The mean striatal 18F-DOPA uptake is not a reliable cut-off threshold for biological tumour volume definition of glioma

  • Francesco CiconeEmail author
  • Luciano Carideo
  • Giuseppe Minniti
  • Francesco Scopinaro
Letter to the Editor

Dear Editor,

We were extremely interested in the procedural guidelines for imaging gliomas with amino acid and fluorodeoxyglocose PET, published jointly by the EANM/RANO/EANO and SNMMI in your journal [1]. Imaging with radiolabelled PET probes, particularly amino acids, has become an essential part of primary brain tumour assessment [2], and these joint guidelines represent an important step towards international standardization of the acquisition and interpretation criteria of this technique.

There is, however, one ambiguous point in these guidelines that needs to be addressed. This point regards the quantification of tumour extent with 3,4-dihydroxy-6-[18F]-fluoro-l-phenylalanine (FDOPA). In the paragraph “Cut-off thresholds for definition of biological tumour volume”, a standardized uptake value (SUV) higher than the mean SUV of the striatum is recommended as the cut-off value for definition of tumour volume on FDOPA PET, although it is acknowledged that this cut-off value lacks...


Compliance with ethical standards

Conflicts of interest


Ethical approval

This article does not describe any studies with human participants or animals performed by any of the authors.


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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Nuclear Medicine and Molecular ImagingLausanne University HospitalLausanneSwitzerland
  2. 2.Nuclear Medicine, Sant’Andrea Hospital, Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and PsychologySapienza University of RomeRomeItaly
  3. 3.Radiation Oncology Unit, UPMC Hillman Cancer CenterSan Pietro Hospital FBFRomeItaly
  4. 4.IRCCS NeuromedPozzilliItaly

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