First-in-Man Noninvasive Initial Diagnostic Approach of Primary CNS Lymphoma Versus Glioblastoma Using PET With 18F-Fludarabine and L-[methyl-11C]Methionineстатья
Статья опубликована в высокорейтинговом журнале
Статья опубликована в журнале из списка Web of Science и/или Scopus
Аннотация:Objectives: This study sought to assess 18F-fludarabine (18F-FLUDA) PET/CT’s ability in differentiating primary central nervous system lymphomas(PCNSLs) from glioblastoma multiformes (GBMs).Patients and Methods: Patients harboring either PCNSL (n = 8) before anytreatment, PCNSL treated using corticosteroids (PCNSLh; n = 10), or GBM(n = 13) were investigated with conventional MRI and PET/CT, using 11C-METand 18F-FLUDA. The main parameters measured with each tracer were SUVTand T/N ratios for the first 30 minutes of 11C-MET acquisition, as well as at 3different times after 18F-FLUDA injection. The early 18F-FLUDA uptake withinthe first minute of injection was equally considered, whereas this parameter wascombined with the later uptakes to obtain R FLUDA 2 and R FLUDA 3 ratios.Results: No significant differences in 11C-MET uptakes were observed amongPCNSL, PCNSLh, and GBM. With 18F-FLUDA, a clear difference in dynamicGBM uptake was observed, which decreased over time after an early maximum,as compared with that of PCNSL, which steadily increased over time, PCNSLhexhibiting intermediate values. The most discriminative parameters consistingof R FLUDA 2 and R FLUDA 3 integrated the early tracer uptake (first60 seconds), thereby provided 100% specificity and sensitivity.Conclusions: 18F-FLUDA was shown to likely be a promising radiopharmaceutical for differentiating PCNSL from other malignancies, although apretreatment with corticosteroids might compromise this differential diagnostic ability. The diagnostic role of 18F-FLUDA should be further investigating, along with its potential of defining therapeutic strategies in patientswith PCNSL, while assessing the treatments’ effectiveness.