Maximum Uptake And Hypermetabolic Volume Of F-18-Fdopa Pet Estimate Molecular Status And Overall Survival In Low-Grade Gliomas A Pet And Mri Study

PurposeWe evaluated F-18-FDOPA PET and MRI characteristics in association with the molecular status and overall survival (OS) in a large number of low-grade gliomas (LGGs). MethodsEighty-six patients who underwent F-18-FDOPA PET and MRI and were diagnosed with new or recurrent LGGs were retrospectively evaluated with respect to their isocitrate dehydrogenase (IDH) and 1p19q status (10 IDH wild type, 57 mutant, 19 unknown; 1p19q status in IDH mutant: 20 noncodeleted, 37 codeleted). After segmentation of the hyperintense area on fluid-attenuated inversion recovery image (FLAIR(ROI)), the following were calculated: normalized SUVmax (nSUVmax) of F-18-FDOPA relative to the striatum, F-18-FDOPA hypermetabolic volume (tumor-to-striatum ratios >1), FLAIR(ROI) volume, relative cerebral blood volume, and apparent diffusion coefficient within FLAIR(ROI). Receiver operating characteristic curve and Cox regression analyses were performed. ResultsPET and MRI metrics combined with age predicted the IDH mutation and 1p19q codeletion statuses with sensitivities of 73% and 76% and specificities of 100% and 94%, respectively. Significant correlations were found between OS and the IDH mutation status (hazard ratio [HR] = 4.939), nSUVmax (HR = 2.827), F-18-FDOPA hypermetabolic volume (HR = 1.048), and FLAIR(ROI) volume (HR = 1.006). The nSUVmax (HR = 151.6) for newly diagnosed LGGs and the F-18-FDOPA hypermetabolic volume (HR = 1.038) for recurrent LGGs demonstrated significant association with OS. ConclusionsCombining F-18-FDOPA PET and MRI with age proved useful for predicting the molecular status in patients with LGGs, whereas the nSUVmax and F-18-FDOPA hypermetabolic volume may be useful for prognostication.