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)./nMethods: 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./nResults: 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./nConclusions: 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.

中文翻译：

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多模态18F-DOPA PET和常规MRI与弥漫性桥脑神经胶质瘤儿童治疗反应和生存的相关性

为了评估¹⁸ F-二羟基苯丙氨酸（DOPA）PET与常规MRI结合对预测弥漫性桥脑神经胶质瘤（DIPG）患儿的治疗反应和生存结果的贡献。/n方法：我们回顾性分析了19例新诊断为DIPG的儿童在入院及随后的MRI随访中，他们在一周之内彼此进行了¹⁸ F-DOPA PET / CT和常规MRI检查。在PET和MRI共同注册和融合之后，¹⁸评估入院时F-DOPA摄取的亲和力和程度（PET肿瘤的大小和均匀度），以及包括环造影增强，入院时的肿瘤体积和一线治疗后最大反应的MRI指数，并将其与总生存期相关（作业系统）。评估入院时¹⁸ F-DOPA摄取肿瘤体积与治疗后MRI肿瘤体积之间的关联。统计数据包括Wilcoxon符号秩检验和Mann-Whitney U检验，Kaplan-Meier OS曲线和Cox分析。/n结果：摄取¹⁸ F-DOPA的DIPG肿瘤/纹状体（T / S）比> 1表示OS≤12治疗后10个月和更低的肿瘤体积减少程度（p = 0.001）。在多变量分析中，T / S（p =0.001），环增强（p = 0.01）和MRI肿瘤体积缩小程度（p = 0.01）与OS独立相关。在所有患者中，¹⁸ F-DOPA摄取增加的区域与显示出更突出的残留成分/治疗后反应缺乏的区域重叠。/n结论： ¹⁸ F-DOPA PET提供了评估DIPG代谢的有用信息。T / S比是结果的独立预测因子。¹⁸ F-DOPA的吸收程度以更具侵略性的生物学行为描绘了肿瘤区域，对一线治疗的敏感性较低。