title: Correlation of SUV-Derived Indices With Tumoral Aggressiveness of Gliomas in Static 18F-FDOPA PET: Use in Clinical Practice.
abstract: OBJECTIVE
  Glioma grading is necessary for prognostic evaluation and optimal treatment decisions. The aims of this study were to establish whether a correlation between F-FDOPA uptake with tumor grade was observed and to determine which of the SUV-derived indices was the best correlated.
  
  
  METHODS
  Thirty-one patients were retrospectively included (mean [SD] age, 36.8 [12.1] years) including 21 proven low-grade tumors due to histology, imaging, and clinical follow-up and 10 histologically proven high-grade tumors. Static PET acquisitions were postreconstructed between the 10th and 30th minute after injection of F-FDOPA. Regions of interest of 20 mm were applied to tumors, and isocontoured volumes were defined at levels of 50% and 80% of the peak intensity voxel. Background was quantified with 30-mm-diameter regions of interest on contralateral striatum and centrum semioval. Tumoral uptake was evaluated with the following SUV-derived indices: SUVmax, SUVmean, SUVmax, and SUVmean of isocontoured volume, tumor/striatum ratio (T/S), and tumor/normal brain ratio (T/N).
  
  
  RESULTS
  All the SUV-derived indices tested were significantly correlated with tumor grade, considering low-grade and high-grade groups (P < 0.05), except for the SUVmean 50%. The 2 best-correlated indices were SUVmean T/N and SUVmean T/S, with correlation coefficients of 0.561 and 0.522, respectively. Receiver operating characteristic analysis defined optimal thresholds of 1.33 and 1 for sensitivity and specificity of 71% and 100% and 67% and 100%, respectively.
  
  
  CONCLUSIONS
  F-FDOPA PET SUV-derived indices are routinely available information that enables accurate discrimination of low-grade and high-grade gliomas. The best-correlated indices were SUVmean T/N and SUVmean T/S with thresholds of 1.33 and 1.
authors.affiliation: From the Departments of *Nuclear Medicine, †Neuro-oncology, and ‡Anatomopathology, CHU Nancy, Nancy; and §Department of Neuro-oncology, CHU Nancy, Poitiers, France.
authors.forename: Lucile
authors.initials: L
authors.lastname: Janvier
authors.forename: Pierre
authors.initials: P
authors.lastname: Olivier
authors.forename: Marie
authors.initials: M
authors.lastname: Blonski
authors.forename: Olivier
authors.initials: O
authors.lastname: Morel
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Vignaud
authors.forename: Gilles
authors.initials: G
authors.lastname: Karcher
authors.forename: Luc
authors.initials: L
authors.lastname: Taillandier
authors.forename: Antoine
authors.initials: A
authors.lastname: Verger
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine