Comparison Between 18F-Dopa and 18F-Fet PET/CT in Patients with Suspicious Recurrent High Grade Glioma: A Literature Review and Our Experience

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Abstract

Purposes: The aims of the present study were to: 1- critically assess the utility of L-3,4- dihydroxy-6-18Ffluoro-phenyl-alanine (18F-DOPA) and O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) Positron Emission Tomography (PET)/Computed Tomography (CT) in patients with high grade glioma (HGG) and 2- describe the results of 18F-DOPA and 18F-FET PET/CT in a case series of patients with recurrent HGG.

Methods: We searched for studies using the following databases: PubMed, Web of Science and Scopus. The search terms were: glioma OR brain neoplasm and DOPA OR DOPA PET OR DOPA PET/CT and FET OR FET PET OR FET PET/CT. From a mono-institutional database, we retrospectively analyzed the 18F-DOPA and 18F-FET PET/CT of 29 patients (age: 56 ± 12 years) with suspicious for recurrent HGG. All patients underwent 18F-DOPA or 18F-FET PET/CT for a multidisciplinary decision. The final definition of recurrence was made by magnetic resonance imaging (MRI) and/or multidisciplinary decision, mainly based on the clinical data.

Results: Fifty-one articles were found, of which 49 were discarded, therefore 2 studies were finally selected. In both the studies, 18F-DOPA and 18F-FET as exchangeable in clinical practice particularly for HGG patients. From our institutional experience, in 29 patients, we found that sensitivity, specificity and accuracy of 18F-DOPA PET/CT in HGG were 100% (95% confidence interval- 95%CI - 81-100%), 63% (95%CI: 39-82%) and 62% (95%CI: 39-81%), respectively. 18F-FET PET/CT was true positive in 4 and true negative in 4 patients. Sensitivity, specificity and accuracy for 18F-FET PET/CT in HGG were 100%.

Conclusion: 18F-DOPA and 18F-FET PET/CT have a similar diagnostic accuracy in patients with recurrent HGG. However, 18F-DOPA PET/CT could be affected by inflammation conditions (false positive) that can alter the final results. Large comparative trials are warranted in order to better understand the utility of 18F-DOPA or 18F-FET PET/CT in patients with HGG.

Keywords: DOPA PET/CT, FET PET/CT, gliomas, accuracy, systematic review, 18F-Dopa, 18F-Fet.

