title: 18F-FDOPA PET/CT for detection of recurrence in patients with glioma: prospective comparison with 18F-FDG PET/CT.
abstract: OBJECTIVE
  Differentiation between recurrence and radiation necrosis in patients with glioma is crucial, since the two entities have completely different management and prognosis. The purpose of the present study was to compare the efficacies of (18)F-FDG PET/CT and 3,4-dihydroxy-6-[(18)F]fluoro-phenylalanine ((18)F-FDOPA) PET/CT in detection of recurrent gliomas.
  
  
  METHODS
  A total of 28 patients (age 38.82 ± 1.25 years; 85.7% men) with histopathologically proven glioma with clinical/imaging suspicion of recurrence were evaluated using (18)F-FDG PET/CT and (18)F-FDOPA PET/CT. (18)F-FDG PET/CT and (18)F-FDOPA PET/CT images were evaluated qualitatively and semiquantitatively. The combination of clinical follow-up, repeat imaging and/or biopsy (when available) was taken as the reference standard.
  
  
  RESULTS
  Based on the reference standard, 21 patients were positive and 7 were negative for tumour recurrence. The sensitivity, specificity and accuracy of (18)F-FDG PET/CT were 47.6%, 100% and 60.7%, respectively, and those of (18)F-FDOPA PET/CT were 100%, 85.7% and 96.4%, respectively. The results of (18)F-FDG PET/CT and (18)F-FDOPA PET/CT were concordant in 57.1% of patients (16 of 28) and discordant in 42.9% (12 of 28). The difference in the findings between (18)F-FDG PET/CT and (18)F-FDOPA PET/CT was significant (P = 0.0005, McNemar's test). The difference was significant for low-grade tumours (P = 0.0039) but not for high-grade tumours (P = 0.250).
  
  
  CONCLUSIONS
  (18)F-FDOPA PET/CT is highly sensitive and specific for detection of recurrence in glioma patients. It is superior to (18)F-FDG PET/CT for this purpose and is especially advantageous in patients with low-grade gliomas.
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Sellam
authors.initials: S
authors.lastname: Karunanithi
authors.forename: Punit
authors.initials: P
authors.lastname: Sharma
authors.forename: Abhishek
authors.initials: A
authors.lastname: Kumar
authors.forename: Bangkim Chandra
authors.initials: BC
authors.lastname: Khangembam
authors.forename: Guru Pada
authors.initials: GP
authors.lastname: Bandopadhyaya
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Deepak Kumar
authors.initials: DK
authors.lastname: Gupta
authors.forename: Arun
authors.initials: A
authors.lastname: Malhotra
authors.forename: Chandrasekhar
authors.initials: C
authors.lastname: Bal
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging; D002648:Child; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005910:Glioma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods* / Q000592:standards; D049268:Positron-Emission Tomography / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D012008:Recurrence; D012015:Reference Standards; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine