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Optimisation des paramètres de quantification en imagerie TEP pour le diagnostic, l'évaluation thérapeuthique et le pronostic des cancers endocriniens

Abstract : The objective of this work was to propose a systematic and reasoned approach of the quantification tools available in clinical routine and in research in the management of patients with endocrine tumors. Our results report the limitations of semi-quantitative parameters to assess the malignancy of fTI detected by 18FDG-PET / CT. Our data on the interest of textural parameters in the diagnosis of malignancy of adrenal tumors show excellent performances of these indices. However these indices do not appear superior in comparison with conventional semi-quantitative parameters.Our approach raises new hypotheses regarding the interest of texture analysis in the characterization of some rare adrenal tumors (pheochromocytomas and adrenocortical carcinoma) that will be the subject of future work. Finally, our work on the multi-parametric 68Ga-DOTATOC-PET / CT imaging highlights the feasibility of a whole-body dynamic 68Ga-DOTATOC-PET / CT acquisition and the possibilities to perform quantification of NETs uptake treated with PRRT on post-therapeutic SPECT / CT acquisitions. Our results open up multiple perspectives for the management of NETs at different stages of the disease (diagnosis, prognosis and therapeutic evaluation).
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Philippe Thuillier. Optimisation des paramètres de quantification en imagerie TEP pour le diagnostic, l'évaluation thérapeuthique et le pronostic des cancers endocriniens. Médecine humaine et pathologie. Université de Bretagne occidentale - Brest, 2019. Français. ⟨NNT : 2019BRES0088⟩. ⟨tel-02735282⟩

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