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Neuro Oncol. 2014 Apr;16(4):603-9. doi: 10.1093/neuonc/not166. Epub 2013 Dec 4.

Comparison of visual and semiquantitative analysis of 18F-FDOPA-PET/CT for recurrence detection in glioblastoma patients.

Author information

1
Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles,California (K.H., J.C., K.P., M.R.B., M.E.P., W.C.); Department of Neurology, David Geffen School of Medicine at University of California Los Angeles,Los Angeles,California (T.C., A.L.); Department of Nuclear Medicine, Universitätsklinikum Würzburg, Würzburg, Germany (K.H., A.K.B.).

Abstract

BACKGROUND:

Amino acid transport imaging with 18F-FDOPA PET is increasingly used for detection of glioblastoma recurrence. However, a standardized image interpretation for 18F-FDOPA brain PET studies has not yet been established. This study compares visual and semiquantitative analysis parameters for detection of tumor recurrence and correlates them with progression-free survival (PFS).

METHODS:

One-hundred ten patients (72 male:38 female) with suspected tumor recurrence who underwent 18F-FDOPA PET imaging were studied. PET scans were analyzed visually (5-point scale) and semiquantitatively (lesion-to-striatum- and lesion- to-normal-brain-tissue ratios using both SUV(mean) and SUV(max)). Accuracies for recurrence detection were calculated using histopathology and clinical follow-up for validation. Receiving operator characteristic and Kaplan-Meier survival analysis were performed to derive imaging-based prediction of PFS and overall survival (OS).

RESULTS:

Accuracies for detection of glioblastoma recurrence were similar for visual (82%) and semiquantitative (range, 77%-82%) analysis. Both visual and semiquantitative indices were significant predictors of PFS, with mean lesion-to normal brain tissue ratios providing the best discriminator (mean survival, 39.4 vs 9.3 months; P < .001). None of the investigated parameters was predictive for OS.

CONCLUSIONS:

Both visual and semiquantitative indices detected glioblastoma recurrence with high accuracy and were predictive for PFS. Lesion-to-normal-tissue ratios were the best discriminators of PFS; however, none of the investigated parameters predicted OS. These retrospectively established analysis parameters need to be confirmed prospectively.

KEYWORDS:

18F-FDOPA; glioblastoma; recurrence detection

PMID:
24305722
PMCID:
PMC3956344
DOI:
10.1093/neuonc/not166
[Indexed for MEDLINE]
Free PMC Article

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