IDH mutation is paradoxically associated with higher 18F-FDOPA PET uptake in diffuse grade II and grade III gliomas

  • A. Verger
  • Ph. Metellus
  • Q. Sala
  • C. Colin
  • E. Bialecki
  • D. Taieb
  • O. Chinot
  • D. Figarella-Branger
  • E. Guedj
Original Article

Abstract

Purpose

The World Health Organization Classification of Tumors of the Central Nervous System has recently been updated by the integration of diagnostic and prognostic molecular parameters, giving pivotal attention to IDH mutation as a favourable factor. Amino acid PET is increasingly used in the management of gliomas, but its prognostic value is a matter of debate. The aim of this study was to assess the relationship between IDH mutation and 18F-FDOPA uptake on PET in newly diagnosed gliomas.

Methods

A total of 43 patients, presenting with diffuse astrocytic and oligodendroglial grade II and III gliomas, reclassified according to the 2016 WHO classification of tumours of the CNS, were retrospectively included. They had all undergone 18F-FDOPA PET at an initial stage before surgery and histological diagnosis. 18F-FDOPA uptake values were compared between patients with and without IDH mutation in terms of maximum standardized uptake value (SUVmax) ratios between tumour and normal contralateral brain (T/N), and between tumour and striatum (T/S).

Results

Patients with IDH mutation showed higher 18F-FDOPA T/N SUVmax ratios (1.6 vs. 1.2) and T/S SUVmax ratios (0.9 vs. 0.6) than patients without IDH mutation (p < 0.05).

Conclusion

This study showed paradoxically higher 18F-FDOPA uptake in diffuse grade II and III gliomas with IDH mutation. Despite evident interest in the management of gliomas, and especially in relation to posttherapy evaluation, our findings raise the question of the prognostic value of 18F-FDOPA uptake on PET uptake in this group of patients. This may be related to differences in amino acid integration, metabolism, or cell differentiation.

Keywords

18F-FDOPA PET IDH mutation Gliomas Prognosis 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Nuclear MedicineAPHM, La Timone HospitalMarseilleFrance
  2. 2.Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU NancyLorraine UniversityNancyFrance
  3. 3.IADI, INSERM, UMR 947Lorraine UniversityNancyFrance
  4. 4.Department of NeurosurgeryCentre Hospitalier Privé ClairvalMarseilleFrance
  5. 5.INSERM, UMR 911Aix-Marseille UniversityMarseilleFrance
  6. 6.CERIMEDAix-Marseille University MarseilleFrance
  7. 7.Department of Neuro-OncologyAPHM, La Timone HospitalMarseilleFrance
  8. 8.Department of AnatomopathologyAPHM, La Timone HospitalMarseilleFrance
  9. 9.Institut de Neurosciences de la Timone, CNRS, UMR 7289Aix-Marseille UniversityMarseilleFrance
  10. 10.Service Central de Biophysique et Médecine NucléaireHôpital de la TimoneMarseilleFrance

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