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Theranostics 2020; 10(26):11881-11891. doi:10.7150/thno.50598 This issue Cite

Research Paper

Correlation of multimodal 18F-DOPA PET and conventional MRI with treatment response and survival in children with diffuse intrinsic pontine gliomas

Giovanni Morana1,2✉, Domenico Tortora1, Gianluca Bottoni3, Matteo Puntoni4, Gianluca Piatelli5, Federica Garibotto6, Salvina Barra7, Flavio Giannelli7, Angelina Cistaro3, Mariasavina Severino1, Antonio Verrico6, Claudia Milanaccio6, Maura Massimino8, Maria Luisa Garrè6, Andrea Rossi1, Arnoldo Piccardo3

1. Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
2. Department of Neurosciences, University of Turin, Turin, Italy.
3. Nuclear Medicine Unit, Ente Ospedaliero Ospedali Galliera, Genova, Italy.
4. Clinical Trial Unit, Scientific Directorate, Ente Ospedaliero Ospedali Galliera, Genoa, Italy.
5. Neurosurgery Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
6. Neuro-oncology Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
7. Department of Radiation Oncology, Ospedale Policlinico San Martino and University, Genova, Italy.
8. Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.

✉ Corresponding author: Giovanni Morana, MD, PhD, Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, via G. Gaslini 5 16147 Genova, Italy. Tel. (39) 010 56362516; Fax (39) 010 3779798; E-mail: giovanni.moranait; Orcid ID: http://orcid.org/00 More

Citation:
Morana G, Tortora D, Bottoni G, Puntoni M, Piatelli G, Garibotto F, Barra S, Giannelli F, Cistaro A, Severino M, Verrico A, Milanaccio C, Massimino M, Garrè ML, Rossi A, Piccardo A. Correlation of multimodal 18F-DOPA PET and conventional MRI with treatment response and survival in children with diffuse intrinsic pontine gliomas. Theranostics 2020; 10(26):11881-11891. doi:10.7150/thno.50598. https://www.thno.org/v10p11881.htm
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Abstract

Graphic abstract

To evaluate the contribution of 18F-dihydroxyphenylalanine (DOPA) PET in association with conventional MRI in predicting treatment response and survival outcome of pediatric patients with diffuse intrinsic pontine gliomas (DIPGs).

Methods: We retrospectively analyzed 19 children with newly diagnosed DIPGs who underwent 18F-DOPA PET/CT and conventional MRI within one week of each other at admission and subsequent MRI follow-up. Following co-registration and fusion of PET and MRI, 18F-DOPA uptake avidity and extent (PET tumor volume and uniformity) at admission, along with MRI indices including presence of ring contrast-enhancement, tumor volume at admission and at maximum response following first-line treatment, were evaluated and correlated with overall survival (OS). The association between 18F-DOPA uptake tumor volume at admission and MRI tumor volume following treatment was evaluated. Statistics included Wilcoxon signed-rank and Mann-Whitney U tests, Kaplan-Meier OS curve and Cox analysis.

Results: DIPGs with a 18F-DOPA uptake Tumor/Striatum (T/S) ratio >1 presented an OS ≤ 12 months and lower degree of tumor volume reduction following treatment (p = 0.001). On multivariate analysis, T/S (p = 0.001), ring enhancement (p = 0.01) and the degree of MRI tumor volume reduction (p = 0.01) independently correlated with OS. In all patients, areas of increased 18F-DOPA uptake overlapped with regions demonstrating more prominent residual components/lack of response following treatment.

Conclusions: 18F-DOPA PET provides useful information for evaluating the metabolism of DIPGs. T/S ratio is an independent predictor of outcome. 18F-DOPA uptake extent delineates tumoral regions with a more aggressive biological behaviour, less sensitive to first line treatment.

Keywords: DOPA PET, MRI, Pediatric, DIPG, diffuse midline glioma

Citation styles

APA
Morana, G., Tortora, D., Bottoni, G., Puntoni, M., Piatelli, G., Garibotto, F., Barra, S., Giannelli, F., Cistaro, A., Severino, M., Verrico, A., Milanaccio, C., Massimino, M., Garrè, M.L., Rossi, A., Piccardo, A. (2020). Correlation of multimodal 18F-DOPA PET and conventional MRI with treatment response and survival in children with diffuse intrinsic pontine gliomas. Theranostics, 10(26), 11881-11891. https://doi.org/10.7150/thno.50598.

ACS
Morana, G.; Tortora, D.; Bottoni, G.; Puntoni, M.; Piatelli, G.; Garibotto, F.; Barra, S.; Giannelli, F.; Cistaro, A.; Severino, M.; Verrico, A.; Milanaccio, C.; Massimino, M.; Garrè, M.L.; Rossi, A.; Piccardo, A. Correlation of multimodal 18F-DOPA PET and conventional MRI with treatment response and survival in children with diffuse intrinsic pontine gliomas. Theranostics 2020, 10 (26), 11881-11891. DOI: 10.7150/thno.50598.

NLM
Morana G, Tortora D, Bottoni G, Puntoni M, Piatelli G, Garibotto F, Barra S, Giannelli F, Cistaro A, Severino M, Verrico A, Milanaccio C, Massimino M, Garrè ML, Rossi A, Piccardo A. Correlation of multimodal 18F-DOPA PET and conventional MRI with treatment response and survival in children with diffuse intrinsic pontine gliomas. Theranostics 2020; 10(26):11881-11891. doi:10.7150/thno.50598. https://www.thno.org/v10p11881.htm

CSE
Morana G, Tortora D, Bottoni G, Puntoni M, Piatelli G, Garibotto F, Barra S, Giannelli F, Cistaro A, Severino M, Verrico A, Milanaccio C, Massimino M, Garrè ML, Rossi A, Piccardo A. 2020. Correlation of multimodal 18F-DOPA PET and conventional MRI with treatment response and survival in children with diffuse intrinsic pontine gliomas. Theranostics. 10(26):11881-11891.

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