and multimedia files from desktop computers,... Read more
 
Copyright © 2000-2015 Globetech Media. All rights reserved.