title: IDH mutation is paradoxically associated with higher18F-FDOPA PET uptake in diffuse grade II and grade III gliomas.
abstract: OBJECTIVE
  The World Health Organization Classification of Tumors of the Central Nervous System has recently been updated by the integration of diagnostic and prognostic molecular parameters, giving pivotal attention to IDH mutation as a favourable factor. Amino acid PET is increasingly used in the management of gliomas, but its prognostic value is a matter of debate. The aim of this study was to assess the relationship between IDH mutation and18F-FDOPA uptake on PET in newly diagnosed gliomas.
  
  
  METHODS
  A total of 43 patients, presenting with diffuse astrocytic and oligodendroglial grade II and III gliomas, reclassified according to the 2016 WHO classification of tumours of the CNS, were retrospectively included. They had all undergone18F-FDOPA PET at an initial stage before surgery and histological diagnosis.18F-FDOPA uptake values were compared between patients with and without IDH mutation in terms of maximum standardized uptake value (SUVmax) ratios between tumour and normal contralateral brain (T/N), and between tumour and striatum (T/S).
  
  
  RESULTS
  Patients with IDH mutation showed higher18F-FDOPA T/N SUVmax ratios (1.6 vs. 1.2) and T/S SUVmax ratios (0.9 vs. 0.6) than patients without IDH mutation (p < 0.05).
  
  
  CONCLUSIONS
  This study showed paradoxically higher18F-FDOPA uptake in diffuse grade II and III gliomas with IDH mutation. Despite evident interest in the management of gliomas, and especially in relation to posttherapy evaluation, our findings raise the question of the prognostic value of18F-FDOPA uptake on PET uptake in this group of patients. This may be related to differences in amino acid integration, metabolism, or cell differentiation.
authors.affiliation: Department of Nuclear Medicine, APHM, La Timone Hospital, Marseille, France.|Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy, Lorraine University, Nancy, France.|IADI, INSERM, UMR 947, Lorraine University, Nancy, France.
authors.forename: A
authors.initials: A
authors.lastname: Verger
authors.affiliation: Department of Neurosurgery, Centre Hospitalier Privé Clairval, Marseille, France.|INSERM, UMR 911, Aix-Marseille University, Marseille, France.
authors.forename: Ph
authors.initials: P
authors.lastname: Metellus
authors.affiliation: Department of Nuclear Medicine, APHM, La Timone Hospital, Marseille, France.
authors.forename: Q
authors.initials: Q
authors.lastname: Sala
authors.affiliation: INSERM, UMR 911, Aix-Marseille University, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Colin
authors.affiliation: Department of Neurosurgery, Centre Hospitalier Privé Clairval, Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Bialecki
authors.affiliation: Department of Nuclear Medicine, APHM, La Timone Hospital, Marseille, France.|CERIMED, Aix-Marseille University , Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Taieb
authors.affiliation: INSERM, UMR 911, Aix-Marseille University, Marseille, France.|Department of Neuro-Oncology, APHM, La Timone Hospital, Marseille, France.
authors.forename: O
authors.initials: O
authors.lastname: Chinot
authors.affiliation: INSERM, UMR 911, Aix-Marseille University, Marseille, France.|Department of Anatomopathology, APHM, La Timone Hospital, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Figarella-Branger
authors.affiliation: Department of Nuclear Medicine, APHM, La Timone Hospital, Marseille, France. eric.guedj@ap-hm.fr.|CERIMED, Aix-Marseille University , Marseille, France. eric.guedj@ap-hm.fr.|Institut de Neurosciences de la Timone, CNRS, UMR 7289, Aix-Marseille University, Marseille, France. eric.guedj@ap-hm.fr.|Service Central de Biophysique et Médecine Nucléaire, Hôpital de la Timone, 264 rue Saint Pierre, 13005, Marseille, France. eric.guedj@ap-hm.fr.
authors.forename: E
authors.identifier: http://orcid.org/0000-0003-1912-6132
authors.initials: E
authors.lastname: Guedj
mesh_terms: D000328:Adult; D001692:Biological Transport; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives* / Q000378:metabolism; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000235:genetics / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D060787:Neoplasm Grading; D049268:Positron-Emission Tomography; D012189:Retrospective Studies
chemical_list: C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine; D007521:Isocitrate Dehydrogenase
keywords: 18F-FDOPA PET; Gliomas; IDH mutation; Prognosis