Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-08-2016 | Original Article

Ability of ¹⁸F-DOPA PET/CT and fused ¹⁸F-DOPA PET/MRI to assess striatal involvement in paediatric glioma

Authors: Giovanni Morana, Matteo Puntoni, Maria Luisa Garrè, Michela Massollo, Egesta Lopci, Merhdad Naseri, Mariasavina Severino, Domenico Tortora, Andrea Rossi, Arnoldo Piccardo

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2016

Abstract

Purpose

To assess the diagnostic performance of ¹⁸F-DOPA PET/CT and fused ¹⁸F-DOPA PET/MRI in detecting striatal involvement in children with gliomas.

Methods

This retrospective study included 28 paediatric patients referred to our institution for the presence of primary, residual or recurrent glioma (12 boys, 16 girls; mean age 10.7 years) and investigated with ¹⁸F-DOPA PET/CT and brain MRI. Fused ¹⁸F-DOPA PET/MR images were obtained and compared with PET/CT and MRI images. Accuracy, sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) for striatal involvement were calculated for each diagnostic tool. Univariate and multivariate logistic analyses were applied to evaluate the associations between ¹⁸F-DOPA PET/CT and fused ¹⁸F-DOPA PET/MRI diagnostic results and tumour uptake outside the striatum, grade, dimension and site of striatal involvement (ventral and/or dorsal).

Results

Accuracy, sensitivity, specificity, PPV, and NPV were 100 % for MRI, 93 %, 89 %, 100 %, 100 % and 82 % for ¹⁸F-DOPA PET/MRI, and 75 %, 74 %, 78 %, 88 % and 58 % for ¹⁸F-DOPA PET/CT, respectively. ¹⁸F-DOPA PET/MRI showed a trend towards higher accuracy compared with ¹⁸F-DOPA PET/CT (p = 0.06). MRI showed significantly higher accuracy compared with ¹⁸F-DOPA PET/CT (p = 0.01), but there was no significant difference between MRI and ¹⁸F-DOPA PET/MRI. Both univariate and multivariate logistic analyses showed a significant association (OR 8.0 and 7.7, respectively) between the tumour-to-normal striatal uptake (T/S) ratio and the diagnostic ability of ¹⁸F-DOPA PET/CT (p = 0.03). A strong significant association was also found between involvement of the dorsal striatum and the ¹⁸F-DOPA PET/CT results (p = 0.001), with a perfect prediction of involvement of the dorsal striatum by ¹⁸F-DOPA PET/MRI.

Conclusion

Physiological striatal ¹⁸F-DOPA uptake does not appear to be a main limitation in the evaluation of basal ganglia involvement.¹⁸F-DOPA PET/CT correctly detected involvement of the dorsal striatum in lesions with a T/S ratio >1, but appeared to be less suitable for evaluation of the ventral striatum. The use of fused ¹⁸F-DOPA PET/MRI further improves the accuracy and is essential for evaluation of the ventral striatum.

Kaplan AM, Bandy DJ, Manwaring KH, Chen K, Lawson MA, Moss SD, et al. Functional brain mapping using positron emission tomography scanning in preoperative neurosurgical planning for pediatric brain tumors. J Neurosurg. 1999;91:797–803.CrossRefPubMed

Pirotte B, Goldman S, Salzberg S, Wikler D, David P, Vandesteene A, et al. Combined positron emission tomography and magnetic resonance imaging for the planning of stereotactic brain biopsies in children: experience in 9 cases. Pediatr Neurosurg. 2003;38:146–55.CrossRefPubMed

Morana G, Piccardo A, Milanaccio C, Puntoni M, Nozza P, Cama A, et al. Value of 18F-3,4-dihydroxyphenylalanine PET/MR image fusion in pediatric supratentorial infiltrative astrocytomas: a prospective pilot study. J Nucl Med. 2014;55:718–23.CrossRefPubMed

Morana G, Piccardo A, Garrè ML, Nozza P, Consales A, Rossi A. Multimodal magnetic resonance imaging and 18F-L-dihydroxyphenylalanine positron emission tomography in early characterization of pseudoresponse and nonenhancing tumor progression in a pediatric patient with malignant transformation of ganglioglioma treated with bevacizumab. J Clin Oncol. 2013;31:e1–5.CrossRefPubMed

Piccardo A, Lopci E, Conte M, Garaventa A, Foppiani L, Altrinetti V, et al. Comparison of 18F-DOPA PET/CT and 123IMIBG scintigraphy in stage 3 and 4 neuroblastoma: a pilot study. Eur J Nucl Med Mol Imaging. 2012;39:57–71.CrossRefPubMed

Piccardo A, Puntoni M, Lopci E, Conte M, Foppiani L, Sorrentino S, et al. Prognostic value of 18F-DOPA PET/CT at the time of recurrence in patients affected by neuroblastoma. Eur J Nucl Med Mol Imaging. 2014;41:1046–56.CrossRefPubMed

