title: Comparative diagnostic accuracy of contrast-enhanced MRI and (18)F-FDOPA PET-CT in recurrent glioma.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of contrast enhanced magnetic resonance imaging (Ce-MRI) and (18)F-fluorodopa ((18)F-FDOPA) positron emission tomography (PET)-computed tomography (CT) for detecting recurrent glioma.
  
  
  METHODS
  In this prospective study, 35 patients (age, 36.62 ± 0.86 years; 80 % male) with histopathologically proven glioma with clinical suspicion of recurrence were evaluated using Ce-MRI and (18)F-FDOPA PET-CT. (18)F-FDOPA PET-CT images were evaluated qualitatively and semi-quantitatively. Combination of clinical follow-up (minimum 1 year), repeat imaging and/or biopsy (when available) was taken as the reference standard.
  
  
  RESULTS
  Based on the reference standard, 26 patients were positive and nine were negative for recurrence. The sensitivity, specificity and accuracy of Ce-MRI were 92.3 %, 44.4 % and 80 % respectively, whereas those of (18)F-FDOPA PET-CT were 100 %, 88.89 % and 97.1 % respectively. Results of Ce-MRI and (18)F-FDOPA PET-CT were concordant in 74.3 % (29/35) and discordant in 17.1 % of patients (6/35). On McNemar analysis the difference was not statistically significant overall (P = 0.687), for high-grade tumour (P = 0.5) or low-grade tumours (P = 1.0). However, (18)F-FDOPA PET-CT was more specific than Ce-MRI overall (P = 0.0002), for high-grade tumour (P = 0.006) and low-grade tumours (P = 0.004).
  
  
  CONCLUSIONS
  F-FDOPA PET-CT shows a high but comparable diagnostic accuracy to Ce-MRI for the detection of recurrent glioma. However, it is more specific than Ce-MRI.
  
  
  CONCLUSIONS
  • Recurrent glioma in the postoperative site remains a diagnostic dilemma. • (18) F-FDOPA PET-CT shows high diagnostic accuracy for detecting recurrent glioma. • Diagnostic accuracies for (18) F-FDOPA PET-CT and contrast enhanced MRI are comparable. • However, (18) F-FDOPA PET-CT is more specific than Ce-MRI for recurrent glioma.
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: Ajit
authors.initials: A
authors.lastname: Goenka
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: D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D003287:Contrast Media / Q000737:chemistry; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012008:Recurrence; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine