18F-3,4-dihydroxyphenylalanine positron emission tomography features in brain tumefactive demyelinating lesions
ECTRIMS Online Library. Sbragia E. 09/13/19; 278287; P1085
Elvira Sbragia
Elvira Sbragia
Contributions
Abstract

Abstract: P1085

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis

E. Sbragia1,2, S. Raffa3,4, S. Morbelli3,5, M. Bauckneht3,5, S. Capitanio6, F. Nobili1, G. Sambuceti3,5, A. Uccelli1,7, C. Lapucci1, M. Pardini1, M. Inglese1,7,8, L. Roccatagliata9

1Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, 2Department of Neurology, IRCCS Ospedale Policlinico, San Martino, 3Department of Health Sciences, Nuclear Medicine Unit, University of Genoa, 4IRCCS Ospedale Policlinico, San Martino, 5IRCCS Ospedale Policlinico San Martino, 6Nuclear Medicine, 7Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy, 8Departments of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States, 9Department of Health Sciences, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

Background: Clinical and neuroradiological features of Tumefactive Demyelinating Lesions (TDLs) may mimic many space-occupying lesions (SOLs). It has been suggested that positron emission tomography (PET), particularly with labelled amino acid tracers, could be useful in the differential diagnosis (d.d.) of TDLs, especially with primary brain tumors (PBTs); PET characteristics of high grade neoplasms usually allow easier discrimination, while d.d. might be more complex between TDLs and low grade gliomas (LGGs) or primary brain lymphomas. To date, there has been little attention on 18F-3,4-dihydroxyphenylalanine (18F-DOPA) to this aim.
Objectives: To focus on 18F-DOPA-PET and MRIs features in TDLs.
Aims: To analyse retrospectively 18F-DOPA PET features in a case series including TDLs, LGGs and lymphomas.
Methods: We searched brain magnetic resonance imaging (MRI) and 18F-DOPA-PET performed between february 2018 and march 2019 in patients with SOLs whose d.d. included TDLs. MRIs were visually coregistered to 18-DOPA-PET images and maximum standardized uptake (SUV-max) values within lesions and their mutual ratios with striatum were calculated.
Results: We identified 8 patients; in 3 patients, final diagnosis was TDLs; out of the 5 patients with PBTs, there were 4 LLGs, one with gliomatosis cerebri pattern, and one primary brain B-cell Lymphoma (PBBCL), all confirmed by histological data. Mean SUV-max was 2,02 for TDLs (standard deviation -s.d.- 0,48; range 1,31-2,42) and 4,48 (s.d. 0,86; range 3,19-5,53) for PBTs, with lowest value recorded in PBBCL (3,19). Mean ratios with striatum in TDLs were 0,70 (s.d. 0,170; range 0,60-0,90) and 1,50 (s.d. 0,44; range 0,90-2,10) for PBTs, with the lowest value recorded in PBBCL, overlapping with values of TDLs (0,90).
Conclusions: Lower values of SUV-max obtained from 18F-DOPA-PET studies could be useful in differencing TDLs from LLGs. A grey-zone between TDLs and lymphomas might exist; further data are needed to assess the value of 18F-DOPA PET in these cases.
Disclosure: Elvira Sbragia: nothing to disclosure.
Stefano Raffa: nothing to disclosure.
Silvia Morbelli: nothing to disclosure.
Matteo Bauckneht: nothing to disclosure.
Selene Capitanio: nothing to disclosure.
Flavio Nobili: nothing to disclosure.
Gianmario Sambuceti: nothing to disclosure.
Antonio Uccelli: received consulting honoraria and/or speaker fees and basic science study grants from Biogen Idec; consulting honoraria and/or speaker fees from Genzyme, Roche, Sanofi Aventis, and Teva; consulting honoraria and/or speaker fees and a basic science study grant from Novartis; consulting honoraria and/or speaker fees and a basic science study grant from Merck Serono.
Caterina Lapucci: nothing to disclosure.
Matteo Pardini: receives research support from Novartis and received honoraria from Merck and Novartis.
Matilde Inglese: received research grants from the NIH, NMSS, Novartis, and Teva Neuroscience.
Luca Roccatagliata: nothing to disclosure.

