title: Can (18)F-FDOPA PET/CT predict survival in patients with suspected recurrent glioma? A prospective study.
abstract: Purpose of the present study was to evaluate the role of (18)F-FDOPA PET/CT for predicting survival in patients with suspected recurrent glioma.
  
  
  METHODS
  A total of 33 previously treated, histopathologically proven glioma patients with clinical and contrast enhanced MRI findings suspicious for recurrence were enrolled in this prospective study. All patients underwent (18)F-FDOPA PET/CT. Ratios of tumor uptake to normal tissue uptake were generated by dividing the tumor SUVmax with SUVmax of the contralateral normal brain tissue (T/N), normal striatum (T/S), normal white matter (T/W) and normal cerebellum (T/C). Patients were followed up clinically and by repeated imaging. Data was censored, if the patient died of disease or at the end of the study. Survival analysis was performed for the distributions of each variable and by multivariate analysis.
  
  
  RESULTS
  (18)F-FDOPA PET/CT was positive for recurrence in 25 patients and negative in 8. Death occurred in nineteen patients. Median follow up period was 20.2 months. Median survival in this study was 39.2 months. In univariate analysis significant association of survival was noted with results of (18)F-FDOPA PET/CT (P=0.007) and (18)F-FDOPA PET/CT quantitative parameters namely SUVmax (P=0.001), T/S (P=0.005), T/W (P=0.0004), T/N (P=0.001) and T/C (P=0.003) were found to be significant. On multivariate analysis, only MRI size of the recurrent tumor (P=0.002) and T/N ratio of (18)F-FDOPA PET/CT (P=0.005) were found to be independent predictors of survival.
  
  
  CONCLUSIONS
  T/N ratio on (18)F-FDOPA PET/CT is an independent predictor of survival in patients with suspected recurrent glioma, along with size of recurrent tumor on MRI.
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India. Electronic address: drsellam84@yahoo.co.in.
authors.forename: Sellam
authors.initials: S
authors.lastname: Karunanithi
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Punit
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Deepak Kumar
authors.initials: DK
authors.lastname: Gupta
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bangkim Chandra
authors.initials: BC
authors.lastname: Khangembam
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sanjana
authors.initials: S
authors.lastname: Ballal
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India. Electronic address: csbal@hotmail.com.
authors.forename: Chandrasekhar
authors.initials: C
authors.lastname: Bal
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis / Q000401:mortality*; D002648:Child; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D005910:Glioma / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000706:statistics & numerical data; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine
keywords: (18)F-FDOPA PET/CT; Glioma; MRI; Recurrence; Survival