DOI: 10.1007/s00259-017-3668-6Pages: 1306-1311

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

1. APHM, La Timone Hospital, Department of Nuclear Medicine

2. Lorraine University, Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy

3. Lorraine University, IADI, INSERM, UMR 947

4. Centre Hospitalier Privé Clairval, Department of Neurosurgery

5. Aix-Marseille University, INSERM, UMR 911

6. Aix-Marseille University , CERIMED

7. APHM, La Timone Hospital, Department of Neuro-Oncology

8. APHM, La Timone Hospital, Department of Anatomopathology

9. Aix-Marseille University, Institut de Neurosciences de la Timone, CNRS, UMR 7289

10. Hôpital de la Timone, Service Central de Biophysique et Médecine Nucléaire

Correspondence to:
E. Guedj
Tel: +33-491385558
Email: eric.guedj@ap-hm.fr

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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.

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  • Accepted: Feb 27, 2017
  • Online: Mar 14, 2017

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