Graphical Abstract

[1]
Ostrom, Q.T.; Gittleman, H.; Farah, P.; Ondracek, A.; Chen, Y.; Wolinsky, Y.; Stroup, N.E.; Kruchko, C.; Barnholtz-Sloan, J.S. CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2006-2010. Neuro. Oncol, 2013, 15, (2), ii 1-56.
[2]
Levivier, M.; Becerra, A.; De Witte, O.; Brotchi, J.; Goldman, S. Radiation necrosis or recurrence. J. Neurosurg., 1996, 84, 148-149.
[3]
Wen, P.Y.; Macdonald, D.R.; Reardon, D.A.; Cloughesy, T.F.; Sorensen, A.G.; Galanis, E.; Degroot, J.; Wick, W.; Gilbert, M.R.; Lassman, A.B.; Tsien, C.; Mikkelsen, T.; Wong, E.T.; Chamberlain, M.C.; Stupp, R.; Lamborn, K.R.; Vogelbaum, M.A.; Van Den Bent, M.J.; Chang, S.M. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J. Clin. Oncol., 2010, 28, 1963-1972.
[4]
Wester, H.J.; Herz, M.; Weber, W.; Heiss, P.; Senekowitsch-Schmidtke, R.; Schwaiger, M.; Stöcklin, G. Synthesis and radiopharmacology of O-(2-[18F]fluoroethyl)-L-tyrosine for tumor imaging. J. Nucl. Med., 1999, 40(1), 205-212.
[5]
Dunet, V.; Rossier, C.; Buck, A.; Stupp, R.; Prior, J.O. Performance of 18F-fluoro-ethyl-tyrosine (18F-FET) PET for the differential diagnosis of primary brain tumor: a systematic review and metaanalysis. J. Nucl. Med., 2012, 53(2), 207-214.
[6]
Muoio, B.; Giovannella, L.; Treglia, G. Recent developments of 18F-FET PET in neuro-oncology. Curr. Med. Chem., 2018, 25(26), 3061-3073.
[7]
Bell, C.; Dowson, N.; Puttick, S.; Gal, Y.; Thomas, P.; Fay, M.; Smith, J.; Rose, S. Increasing feasibility and utility of (18)F-FDOPA PET for the management of glioma. Nucl. Med. Biol., 2015, 42(10), 788-795.
[8]
Lahoutte, T.; Cavaliers, V.; Camargo, S.M.R.; Franca, R.; Ramadan, T.; Veljkovic, E.; Mertens, J.; Bossuyt, A.; Verrey, F. SPECT and PET amino acid tracer influx via system L (h4F2hc-hLAT1) and its trans stimulation. J. Nucl. Med., 2004, 45, 1591-1596.
[9]
Langen, K.J.; Hamacher, K.; Weckesser, M.; Floeth, F.; Stoffels, G.; Bauer, D.; Coenen, H.H.; Pauleit, D.O. -(2-[18F]fluoroethyl)-L-tyrosine: uptake mechanisms and clinical applications. Nucl. Med. Biol., 2006, 33(3), 287-294.
[10]
Youland, R.S.; Kitange, G.J.; Peterson, T.E.; Pafundi, D.H.; Ramiscal, J.A.; Pokorny, J.L.; Giannini, C.; Laack, N.N.; Parney, I.F.; Lowe, V.J.; Brinkmann, D.H.; Sarkaria, J.N. The role of LAT1 in (18)F-DOPA uptake in malignant gliomas. J. Neurooncol., 2013, 111(1), 11-18.
[11]
Rau, F.C.; Weber, W.A.; Wester, H.J.; Herz, M.; Becker, I.; Krüger, A.; Schwaiger, M.; Senekowitsch-Schmidtke, R.O. -(2-[(18)F]Fluoroethyl)- L-tyrosine (FET): A tracer for differentiation of tumour from inflammation in murine lymph nodes. Eur. J. Nucl. Med. Mol. Imaging, 2002, 29(8), 1039-1046.
[12]
Lapa, C.; Linsenman, T.; Monoranu, C.M.; Samnick, S.; Buck, A.K.; Bluemel, C.; Czernin, J.; Kessler, A.F.; Homola, G.A.; Ernestus, R.I.; Löhr, M.; Herrmann, K. Comparison of the amino acid tracers 18F-FET and 18F-DOPA in high-grade glioma patients. J. Nucl. Med., 2014, 55(10), 1611-1616.
[13]
Kratochwil, C.; Combs, S.E.; Leotta, K.; Afshar-Oromieh, A.; Rieken, S.; Debus, J.; Haberkorn, U.; Giesel, F.L. Intra-individual comparison of 18F-FET and 18F-DOPA in PET imaging of recurrent brain tumors. Neuro-oncol., 2014, 16(3), 434-440.
[14]
Kauhanen, S.; Seppänen, M.; Nuutila, P. Premedication with carbidopa masks positive finding of insulinoma and beta-cell hyperplasia in [(18)F]-dihydroxy-phenyl-alanine positron emission tomography. Clin. Oncol., 2008, 26(32), 5307-5308.
[15]
Timmers, H.J.; Hadi, M.; Carrasquillo, J.A.; Chen, C.C.; Martiniova, L.; Whatley, M.; Ling, A.; Eisenhofer, G.; Adams, K.T.; Pacak, K. The effects of carbidopa on uptake of 6-18F-Fluoro-L-DOPA in PET of pheochromocytoma and extra-adrenal abdominal paraganglioma. J. Nucl. Med., 2007, 48(10), 1599-1606.
[16]
Schiepers, C.; Chen, W.; Cloughesy, T.; Dahlbom, M.; Huang, S.C. 18F-FDOPA kinetics in brain tumors. J. Nucl. Med., 2007, 48(10), 1651-1661.
[17]
Becherer, A.; Karanikas, G.; Szabó, M.; Zettinig, G.; Asenbaum, S.; Marosi, C.; Henk, C.; Wunderbaldinger, P.; Czech, T.; Wadsak, W.; Kletter, K. Brain tumour imaging with PET: a comparison between [18F]fluorodopa and [11C]methionine. Eur. J. Nucl. Med. Mol. Imaging, 2003, 30(11), 1561-1567.
[18]
Grosu, A.L.; Astner, S.T.; Riedel, E.; Nieder, C.; Wiedenmann, N.; Heinemann, F.; Schwaiger, M.; Molls, M.; Wester, H.J.; Weber, W.A. An interindividual comparison of O-(2-[18F]fluoroethyl)-L-tyrosine (FET)- and L-[methyl-11C]methionine (MET)-PET in patients with brain gliomas and metastases. Int. J. Radiat. Oncol. Biol. Phys., 2011, 81(4), 1049-1058.
