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=Volume 8 - 2021

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=Purpose: 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. 
Methods: Fourteen patients with untreated gliomas were investigated. Twenty minutes of dynamic PET imaging and a 20-min static image 10 minutes 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). 
Results: 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, p=0.025, median k2 value=0.093 vs 0.063 min− 1, p=0.025, and median TTP value=10.0 vs 15.0 min, p=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 AUCK1=0.787, AUCk2=0.785, AUCTTP=0.775, AUCTBRmax=0.551, AUCTBRmean=0.575), significantly compared to TBRmax (respectively p=0.001 for K1, p=0.031 for k2 and p=0.029 for TTP).
Conclusion: The present study suggests an additive value of FDOPA PET/CT kinetic parameters for newly-diagnosed gliomas grading.