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Clinical applications of PET using C-11/F-18-choline in brain tumours: a systematic review

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Abstract

Purpose

The purpose of this study is to conduct a systematic review of the published data about the current indications in clinical practice for the use of positron emission tomography (PET) or PET/computed tomography (PET/CT) using either Carbon-11 (11C) or Fluorine-18 (18F) choline tracer in brain tumours.

Methods

A comprehensive literature search of PubMed until April 30, 2016 with the Mesh terms: ‘‘positron emission tomography’’, ‘‘choline’’, and ‘‘brain neoplasm’’ was first performed. On a second step, the references of the retrieved articles were also screened, adding any relevant publications about the subject.

Results

A total of 15 articles corresponding to 453 patients with brain lesions (mostly gliomas) were included for the analysis, successfully imaging brain tumours for the following indications: diagnosis and tumour characterisation; biopsy guide; treatment planning; differential diagnosis of recurrence or radiation necrosis; and therapy response assessment and prognosis. In addition, other brain lesions have been imaged by PET choline, such as meningiomas and metastasis. PET or PET/CT with radiolabelled choline must be considered as an emerging procedure for the evaluation of brain tumours. Since choline has a low physiological uptake, it provides precise images with a very good tumour-to-background ratio, especially in lesions with disruption of the blood–brain barrier.

Conclusions

Even though the small population and heterogeneity of analyzed studies precluded performing a meta-analysis, the exposed results in this review support the use of choline in the aforementioned indications based on its availability, but larger studies are needed to better validate its use.

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Article 04 December 2018

Davide Donner, Umberto Rozzanigo, … Franca Chierichetti

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Authors and Affiliations

  1. Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Granada, Granada, Spain

    Nathalie Testart Dardel, Manuel Gómez-Río, Eva Triviño-Ibáñez & José Manuel Llamas-Elvira

  2. Instituto de Investigación Biosanitaria de Granada (IBS), Granada, Spain

    Nathalie Testart Dardel, Manuel Gómez-Río, Eva Triviño-Ibáñez & José Manuel Llamas-Elvira

  3. Programa de Doctorado, Universidad de Granada, Granada, Spain

    Nathalie Testart Dardel

Authors
  1. Nathalie Testart Dardel
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  2. Manuel Gómez-Río
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  3. Eva Triviño-Ibáñez
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  4. José Manuel Llamas-Elvira
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Corresponding author

Correspondence to Nathalie Testart Dardel.

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Funding

No financial relationship exists. NT developed this review within the doctoral program of the Granada University (Spain) and was logistically supported by the “Instituto de Investigación Biosanitaria de Granada” (IBS), the FIS-Instituto de Salud Carlos III (PI 13/00539) (FEDER), and the “Fundación para la Investigación Biosanitaria de Andalucía Oriental Alejandro-Otero” (FIBAO), Spain. The authors thank Isabel Del Canto for language style support.

Conflict of interest

Nathalie Testart Dardel, Manuel Gómez-Río, Eva Triviño-Ibáñez, and José Manuel Llamas-Elvira declare no conflict of interest.

Ethical standards

This article does not contain any studies with human or animal subjects performed by the any of the authors.

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Testart Dardel, N., Gómez-Río, M., Triviño-Ibáñez, E. et al. Clinical applications of PET using C-11/F-18-choline in brain tumours: a systematic review. Clin Transl Imaging 5, 101–119 (2017). https://doi.org/10.1007/s40336-016-0200-0

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  • DOI: https://doi.org/10.1007/s40336-016-0200-0

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