[19]
Albert, N.L.; Winkelmann, I.; Suchorska, B.; Wenter, V.; Schmid-Tannwald, C.; Mille, E.; Todica, A.; Brendel, M.; Tonn, J.C.; Bartenstein, P.; la Fougère, C. Early static (18)F-FET-PET scans have a higher accuracy for glioma grading than the standard 20-40 min scans. Eur. J. Nucl. Med. Mol. Imaging, 2016, 43(6), 1105-1114.
[20]
Galldiks, N.; Stoffels, G.; Filss, C.; Rapp, M.; Blau, T.; Tscherpel, C.; Ceccon, G.; Dunkl, V.; Weinzierl, M.; Stoffel, M.; Sabel, M.; Fink, G.R.; Shah, N.J.; Langen, K.J. The use of dynamic O-(2-18F-fluoroethyl)-l-tyrosine PET in the diagnosis of patients with progressive and recurrent glioma. Neuro-oncol., 2015, 17(9), 1293-1300.
[21]
Herrmann, K.C.J.; Cloughesy, T.; Lai, A.; Pomykala, K.L.; Benz, M.R. Comparison of visual and semiquantitative analysis of 18F-FDOPA-PET/CT for recurrence detection in glioblastoma patients. Neuro-oncol., 2014, 16, 603-609.
[22]
Galldiks, N.; Langen, K.J.; Pope, W.B. From the clinician’s point of view - What is the status quo of positron emission tomography in patients with brain tumors? Neuro-oncol., 2015, 17(11), 1434-1444.
[23]
Galldiks, N.; Dunkl, V.; Ceccon, G.; Tscherpel, C.; Stoffels, G.; Law, I.; Henriksen, O.M.; Muhic, A.; Poulsen, H.S.; Steger, J.; Bauer, E.K.; Lohmann, P.; Schmidt, M.; Shah, N.J.; Fink, G.R.; Langen, K.J. Early treatment response evaluation using FET PET compared to MRI in glioblastoma patients at first progression treated with bevacizumab plus lomustine. Eur. J. Nucl. Med. Mol. Imaging, 2018, 45(13), 2377-2386.
[24]
Schwarzenberg, J.; Czernin, J.; Cloughesy, T.F.; Ellingson, B.M.; Pope, W.B.; Grogan, T.; Elashoff, D.; Geist, C.; Silverman, D.H.; Phelps, M.E.; Chen, W. Treatment response evaluation using 18F-FDOPA PET in patients with recurrent malignant glioma on bevacizumab therapy. Clin. Cancer Res., 2014, 20(13), 3550-3559.
[25]
Weller, M.; van den Bent, M.; Hopkins, K.; Tonn, J.C.; Stupp, R.; Falini, A.; Cohen-Jonathan-Moyal, E.; Frappaz, D.; Henriksson, R.; Balana, C.; Chinot, O.; Ram, Z.; Reifenberger, G.; Soffietti, R.; Wick, W. EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. Lancet Oncol., 2014, 15(9), e395-e403.
[26]
Marner, L.; Henriksen, O.M.; Lundemann, M.; Larsen, V.A.; Law, I. Clinical PET/MRI in neuro-oncology: opportunities and challenges from a single-institution perspective. Clin. Transl. Imaging, 2017, 5(2), 135-149.
[27]
Kim, W.; Liau, L.M. IDH mutations in human glioma. Neurosurg. Clin. N. Am., 2012, 23(3), 471-480.
[28]
Verger, A.; Metellus, P.; Sala, Q.; Colin, C.; Bialecki, E.; Taieb, D.; Chinot, O.; Figarella-Branger, D.; Guedj, E. IDH mutation is paradoxically associated with higher 18F-FDOPA PET uptake in diffuse grade II and grade III gliomas. Eur. J. Nucl. Med. Mol. Imaging, 2017, 44(8), 1306-1311.
[29]
Bette, S.; Gempt, J.; Delbridge, C.; Kirschke, J.S.; Schlegel, J.; Foerster, S.; Huber, T.; Pyka, T.; Zimmer, C.; Meyer, B.; Ringel, F. Prognostic Value of O-(2-[18F]-Fluoroethyl)-L-Tyrosine-Positron Emission Tomography Imaging for Histopathologic Characteristics and Progression-Free Survival in Patients with Low-Grade Glioma. World Neurosurg., 2016, 89, 230-239.
[30]
Unterrainer, M.; Winkelmann, I.; Suchorska, B.; Giese, A.; Wenter, V.; Kreth, F.W.; Herms, J.; Bartenstein, P.; Tonn, J.C.; Albert, N.L. Biological tumour volumes of gliomas in early and standard 20-40 min 18F-FET PET images differ according to IDH mutation status. Eur. J. Nucl. Med. Mol. Imaging, 2018, 45(7), 1242-1249.
[31]
Floeth, F.W.; Sabel, M.; Stoffels, G.; Pauleit, D.; Hamacher, K.; Steiger, H.J.; Langen, K.J. Prognostic value of 18F-fluoroethyl-L-tyrosine PET and MRI in small nonspecific incidental brain lesions. J. Nucl. Med., 2008, 49(5), 730-737.
[32]
Floeth, F.W.; Pauleit, D.; Sabel, M.; Stoffels, G.; Reifenberger, G.; Riemenschneider, M.J.; Jansen, P.; Coenen, H.H.; Steiger, H.J.; Langen, K.J. Prognostic value of O-(2-18F-fluoroethyl)-L-tyrosine PET and MRI in low-grade glioma. J. Nucl. Med., 2007, 48(4), 519-527.
[33]
Jansen, N.L.; Suchorska, B.; Wenter, V.; Schmid-Tannwald, C.; Todica, A.; Eigenbrod, S.; Niyazi, M.; Tonn, J.C.; Bartenstein, P.; Kreth, F.W.; la Fougère, C. Prognostic significance of dynamic 18F-FET PET in newly diagnosed astrocytic high-grade glioma. J. Nucl. Med., 2015, 56(1), 9-15.