Dynamic ¹⁸F-FDOPA-PET/MRI for the preoperative evaluation of gliomas: correlation with stereotactic histopathology.

Content Provider	Europe PMC
Author	Ponisio, Maria R McConathy, Jonathan E Dahiya, Sonika M Miller-Thomas, Michelle M Rich, Keith M Salter, Amber Wang, Qing LaMontagne, Pamela J Guzmán Pérez-Carrillo, Gloria J Benzinger, Tammie L S
Copyright Year	2020
Abstract	Abstract Background MRI alone has limited accuracy for delineating tumor margins and poorly predicts the aggressiveness of gliomas, especially when tumors do not enhance. This study evaluated simultaneous 3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine (FDOPA)-PET/MRI to define tumor volumes compared to MRI alone more accurately, assessed its role in patient management, and correlated PET findings with histopathology. Methods Ten patients with known or suspected gliomas underwent standard of care surgical resection and/or stereotactic biopsy. FDOPA-PET/MRI was performed prior to surgery, allowing for precise co-registration of PET, MR, and biopsies. The biopsy sites were modeled as 5-mm spheres, and the local FDOPA uptake at each site was determined. Correlations were performed between measures of tumor histopathology, and static and dynamic PET values: standardized uptake values (SUVs), tumor to brain ratios, metabolic tumor volumes, and tracer kinetics at volumes of interest (VOIs) and biopsy sites. Results Tumor FDOPA-PET uptake was visualized in 8 patients. In 2 patients, tracer uptake was similar to normal brain reference with no histological findings of malignancy. Eight biopsy sites confirmed for glioma had FDOPA uptake without T1 contrast enhancement. The PET parameters were highly correlated only with the cell proliferation marker, Ki-67 (SUVmax: r = 0.985, P = .002). In this study, no statistically significant difference between high-grade and low-grade tumors was demonstrated. The dynamic PET analysis of VOIs and biopsy sites showed decreasing time-activity curves patterns. FDOPA-PET imaging directly influenced patient management. Conclusions Simultaneous FDOPA-PET/MRI allowed for more accurate visualization and delineation of gliomas, enabling more appropriate patient management and simplified validation of PET findings with histopathology.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7716181&blobtype=pdf
Page Count	12
ISSN	20542577
Volume Number	7
DOI	10.1093/nop/npaa044
PubMed Central reference number	PMC7716181
Issue Number	6
PubMed reference number	33312679
Journal	Neuro-Oncology Practice [Neurooncol Pract]
e-ISSN	20542585
Language	English
Publisher	Oxford University Press
Publisher Date	2020-08-07
Publisher Place	US
Access Restriction	Open
Rights License	This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Subject Keyword	adult gliomas dynamic FDOPA-PET glioma delineation PET/MRI stereotactic biopsy
Content Type	Text
Resource Type	Article
Subject	Neurology Medicine Oncology