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

Abstract

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.

Pseudoprogression, radionecrosis, inflammation or true tumor progression? challenges associated with glioblastoma response assessment in an evolving therapeutic landscape

“…A recent systematic review finds amino acid tracers (MET, FET, and FDOPA) to have higher diagnostic accuracy than conventional and advanced MRI in the differentiation of glioma recurrence from treatment-induced changes, and superior to MRI in the assessment of treatment response [48]. For instance, 18 F-FET has been shown to have greater than 90% sensitivity and specificity in the diagnosis of pseudoprogression [49]; and 18 F-FDOPA has been shown to have a nearly 90% sensitivity and 72% specificity for the diagnosis of glioblastoma recurrence [50]. Similar to amino acid PET, SPECT imaging using a variety of radiolabeled 201 Tl, 99m Tc, or 123 I compounds has shown promise [51][52][53].…”

PET for Therapy Response Assessment in Glioblastoma

“…Furthermore, amino acid PET was assumed to be superior to both 18 F-FCho PET and 18 F-FDG PET for diagnostic accuracy in distinguishing glioma recurrence from RN (6,49,50,83). Using 18 F-FDOPA PET, a sensitivity and specificity of more than 80% to distinguish recurrent GB or recurrent brain metastasis and radiation-related effects was shown (25,84). However, the lack of physiological 18 F-FET uptake in the basal ganglia when compared with 18 F-FDOPA PET makes 18 F-FET the most promising amino acid tracer for PET imaging in brain tumor patients (31).…”

Letter to the Editor: “The role of imaging in the management of progressive glioblastoma. A systematic review and evidence-based clinical practice guideline” [J Neurooncol 2014; 118:435–460]

“…Using FDOPA PET, a recent study including 110 patients reported an accuracy of 82% to detect recurrent glioblastoma and FDOPA uptake was a significant predictor of progressionfree survival [13]. Excellent results with FDOPA PET were also reported regarding the monitoring of antiangiogenic treatement [14] and for the differentiation of recurrent brain metastases from radiation-induced changes [15].…”