Maximum Uptake and Hypermetabolic Volume of 18F-FDOPA PET Estimate Molecular Status and Overall Survival in Low-Grade Gliomas: A PET and MRI Study. (December 2020)

• Record Type: Journal Article
• Authors: Tatekawa, Hiroyuki; Yao, Jingwen; Oughourlian, Talia C.; Hagiwara, Akifumi; Wang, Chencai; Raymond, Catalina; Lai, Albert; Cloughesy, Timothy F.; Nghiemphu, Phioanh L.; Liau, Linda M.; Salamon, Noriko; Ellingson, Benjamin M.
• Is Part Of: Clinical nuclear medicine. Volume 45:Number 12(2020)
• Publication Date: 2020-12
• Subjects: 18F-FDOPA PET -- low-grade glioma -- molecular biomarker -- overall survival; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000003318
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: We evaluated 18 F-FDOPA PET and MRI characteristics in association with the molecular status and overall survival (OS) in a large number of low-grade gliomas (LGGs). Methods: Eighty-six patients who underwent 18 F-FDOPA PET and MRI and were diagnosed with new or recurrent LGGs were retrospectively evaluated with respect to their isocitrate dehydrogenase (IDH) and 1p19q status (10 IDH wild type, 57 mutant, 19 unknown; 1p19q status in IDH mutant: 20 noncodeleted, 37 codeleted). After segmentation of the hyperintense area on fluid-attenuated inversion recovery image (FLAIRROI ), the following were calculated: normalized SUVmax (nSUVmax) of 18 F-FDOPA relative to the striatum, 18 F-FDOPA hypermetabolic volume (tumor-to-striatum ratios >1), FLAIRROI volume, relative cerebral blood volume, and apparent diffusion coefficient within FLAIRROI . Receiver operating characteristic curve and Cox regression analyses were performed. Results: PET and MRI metrics combined with age predicted the IDH mutation and 1p19q codeletion statuses with sensitivities of 73% and 76% and specificities of 100% and 94%, respectively. Significant correlations were found between OS and the IDH mutation status (hazard ratio [HR] = 4.939), nSUVmax (HR = 2.827), 18 F-FDOPA hypermetabolic volume (HR = 1.048), and FLAIRROI volume (HR = 1.006). The nSUVmax (HR = 151.6) for newly diagnosed LGGs and the 18 F-FDOPA hypermetabolic volume (HR = 1.038) for recurrent LGGs demonstrated significant association with OS. Conclusions: Combining 18 F-FDOPA PET and MRI with age proved useful for predicting the molecular status in patients with LGGs, whereas the nSUVmax and 18 F-FDOPA hypermetabolic volume may be useful for prognostication. Abstract : Supplemental digital content is available in the text.