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A Practical, Short, [18F]F-DOPA PET/CT Acquisition Method for Distinguishing Recurrent Brain Metastases from

Pascal Bailly1, Roger Bouzerar1, Ines Barrat1

  • 1Nuclear Medicine Department, Amiens University Hospital, 80000 Amiens, France.

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|April 12, 2025
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A rapid [18F]F-DOPA PET/CT scan, under five minutes, effectively distinguishes brain metastasis progression from radionecrosis. This method offers high accuracy without specialized software, simplifying clinical use.

Keywords:
[18F]F-DOPA PET imagingbrain metastasisprogressionradionecrosisshort acquisition

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Area of Science:

  • Nuclear Medicine
  • Radiology
  • Oncology

Background:

  • Differentiating brain metastasis progression (MP) from radionecrosis (RN) using [18F]F-DOPA PET/CT is clinically challenging.
  • Current methods may require lengthy acquisition times or specialized software, limiting accessibility.
  • Developing a rapid, clinically applicable method is crucial for timely patient management.

Purpose of the Study:

  • To present a simplified method for distinguishing MP from RN using short [18F]F-DOPA PET/CT acquisitions.
  • To validate the method's diagnostic performance using data collected immediately after tracer injection.
  • To enable clinical utility without reliance on dedicated post-processing software.

Main Methods:

  • Prospective enrollment of 15 patients with 19 brain lesions.
  • Short (120s, 270s) and standard (10 min) static [18F]F-DOPA PET/CT acquisitions.
  • Calculation of lesion SUVmax/background SUVmean ratio and coefficient of variation (COV).

Main Results:

  • Both short acquisition durations (120s, 270s) showed significant differences in lesion metrics compared to standard scans.
  • The COV parameter demonstrated significant differences across most comparisons, aiding discrimination.
  • Optimal diagnostic performance (94.7% accuracy, 97.6% AUC) was achieved with 120s and 270s acquisitions.

Conclusions:

  • A rapid [18F]F-DOPA PET/CT acquisition ( < 5 min) provides excellent diagnostic performance for differentiating RN from MP.
  • The proposed method achieves high sensitivity (100%) and specificity (91.7%) with high AUC (97.6%).
  • This approach simplifies clinical workflow and enhances diagnostic confidence in managing brain lesions.