Piccardo A, Morana G, Massollo M, Pescetto M, Conte M, Garaventa A. Brain metastasis from neuroblastoma depicted by 18F-DOPA PET/CT. Nucl Med Mol Imaging. 2015;49:241–2. doi:10.1007/s13139-015-0322-8.CrossRefPubMed

Ribeiro MJ, De Lonlay P, Delzescaux T, Boddaert N, Jaubert F, Bourgeois S, et al. Characterization of hyperinsulinism in infancy assessed with PET and 18F-fluoro-L-DOPA. J Nucl Med. 2005;46:560–6.PubMed

Morana G, Piccardo A, Puntoni M, Nozza P, Cama A, Raso A, et al. Diagnostic and prognostic value of 18F-DOPA PET and 1H-MR spectroscopy in pediatric supratentorial infiltrative gliomas: a comparative study. Neuro Oncol. 2015;17:1637–47.CrossRefPubMed

10.

Misch M, Guggemos A, Driever PH, Koch A, Grosse F, Steffen IG, et al. (18)F-FET-PET guided surgical biopsy and resection in children and adolescence with brain tumors. Childs Nerv Syst. 2015;31:261–7.CrossRefPubMed

11.

Dunkl V, Cleff C, Stoffels G, Judov N, Sarikaya-Seiwert S, Law I, et al. The usefulness of dynamic O-(2-18F-fluoroethyl)-L-tyrosine PET in the clinical evaluation of brain tumors in children and adolescents. J Nucl Med. 2015;56:88–92.CrossRefPubMed

12.

Fraioli F, Shankar A, Hargrave D, Hyare H, Gaze MN, Groves AM, et al. 18F-fluoroethylcholine (18F-Cho) PET/MRI functional parameters in pediatric astrocytic brain tumors. Clin Nucl Med. 2015;40:e40–5.CrossRefPubMed

13.

Porter JN, Roy AK, Benson B, Carlisi C, Collins PF, Leibenluft E, et al. Age-related changes in the intrinsic functional connectivity of the human ventral vs. dorsal striatum from childhood to middle age. Dev Cogn Neurosci. 2015;11:83–95.CrossRefPubMed

14.

Galldiks N, Langen KJ, Pope WB. From the clinician’s point of view – What is the status quo of positron emission tomography in patients with brain tumors? Neuro Oncol. 2015;17:1434–44.CrossRefPubMed

15.

Lapa C, Linsenmann T, Monoranu CM, Samnick S, Buck AK, Bluemel C, et al. Comparison of the amino acid tracers 18F-FET and 18F-DOPA in high-grade glioma patients. J Nucl Med. 2014;55:1611–6.CrossRefPubMed

16.

Kratochwil C, Combs SE, Leotta K, Afshar-Oromieh A, Rieken S, Debus J, et al. Intra-individual comparison of 18F-FET and 18F-DOPA in PET imaging of recurrent brain tumors. Neuro Oncol. 2014;16:434–40.CrossRefPubMed

17.

Morana G, Piccardo A, Garrè ML, Nobili F, Rossi A. Late persistent increased putaminal 18F-DOPA uptake following ipsilateral frontal resection: evidence for corticostriatal synaptic plasticity? Clin Nucl Med. 2015;40:e451–2.CrossRefPubMed

Title: Ability of 18F-DOPA PET/CT and fused 18F-DOPA PET/MRI to assess striatal involvement in paediatric glioma
Authors: Giovanni Morana
Matteo Puntoni
Maria Luisa Garrè
Michela Massollo
Egesta Lopci
Merhdad Naseri
Mariasavina Severino
Domenico Tortora
Andrea Rossi
Arnoldo Piccardo
Publication date: 01-08-2016
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-016-3333-5

At a glance: The STEP trials

Springer Medicine

Ability of ¹⁸F-DOPA PET/CT and fused ¹⁸F-DOPA PET/MRI to assess striatal involvement in paediatric glioma

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 9/2016

Erratum to: Dual-phase amyloid PET: hitting two birds with one stone

William T. O’Brien Sr. (Ed.), Top 3 Differentials in Neuroradiology: A Case Review. Thieme Medical Publishers, Inc., 2015. ISBN 978-1- 60406-723-1

Early [18F]florbetaben and [11C]PiB PET images are a surrogate biomarker of neuronal injury in Alzheimer’s disease

FDG-PET/ceCT is useful to predict recurrence of Pseudomyxoma peritonei

The EANM practice guidelines for bone scintigraphy

In vivo PET imaging of the neuroinflammatory response in rat spinal cord injury using the TSPO tracer [18F]GE-180 and effect of docosahexaenoic acid