18F-FDOPA PET/MRI fusion in patients with primary/recurrent gliomas: initial experience.

Abstract

BACKGROUND AND PURPOSE:

(18)F-FDOPA PET demonstrates higher sensitivity and specificity for gliomas than traditional [(18)F] FDG PET imaging. However, PET provides limited anatomic localization. The purpose of this study was to determine whether (18)F-FDOPA PET/MRI fusion can provide precise anatomic localization of abnormal tracer uptake and how this activity corresponds to MR signal abnormality.

METHODS:

Two groups of patients were analyzed. Group I consisted of 21 patients who underwent (18)F-FDOPA PET and MRI followed by craniotomy for tumor resection. Group II consisted of 70 patients with a pathological diagnosis of glioma that had (18)F-FDOPA PET and MRI but lacked additional pathologic follow-up. Fused (18)F-FDOPA PET and MRI images were analyzed for concordance and correlated with histopathologic data.

RESULTS:

Fusion technology facilitated precise anatomical localization of (18)F-FDOPA activity. In group I, all 21 cases showed pathology-confirmed tumor. Of these, (18)F-FDOPA scans were positive in 9/10 (90%) previously unresected tumors, and 11/11 (100%) of recurrent tumors. Of the 70 patients in group II, concordance between MRI and (18)F-FDOPA was found in 49/54 (90.1%) of patients with sufficient follow-up; in the remaining 16 patients concordance could not be determined due to lack of follow-up. (18)F-FDOPA labeling was comparable in both high- and low-grade gliomas and identified both enhancing and non-enhancing tumor equally well. In some cases, (18)F-FDOPA activity preceded tumor detection on MRI.

CONCLUSION:

(18)F-FDOPA PET/MRI fusion provides precise anatomic localization of tracer uptake and labels enhancing and non-enhancing tumor well. In a small minority of cases, (18)F-FDOPA activity may identify tumor not visible on MRI.

• Authors: Carlos J Ledezma, Wei Chen, Victor Sai, Bonnie Freitas, Tim Cloughesy, Johannes Czernin, Whitney Pope
• Journal: European journal of radiology (Eur J Radiol) Vol. 71 Issue 2 Pg. 242-8 (Aug 2009) ISSN: 1872-7727 [Electronic] Ireland
• PMID: 18511228 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• fluorodopa F 18
• Dihydroxyphenylalanine

Topics

• Adult
• Aged
• Brain Neoplasms (diagnosis)
• Dihydroxyphenylalanine (analogs & derivatives)
• Female
• Glioma (diagnosis)
• Humans
• Image Enhancement (methods)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (diagnosis)
• Pilot Projects
• Positron-Emission Tomography (methods)
• Radiopharmaceuticals
• Reproducibility of Results
• Sensitivity and Specificity
• Subtraction Technique