Comparative study of ¹⁸ F-DOPA, ¹³ N-Ammonia and F18-FDG PET/CT in primary brain tumors

Abstract

Aim:To determine the diagnostic reliability of 18F-FDOPA, 13N-Ammonia and F18-FDG PET/CT in primary brain tumors. We evaluated the amino acid and glucose metabolism of brain tumors by using PET with 18F-FDOPA, 13N-Ammonia and F18-FDG PET/CT.Materials and Methods:Nine patients undergoing evaluation for brain tumors were studied. Tracer uptake was quantified by the use of standardized uptake values and the ratio of tumor uptake to normal identical area of contra lateral hemisphere (T/N). In addition, PET uptake with 18F-FDOPA was quantified by use of ratio of tumor uptake to striatum uptake (T/S). The results were correlated with the patient's clinical profile.Results:Both high-grade and low-grade tumors were well visualized with 18F-FDOPA. The sensitivity for identifying tumors was substantially higher with 18F-FDOPA PET than with F18-FDG and 13N-Ammonia PET as determined by simple visual inspection. The sensitivity for identifying recurrence in low grade gliomas is higher with 13N-Ammonia than with F18-FDG.Conclusion:18F-FDOPA PET is more reliable than F18-FDG and 13N-Ammonia PET for evaluating brain tumors.

Usefulness of 18F-FDOPA PET for the management of primary brain tumors: a systematic review of the literature

“…Other amino-acid radiotracers labeled with fluor 18 have been synthetized, such as [18F]-fluoroethyl-tyrosine ( 18 F-FET) and [18F]-L-dihydroxyphenylalanine ( 18 F-FDOPA), which are easier to use in clinical routine because of their longer half-life (110 min). Studies have shown that 18 F-FDOPA PET/CT is more accurate than 18 F-FDG PET/CT and is more sensitive in detecting primary or recurrent gliomas [9][10][11]. Several studies have shown that these different amino-acid radiotracers ( 18 F-FET, 11 C-MET and 18 F-FDOPA) performed equally well in the visual assessment of primary brain tumors [12][13][14].…”

Increasing feasibility and utility of 18 F-FDOPA PET for the management of glioma

“…As with their findings for primary gliomas, Chen et al [53] and Tripathi et al [54] demonstrated that 18 F-FDOPA also outperforms 18 F-FDG in the detection of recurrence. In similar studies, Jacob et al [57] and Jora et al [56] showed that the performance of 18 F-FDOPA was superior compared to that of 13…”

“…Jora et al [56] and Jacob et al [57] both performed comparative investigations into the uptake of 18 F-FDOPA, 13 N-Ammonia, 18 F-FDG and MRI in low and high-grade primary and recurrent gliomas. Both studies reported that 18 F-FDOPA was significantly more reliable in the detection of primary gliomas than 13 N-Ammonia or 18 F-FDG.…”

Evaluation of Technetium-99m glucoheptonate single photon emission computed tomography for brain tumor grading

“…showed the F-18 FDOPA PET-CT was more reliable than F-18 FDG PET-CT or N-13 ammonia PET-CT in evaluating brain tumors, thereby putting Tc-99m GHA in the same league of radiotracers even though it is more economical and widely available than the other PET radiotracers. [ 39 ]…”