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

Abstract

Contrast-enhanced magnetic resonance imaging is currently the standard of care in the management of primary brain tumors, although certain limitations remain. Metabolic imaging has proven useful for an increasing number of indications in oncology over the past few years, most particularly 18F-FDG PET/CT. In neuro-oncology, 18F-FDG was insufficient to clearly evaluate brain tumors. Amino-acid radiotracers such as 18F-FDOPA were then evaluated in the management of brain diseases, notably tumoral diseases. Even though European guidelines on the use of amino-acid PET in gliomas have been published, it is crucial that future studies standardize acquisition and interpretation parameters. The aim of this article was to systematically review the potential effect of this metabolic imaging technique in numerous steps of the disease: primary and recurrence diagnosis, grading, local and systemic treatment assessment, and prognosis. A total of 41 articles were included and analyzed in this review. It appears that 18F-FDOPA PET holds promise as an effective additional tool in the management of gliomas. More consistent prospective studies are still needed.

Additional Value of 18F-FDOPA Amino Acid Analog Radiotracer to Irradiation Planning Process of Patients With Glioblastoma Multiforme

“…In the modern radiotherapy of brain malignancies, the irradiated treatment volumes are based on conventional computed tomography (CT) and magnetic resonance (MR) information. For the macroscopic target volume (gross tumor volume GTV) definition pre- and postoperative gadolinium enhanced T1; and T2-weighted MR images are used, the resection cavity must be considered also if present ( 2 , 3 ).…”

“…3,4-dihydroxy-6-(18F) fluoro- l -phenylalanine (18F-FDOPA) is one of the most studied amino acid analog radiotracers to describe central nervous system malignancies. As mentioned, radiotracer increased amino acid transport of the tumor cells are responsible for the elevated accumulation at the malignant tissue ( 3 , 14 – 18 ).…”

“…Results: Average (range) GTV, BTV1.7, and BTV2.0 were 46.58 (6-182.5), 68.68 (9.6-204.1), 42.89 (3.8-147.6) cm 3 , respectively. HD95% from GTV were 15.5 mm (7.9-30.7 mm) and 10.5 mm (4.3-21.4 mm) for BTV1.7 and BTV2.0, respectively.…”

“…The MRI T1CE GTV; BTV 1.7 and BTV 2.0 and the relation between measured volume (overlap/difference) values are shown in cm3 .…”

The chemical tool-kit for molecular imaging with radionuclides in the age of targeted and immune therapy

“…In addition, its covalent bond with carbon generally has high in vivo kinetic stability. These chemical features, alongside its growing availability, make 18 F an important and attractive radiolabel for an enormous range of potential small molecular radiopharmaceuticals, such as FLT ([ 18 F]-3′-fluoro-3′deoxythymidine, a nucleoside analogue and cell proliferation marker) [21]; F-DOPA ([ 18 F]dihydroxyphenylalanine, a dopamine precursor analogue used in neuroendocrine and brain tumours) [22]; F-MISO ([ 18 F]fluoromisonidazole, a nitroimidazole hypoxia imaging agent) and related nitroimidazole derivatives [23]; [ 18 F]DCFPyL (a prostate-specific membrane antigen (PSMA) ligand used for prostate cancer imaging) and other 18 F-labelled PSMA ligands [24]; [ 18 F]fluoroethylcholine [25] and related tracers for prostate and other tumours; and amino acid analogues such as FET ([ 18 F]fluoroethyltyrosine), [26] FSPG (3-[ 18 F]fluoropropyl)-L-glutamic acid (glutamate analogue taken up by cells through the system x C− transporter) [27] and [ 18 F]fluciclovine [28]; to name but a few (Fig. 4).…”