Abstract: P1085

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis

E. Sbragia1,2, S. Raffa3,4, S. Morbelli3,5, M. Bauckneht3,5, S. Capitanio6, F. Nobili1, G. Sambuceti3,5, A. Uccelli1,7, C. Lapucci1, M. Pardini1, M. Inglese1,7,8, L. Roccatagliata9

1Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, 2Department of Neurology, IRCCS Ospedale Policlinico, San Martino, 3Department of Health Sciences, Nuclear Medicine Unit, University of Genoa, 4IRCCS Ospedale Policlinico, San Martino, 5IRCCS Ospedale Policlinico San Martino, 6Nuclear Medicine, 7Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy, 8Departments of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States, 9Department of Health Sciences, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

Background: Clinical and neuroradiological features of Tumefactive Demyelinating Lesions (TDLs) may mimic many space-occupying lesions (SOLs). It has been suggested that positron emission tomography (PET), particularly with labelled amino acid tracers, could be useful in the differential diagnosis (d.d.) of TDLs, especially with primary brain tumors (PBTs); PET characteristics of high grade neoplasms usually allow easier discrimination, while d.d. might be more complex between TDLs and low grade gliomas (LGGs) or primary brain lymphomas. To date, there has been little attention on 18F-3,4-dihydroxyphenylalanine (18F-DOPA) to this aim.
Objectives: To focus on 18F-DOPA-PET and MRIs features in TDLs.
Aims: To analyse retrospectively 18F-DOPA PET features in a case series including TDLs, LGGs and lymphomas.
Methods: We searched brain magnetic resonance imaging (MRI) and 18F-DOPA-PET performed between february 2018 and march 2019 in patients with SOLs whose d.d. included TDLs. MRIs were visually coregistered to 18-DOPA-PET images and maximum standardized uptake (SUV-max) values within lesions and their mutual ratios with striatum were calculated.
Results: We identified 8 patients; in 3 patients, final diagnosis was TDLs; out of the 5 patients with PBTs, there were 4 LLGs, one with gliomatosis cerebri pattern, and one primary brain B-cell Lymphoma (PBBCL), all confirmed by histological data. Mean SUV-max was 2,02 for TDLs (standard deviation -s.d.- 0,48; range 1,31-2,42) and 4,48 (s.d. 0,86; range 3,19-5,53) for PBTs, with lowest value recorded in PBBCL (3,19). Mean ratios with striatum in TDLs were 0,70 (s.d. 0,170; range 0,60-0,90) and 1,50 (s.d. 0,44; range 0,90-2,10) for PBTs, with the lowest value recorded in PBBCL, overlapping with values of TDLs (0,90).
Conclusions: Lower values of SUV-max obtained from 18F-DOPA-PET studies could be useful in differencing TDLs from LLGs. A grey-zone between TDLs and lymphomas might exist; further data are needed to assess the value of 18F-DOPA PET in these cases.
Disclosure: Elvira Sbragia: nothing to disclosure.
Stefano Raffa: nothing to disclosure.
Silvia Morbelli: nothing to disclosure.
Matteo Bauckneht: nothing to disclosure.
Selene Capitanio: nothing to disclosure.
Flavio Nobili: nothing to disclosure.
Gianmario Sambuceti: nothing to disclosure.
Antonio Uccelli: received consulting honoraria and/or speaker fees and basic science study grants from Biogen Idec; consulting honoraria and/or speaker fees from Genzyme, Roche, Sanofi Aventis, and Teva; consulting honoraria and/or speaker fees and a basic science study grant from Novartis; consulting honoraria and/or speaker fees and a basic science study grant from Merck Serono.
Caterina Lapucci: nothing to disclosure.
Matteo Pardini: receives research support from Novartis and received honoraria from Merck and Novartis.
Matilde Inglese: received research grants from the NIH, NMSS, Novartis, and Teva Neuroscience.
Luca Roccatagliata: nothing to disclosure.

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