Diagnostic performances of [18F]fluorocholine positron emission tomography in brain tumors.
BACKGROUND
Brain tumors characterization by molecular imaging that allows the depiction of brain lesions metabolic pattern is crucial. Our study aimed to: 1) to evaluate the diagnostic performances of [18F]fluoroethylcholine positron emission tomography/computed tomography ([18F]FECH PET/CT), and 2) correlate PET imaging derived parameters of [18F]FECH to survival in brain tumors.


METHODS
From 2009 to 2012, we enrolled 30 patients who underwent [18F]FECH PET/CT. Final diagnosis was established by clinical and radiological follow-up.


RESULTS
Final diagnosis was consistent with tumor disease in 27/30 cases. In 3/30 cases tumor disease was ruled out. [18F]FECH PET/CT resulted true positive and negative in 21/30 and 9/30 patients, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of [18F]FECH PET/CT were 78%, 100%, 100%, 33%, and 80%, respectively. Mean and maximum standardized uptake value (SUVmean and SUVmax) resulted statistically correlated to histology (P=0.0255 and P=0.0222, respectively). Using a SUVmax cut-off of 2.0 or 3.2, we distinguished between low- and high-grade gliomas with a good specificity (70% and 80%, respectively). SUVmax and histology resulted correlated to overall survival and disease related survival at multivariate analysis.


CONCLUSIONS
Our results, worthy of further investigations, show high diagnostic performances of [18F]FECH PET/CT, and a correlation between PET imaging derived parameters and survival.
Unit of Nuclear Medicine, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy - martinasollini@msn.com.
Martina
M
Sollini
Unit of Medical Physics, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Roberto
R
Sghedoni
Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy.
Paola A
PA
Erba
Unit of Infrastructure Research and Statistics, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Silvio
S
Cavuto
Unit of Nuclear Medicine, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Armando
A
Froio
Neuroradiology Section, Villa Verde Clinic, Reggio Emilia, Italy.
Gianni
G
De Berti
Unit of Neurology, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Anna
A
Pisanello
Unit of Nuclear Medicine, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Alessandro
A
Fraternali
Unit of Nuclear Medicine, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Michele
M
Iori
Unit of Neurosurgery and Neurotraumatology, Parma University Hospital, Parma, Italy.|Unit of Emergency Neurosurgery, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Corrado
C
Iaccarino
Unit of Medical Physics, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Mauro
M
Iori
Unit of Nuclear Medicine, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Mattia
M
Asti
Unit of Nuclear Medicine, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Angelina
A
Filice
Unit of Nuclear Medicine, Santa Maria Nuova Hospital, Institute for Research and Care of Reggio Emilia, Reggio Emilia, Italy.
Annibale
A
Versari
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D002794:Choline / Q000031:analogs & derivatives*; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C448902:fluoroethylcholine; C000615276:Fluorine-18; D002794:Choline