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18F-FDOPA PET and MRI characteristics correlate with degree of malignancy and predict survival in treatment-naïve gliomas: a cross-sectional study

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Abstract

Introduction

To report the potential value of pre-operative 18F-FDOPA PET and anatomic MRI in diagnosis and prognosis of glioma patients.

Methods

Forty-five patients with a pathological diagnosis of glioma with pre-operative 18F-FDOPA PET and anatomic MRI were retrospectively examined. The volume of contrast enhancement and T2 hyperintensity on MRI images along with the ratio of maximum 18F-FDOPA SUV in tumor to normal tissue (T/N SUVmax) were measured and used to predict tumor grade, molecular status, and overall survival (OS).

Results

A significant correlation was observed between WHO grade and: the volume of contrast enhancement (r = 0.67), volume of T2 hyperintensity (r = 0.42), and 18F-FDOPA uptake (r = 0.60) (P < 0.01 for each correlation). The volume of contrast enhancement and 18F-FDOPA T/N SUVmax were significantly higher in glioblastoma (WHO IV) compared with lower grade gliomas (WHO I–III), as well as for high-grade gliomas (WHO III–IV) compared with low-grade gliomas (WHO I–II). Receiver-operator characteristic (ROC) analyses confirmed the volume of contrast enhancement and 18F-FDOPA T/N SUVmax could each differentiate patient groups. No significant differences in 18F-FDOPA uptake were observed by IDH or MGMT status. Multivariable Cox regression suggested age (HR 1.16, P = 0.0001) and continuous measures of 18F-FDOPA PET T/N SUVmax (HR 4.43, P = 0.016) were significant prognostic factors for OS in WHO I–IV gliomas.

Conclusions

Current findings suggest a potential role for the use of pre-operative 18F-FDOPA PET in suspected glioma. Increased 18F-FDOPA uptake may not only predict higher glioma grade, but also worse OS.

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Funding

NIH/NINDS R25 NS065723 Translational Neuroscience Training Grant (Patel); American Medical Association Foundation Seed Research Grant (Patel); American Cancer Society (ACS) Research Scholar Grant (RSG-15-003-01-CCE) (Ellingson); American Brain Tumor Association (ABTA) Research Collaborators Grant (ARC1700002)(Ellingson); National Brain Tumor Society (NBTS) Research Grant (Ellingson, Cloughesy); Art of the Brain (Cloughesy); NIH/NCI UCLA Brain Tumor SPORE (1P50CA211015-01A1) (Ellingson, Lai, Cloughesy, Nghiemphu); NIH/NCI 1R21CA223757-01 (Ellingson).

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Author notes

  1. Chirag B. Patel, Elisa Fazzari and Ararat Chakhoyan have contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Chirag B. Patel, Elisa Fazzari, Huytram Nguyen, Jasmine Manoukian, Nhung Nguyen, Timothy F. Cloughesy, Phioanh L. Nghiemphu & Albert Lai

  2. UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Chirag B. Patel, Elisa Fazzari, Huytram Nguyen, Jasmine Manoukian, Nhung Nguyen, Timothy F. Cloughesy, Phioanh L. Nghiemphu, Albert Lai & Benjamin M. Ellingson

  3. UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Ararat Chakhoyan, Jingwen Yao, Catalina Raymond, Whitney Pope & Benjamin M. Ellingson

  4. Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Ararat Chakhoyan, Jingwen Yao, Catalina Raymond, Whitney Pope & Benjamin M. Ellingson

  5. Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Johannes Czernin

  6. Departments of Radiological Sciences and Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA

    Benjamin M. Ellingson

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  1. Chirag B. Patel
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  2. Elisa Fazzari
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  3. Ararat Chakhoyan
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  4. Jingwen Yao
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  5. Catalina Raymond
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  6. Huytram Nguyen
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  7. Jasmine Manoukian
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  8. Nhung Nguyen
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  9. Whitney Pope
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  10. Timothy F. Cloughesy
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  11. Phioanh L. Nghiemphu
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  12. Johannes Czernin
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  13. Albert Lai
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  14. Benjamin M. Ellingson
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Corresponding author

Correspondence to Benjamin M. Ellingson.

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Patel, C.B., Fazzari, E., Chakhoyan, A. et al. 18F-FDOPA PET and MRI characteristics correlate with degree of malignancy and predict survival in treatment-naïve gliomas: a cross-sectional study. J Neurooncol 139, 399–409 (2018). https://doi.org/10.1007/s11060-018-2877-6

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  • DOI: https://doi.org/10.1007/s11060-018-2877-6

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