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胶质母细胞瘤的复杂诊断挑战:F-FDOPA PET成像的作用

Complex Diagnostic Challenges in Glioblastoma: The Role of F-FDOPA PET Imaging.

作者信息

Sipos David, Debreczeni-Máté Zsanett, Ritter Zsombor, Freihat Omar, Simon Mihály, Kovács Árpád

机构信息

Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary.

Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary.

出版信息

Pharmaceuticals (Basel). 2024 Sep 15;17(9):1215. doi: 10.3390/ph17091215.

Abstract

Glioblastoma multiforme (GBM) remains one of the most aggressive and lethal forms of brain cancer, characterized by rapid proliferation and diffuse infiltration into the surrounding brain tissues. Despite advancements in therapeutic approaches, the prognosis for GBM patients is poor, with median survival times rarely exceeding 15 months post-diagnosis. An accurate diagnosis, treatment planning, and monitoring are crucial for improving patient outcomes. Core imaging modalities such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are indispensable in the initial diagnosis and ongoing management of GBM. Histopathology remains the gold standard for definitive diagnoses, guiding treatment by providing molecular and genetic insights into the tumor. Advanced imaging modalities, particularly positron emission tomography (PET), play a pivotal role in the management of GBM. Among these, 3,4-dihydroxy-6-[F]-fluoro-L-phenylalanine (F-FDOPA) PET has emerged as a powerful tool due to its superior specificity and sensitivity in detecting GBM and monitoring treatment responses. This introduction provides a comprehensive overview of the multifaceted role of F-FDOPA PET in GBM, covering its diagnostic accuracy, potential as a biomarker, integration into clinical workflows, impact on patient outcomes, technological and methodological advancements, comparative effectiveness with other PET tracers, and its cost-effectiveness in clinical practice. Through these perspectives, we aim to underscore the significant contributions of F-FDOPA PET to the evolving landscape of GBM management and its potential to enhance both clinical and economic outcomes for patients afflicted with this formidable disease.

摘要

多形性胶质母细胞瘤(GBM)仍然是最具侵袭性和致命性的脑癌形式之一,其特征是快速增殖并弥漫性浸润周围脑组织。尽管治疗方法有所进步,但GBM患者的预后仍然很差,诊断后的中位生存时间很少超过15个月。准确的诊断、治疗规划和监测对于改善患者预后至关重要。计算机断层扫描(CT)和磁共振成像(MRI)等核心成像模态在GBM的初始诊断和持续管理中不可或缺。组织病理学仍然是明确诊断的金标准,通过提供肿瘤的分子和遗传见解来指导治疗。先进的成像模态,特别是正电子发射断层扫描(PET),在GBM的管理中发挥着关键作用。其中,3,4-二羟基-6-[F]-氟-L-苯丙氨酸(F-FDOPA)PET由于其在检测GBM和监测治疗反应方面具有卓越的特异性和敏感性,已成为一种强大的工具。本介绍全面概述了F-FDOPA PET在GBM中的多方面作用,包括其诊断准确性、作为生物标志物的潜力、融入临床工作流程、对患者预后的影响、技术和方法学进展、与其他PET示踪剂的比较有效性及其在临床实践中的成本效益。通过这些视角,我们旨在强调F-FDOPA PET对GBM管理不断演变的格局的重大贡献及其增强患有这种可怕疾病的患者的临床和经济结局的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11434841/118345166feb/pharmaceuticals-17-01215-g001.jpg

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