Purpose: To assess the diagnostic performance of 18F-DOPA PET/CT and fused 18F-DOPA PET/MRI in detecting striatal involvement in children with gliomas. Methods: This retrospective study included 28 paediatric patients referred to our institution for the presence of primary, residual or recurrent glioma (12 boys, 16 girls; mean age 10.7 years) and investigated with 18F-DOPA PET/CT and brain MRI. Fused 18F-DOPA PET/MR images were obtained and compared with PET/CT and MRI images. Accuracy, sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) for striatal involvement were calculated for each diagnostic tool. Univariate and multivariate logistic analyses were applied to evaluate the associations between 18F-DOPA PET/CT and fused 18F-DOPA PET/MRI diagnostic results and tumour uptake outside the striatum, grade, dimension and site of striatal involvement (ventral and/or dorsal). Results: Accuracy, sensitivity, specificity, PPV, and NPV were 100 % for MRI, 93 %, 89 %, 100 %, 100 % and 82 % for 18F-DOPA PET/MRI, and 75 %, 74 %, 78 %, 88 % and 58 % for 18F-DOPA PET/CT, respectively. 18F-DOPA PET/MRI showed a trend towards higher accuracy compared with 18F-DOPA PET/CT (p = 0.06). MRI showed significantly higher accuracy compared with 18F-DOPA PET/CT (p = 0.01), but there was no significant difference between MRI and 18F-DOPA PET/MRI. Both univariate and multivariate logistic analyses showed a significant association (OR 8.0 and 7.7, respectively) between the tumour-to-normal striatal uptake (T/S) ratio and the diagnostic ability of 18F-DOPA PET/CT (p = 0.03). A strong significant association was also found between involvement of the dorsal striatum and the 18F-DOPA PET/CT results (p = 0.001), with a perfect prediction of involvement of the dorsal striatum by 18F-DOPA PET/MRI. Conclusion: Physiological striatal 18F-DOPA uptake does not appear to be a main limitation in the evaluation of basal ganglia involvement.18F-DOPA PET/CT correctly detected involvement of the dorsal striatum in lesions with a T/S ratio >1, but appeared to be less suitable for evaluation of the ventral striatum. The use of fused 18F-DOPA PET/MRI further improves the accuracy and is essential for evaluation of the ventral striatum.
- F-DOPA PET/MRI
- F-DOPA PET/CT
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging