Multiparametric evaluation of low grade gliomas at follow-up: comparison between diffusion and perfusion MR with ¹⁸F-FDOPA PET

Abstract

Objective: To compare MRI using perfusion and diffusion techniques with 6-[ LGGs) and to identify the best imaging parameter to differentiate patients with different prognosis. Methods: Between 2010 and 2015, 12 patients with a pathology-proven diagnosis of LGG and MR (with perfusion and diffusion sequences) and a PET study during their follow-up were retrospectively included in our study. Cerebral blood volume (CBV) and apparent diffusion coefficient (ADC) maps on MR studies and PET images were evaluated using a region of interest-based method. All patients were categorized as stable or as having progressive disease at 1-year follow-up. Statistical analysis was performed using Pearson's correlation test and multivariate analysis of variance (p , 0.05). Results: No significant correlations were found between PET parameters [maximum tumour-to-controlateral normal brain ratio (T/N max ) and tumour-to-striatum ratio] and ADC or relative CBV values measured in both PET hotspot regions and areas of maximum signal alterations. T/N max demonstrated a good sensitivity (83%) and specificity (100%) for differentiating two subgroups of patients with different outcomes at 1-year-follow-up (p , 0.05). Conclusion: Perfusion and diffusion MR images provide different information compared with 18

IDH mutation is paradoxically associated with higher 18F-FDOPA PET uptake in diffuse grade II and grade III gliomas

“…Briefly, 18 F-FDopa, is mainly integrated in cells by L-Amino-acid Transporter 1 (LAT 1), which is overexpressed in gliomas [5]. 18 F-FDopa PET allows to distinguish glioblastoma from other gliomas but its contribution to prognosis remains debated inside a same grade, particularly to stratify newly diagnosed low-grade gliomas [4,6,7]. Up to now, only two studies have reported a prognostic value of 18F-FDopa uptake in low-grade gliomas for disease progression [6,7].…”

“…18 F-FDopa PET allows to distinguish glioblastoma from other gliomas but its contribution to prognosis remains debated inside a same grade, particularly to stratify newly diagnosed low-grade gliomas [4,6,7]. Up to now, only two studies have reported a prognostic value of 18F-FDopa uptake in low-grade gliomas for disease progression [6,7]. Nevertheless, the relationship with molecular parameters was not evaluated; the first one did not provide semi-quantitative ratios [6], and the second one involved a weak number of patients (n=12) [7].…”

“…Up to now, only two studies have reported a prognostic value of 18F-FDopa uptake in low-grade gliomas for disease progression [6,7]. Nevertheless, the relationship with molecular parameters was not evaluated; the first one did not provide semi-quantitative ratios [6], and the second one involved a weak number of patients (n=12) [7].…”

Diagnostic Performance of PET and Perfusion-Weighted Imaging in Differentiating Tumor Recurrence or Progression from Radiation Necrosis in Posttreatment Gliomas: A Review of Literature

“…13 On-line Table 2 summarizes the various PET radiotracers and their uptake mechanism, half-life, availability, and uptake in the healthy brain. We will discuss the most commonly used FDG, 32-37 and other various radio-labeled AATs such as 11 C-MET), 32,36,38-42 6[ 18 F]fluoro-L-dopa (FDOPA), [43][44][45] and [ 18 F]fluoroethyl-L-tyrosine (FET), [46][47][48][49][50][51] as well as 18 F-fluorothymidine (FLT), 50,52 which evaluates DNA syntheses (On-line Table 3).…”

“…Hence, the use of various AATs has been proposed. 32,33,36,52 Amino Acid Transport and Protein Synthesis PET with AAT-11 C-MET, 32,36,39,40,42 [ 18 F] FET, [46][47][48][49][50] and [ 18 F] FDOPA 33, [43][44][45] has shown remarkable results in evaluating posttreatment changes of gliomas. Radiolabeled AATs show high tumor-to-background ratio (TBR) in gliomas because of increased cell proliferation and extracellular matrix production.…”