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Additive Value of Dynamic FDOPA PET/CT for Glioma Grading.

Authors :: Girard A
Le Reste PJ
Metais A
Chaboub N
Devillers A
Saint-Jalmes H
Jeune FL
Palard-Novello X
Source :: Frontiers in medicine [Front Med (Lausanne)] 2021 Jul 09; Vol. 8, pp. 705996. Date of Electronic Publication: 2021 Jul 09 (Print Publication: 2021).
Publication Year :: 2021
Abstract: Purpose: The aim of this study was to assess the value of the FDOPA PET kinetic parameters extracted using full kinetic analysis for tumor grading with neuronavigation-guided biopsies as reference in patients with newly-diagnosed gliomas. Methods: Fourteen patients with untreated gliomas were investigated. Twenty minutes of dynamic positron-emission tomography (PET) imaging and a 20-min static image 10 min after injection were reconstructed from a 40-min list-mode acquisition immediately after FDOPA injection. Tumors volume-of-interest (VOI) were generated based on the MRI-guided brain biopsies. Static parameters (TBRmax and TBRmean) and kinetic parameters [K1 and k2 using full kinetic analysis with the reversible single-tissue compartment model with blood volume parameter and the time-to-peak (TTP)] were extracted. Performances of each parameter for differentiating low-grade gliomas (LGG) from high-grade gliomas (HGG) were evaluated by receiver-operating characteristic analyses (area under the curve; AUC). Results: Thirty-two tumoral VOI were analyzed. K1, k2, and TTP were significantly higher for HGG than for LGG (median K1-value = 0.124 vs. 0.074 ml/ccm/min, p = 0.025, median k2-value = 0.093 vs. 0.063 min <superscript>-1</superscript> , p = 0.025, and median TTP-value = 10.0 vs. 15.0 min, p = 0.025). No significant difference was observed for the static parameters. The AUC for the kinetic parameters was higher than the AUC for the static parameters (respectively, AUC <subscript>K1</subscript> = 0.787, AUC <subscript>k2</subscript> = 0.785, AUC <subscript>TTP</subscript> = 0.775, AUC <subscript>TBRmax</subscript> = 0.551, AUC <subscript>TBRmean</subscript> = 0.575), significantly compared to TBRmax (respectively, p = 0.001 for K1, p = 0.031 for k2, and p = 0.029 for TTP). Conclusion: The present study suggests an additive value of FDOPA PET/CT kinetic parameters for newly-diagnosed gliomas grading.<br />Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.<br /> (Copyright © 2021 Girard, Le Reste, Metais, Chaboub, Devillers, Saint-Jalmes, Jeune and Palard-Novello.)