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


CONCLUSIONS
(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.
Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. ledezmacjl@gmail.com
Carlos J
CJ
Ledezma
Wei
W
Chen
Victor
V
Sai
Bonnie
B
Freitas
Tim
T
Cloughesy
Johannes
J
Czernin
Whitney
W
Pope
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis*; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique
D019275:Radiopharmaceuticals; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine