AUTHOR=Girard Antoine , Le Reste Pierre-Jean , Metais Alice , Chaboub Nibras , Devillers Anne , Saint-Jalmes Hervé , Jeune Florence Le , Palard-Novello Xavier 

TITLE=Additive Value of Dynamic FDOPA PET/CT for Glioma Grading

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.705996

DOI=10.3389/fmed.2021.705996

ISSN=2296-858X

ABSTRACT=<p><bold>Purpose:</bold> The aim of this study was to assess the value of the FDOPA PET kinetic parameters extracted using full kinetic analysis for tumor grading with neuronavigation-guided biopsies as reference in patients with newly-diagnosed gliomas.</p><p><bold>Methods:</bold> Fourteen patients with untreated gliomas were investigated. Twenty minutes of dynamic positron-emission tomography (PET) imaging and a 20-min static image 10 min after injection were reconstructed from a 40-min list-mode acquisition immediately after FDOPA injection. Tumors volume-of-interest (VOI) were generated based on the MRI-guided brain biopsies. Static parameters (TBRmax and TBRmean) and kinetic parameters [K1 and k2 using full kinetic analysis with the reversible single-tissue compartment model with blood volume parameter and the time-to-peak (TTP)] were extracted. Performances of each parameter for differentiating low-grade gliomas (LGG) from high-grade gliomas (HGG) were evaluated by receiver-operating characteristic analyses (area under the curve; AUC).</p><p><bold>Results:</bold> Thirty-two tumoral VOI were analyzed. K1, k2, and TTP were significantly higher for HGG than for LGG (median K1-value = 0.124 vs. 0.074 ml/ccm/min, <italic>p</italic> = 0.025, median k2-value = 0.093 vs. 0.063 min<sup>−1</sup>, <italic>p</italic> = 0.025, and median TTP-value = 10.0 vs. 15.0 min, <italic>p</italic> = 0.025). No significant difference was observed for the static parameters. The AUC for the kinetic parameters was higher than the AUC for the static parameters (respectively, AUC<sub>K1</sub> = 0.787, AUC<sub>k2</sub> = 0.785, AUC<sub>TTP</sub> = 0.775, AUC<sub>TBRmax</sub> = 0.551, AUC<sub>TBRmean</sub> = 0.575), significantly compared to TBRmax (respectively, <italic>p</italic> = 0.001 for K1, <italic>p</italic> = 0.031 for k2, and <italic>p</italic> = 0.029 for TTP).</p><p><bold>Conclusion:</bold> The present study suggests an additive value of FDOPA PET/CT kinetic parameters for newly-diagnosed gliomas grading.</p>