Overall survival and progression-free survival in patients with primary brain tumors after treatment: is the outcome of [18F] FDOPA PET a prognostic factor in these patients?

Abstract

Aim To investigate the progression-free survival (PFS) and the overall survival (OS) in a population affected by primary brain tumors (PBT) evaluated by [ 18 F]-l-dihydroxyphenylalanine ([ 18 F] FDOPA) positron emission tomography/computed tomography (PET/CT). Materials and methods 133 subjects with PBT (65 women and 68 men, mean age 45 ± 10 years old) underwent 18 F FDOPA PET/CT after treatment. Of them, 68 (51.2%) were Grade II, 34 (25.5%) were Grade III and 31 (23.3%) were Grade IV. PET/CT was scored as positive or negative and standardized uptake value ratio (SUVr) was calculated as the ratio between SUVmax of the lesion vs. that of the background. Patients have been observed for a mean of 24 months. Results The outcome of [ 18 F] FDOPA PET/CT scan was significantly related to the OS and PFS in Grade II gliomas. In Grade II PBT, the OS proportions at 24 months were 100% in subjects with a negative PET/CT scan and 82% in those with a positive scan. Gehan-Breslow-Wilcoxon test showed a significant difference in the OS curves (P = 0.03) and the hazard-ratio was equal to 5.1 (95% CI of ratio 1.1-23.88). As for PFS, the proportion at 24 months was 90% in subjects with a negative PET/CT scan and 58% in those with a positive scan. Gehan-Breslow-Wilcoxon test showed a significant difference in the OS curves (P = 0.007) and the hazard-ratio was equal to 4.1 (95% CI of ratio 1.3-8). We did not find any significant relationship between PET outcome and OS and PFS in Grade III and IV PBT. Conclusions A positive [ 18 F] FDOPA PET/CT scan is related to a poor OS and PFS in subjects with low-grade PBT. This imaging modality could be considered as a prognostic factor in these subjects.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

MGMT Promoter Methylation and IDH1 Mutations Do Not Affect [18F]FDOPA Uptake in Primary Brain Tumors

“…starting from the slice with the highest uptake of the radiopharmaceutical. Moreover, the use of co-registered MRI images [ 16 ] permitted a correct placement of the VOI, even in tumors with involvement of the striatum ( Figure 1 A). From the VOI, the maximum standardized uptake value for the site of recurrence (SUVmax lesion) was calculated on a dedicated workstation (version 4.4, Advantage Workstation, GE Healthcare, Chicago, IL, USA).…”

Usefulness of 18F-FDOPA PET for the management of primary brain tumors: a systematic review of the literature

“…Nevertheless, a recent study reported results that are more restrained. Chiaravalloti et al retrospectively included 133 primary brain tumors [62]. They correlated the OS and the PFS with the SUV max and the SUVr (defined by the SUV max of the tumor divided by the SUV max of the contralateral occipital region).…”

Cost-Effectiveness of [18F] Fluoroethyl-L-Tyrosine for Temozolomide Therapy Assessment in Patients With Glioblastoma

“…The use of PET as a prognostic tool for high-grade gliomas has been investigated over a period of several years. A previous study conducted on [ 18 F] dihdryoxyphenylalanine ([ 18 F] FDOPA) within a large target population did not find that the amino acid PET tracer had any prognostic power (19). However, studies on [ 18 F] FET have shown that this tracer could have prognostic potential (12, 13).…”