Stefanie Bette1, Jens Gempt2, Claire Delbridge3, Jan S Kirschke1, Juergen Schlegel3, Stefan Foerster4, Thomas Huber1, Thomas Pyka4, Claus Zimmer1, Bernhard Meyer2, Florian Ringel5. 1. Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 2. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 3. Department of Neuropathology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 4. Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 5. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: florian.ringel@tum.de.
Abstract
OBJECTIVE: O-(2-[18F]-fluoroethyl)-L-tyrosine positron emission tomography ((18)F-FET-PET) imaging is applied for tumor grading, prognostic stratification, and diagnosis of tumor recurrence, especially in high-grade gliomas. Experience with (18)F-FET-PET imaging in low-grade gliomas is limited. Therefore, the objective of the present study was to assess (18)F-FET-PET tracer uptake in low-grade gliomas and to investigate possible correlations with contrast enhancement in magnetic resonance imaging (MRI) and histopathology. METHODS: A total of 65 patients (29 female, 36 male, median age 38 years) with newly diagnosed or recurrent low-grade gliomas for whom preoperative MRI and (18)F-FET-PET imaging were available were included. Tumor entity, tumor location, as well as histopathology (isocitrate dehydrogenase [IDH] 1/2 mutation, Ki67, p53, oligodendroglial differentiation, 1p19q codeletion), and progression-free survival were assessed. (18)F-FET-PET images were acquired and fused to MRI (T2-weighted fluid-attenuated inversion recovery) and tumor volume was measured in areas with a tumor-to-background ratio >1.3, >1.6, and >2.0 and in MRI. RESULTS: PET tracer uptake was observed in 78.5% of all World Health Organization Grade I and II tumors. (18)F-FET uptake showed a high negative predictive value for oligodendroglial components and for 1p19q codeletion. No further significant correlation between histologic features, progression-free survival, or IDH1/2 mutation status and tracer uptake was observed. CONCLUSIONS: We found that 78.5% of low-grade gliomas do show elevated tracer uptake in (18)F-FET-PET imaging. Low-grade glioma without tracer uptake exclude oligodendroglial differentiation and 1p19q codeletion. Further differentiation between molecular subtypes is not possible with static (18)F-FET-PET. No correlation of progression-free survival to tracer uptake and IDH1/2-mutation status was observed.
OBJECTIVE:O-(2-[18F]-fluoroethyl)-L-tyrosine positron emission tomography ((18)F-FET-PET) imaging is applied for tumor grading, prognostic stratification, and diagnosis of tumor recurrence, especially in high-grade gliomas. Experience with (18)F-FET-PET imaging in low-grade gliomas is limited. Therefore, the objective of the present study was to assess (18)F-FET-PET tracer uptake in low-grade gliomas and to investigate possible correlations with contrast enhancement in magnetic resonance imaging (MRI) and histopathology. METHODS: A total of 65 patients (29 female, 36 male, median age 38 years) with newly diagnosed or recurrent low-grade gliomas for whom preoperative MRI and (18)F-FET-PET imaging were available were included. Tumor entity, tumor location, as well as histopathology (isocitrate dehydrogenase [IDH] 1/2 mutation, Ki67, p53, oligodendroglial differentiation, 1p19q codeletion), and progression-free survival were assessed. (18)F-FET-PET images were acquired and fused to MRI (T2-weighted fluid-attenuated inversion recovery) and tumor volume was measured in areas with a tumor-to-background ratio >1.3, >1.6, and >2.0 and in MRI. RESULTS: PET tracer uptake was observed in 78.5% of all World Health Organization Grade I and II tumors. (18)F-FET uptake showed a high negative predictive value for oligodendroglial components and for 1p19q codeletion. No further significant correlation between histologic features, progression-free survival, or IDH1/2 mutation status and tracer uptake was observed. CONCLUSIONS: We found that 78.5% of low-grade gliomas do show elevated tracer uptake in (18)F-FET-PET imaging. Low-grade glioma without tracer uptake exclude oligodendroglial differentiation and 1p19q codeletion. Further differentiation between molecular subtypes is not possible with static (18)F-FET-PET. No correlation of progression-free survival to tracer uptake and IDH1/2-mutation status was observed.
Authors: Olivia Kertels; Almuth F Kessler; Milena I Mihovilovic; Antje Stolzenburg; Thomas Linsenmann; Samuel Samnick; Stephanie Brändlein; Camelia Maria Monoranu; Ralf-Ingo Ernestus; Andreas K Buck; Mario Löhr; Constantin Lapa Journal: Mol Imaging Biol Date: 2019-12 Impact factor: 3.488
Authors: A Verger; Ph Metellus; Q Sala; C Colin; E Bialecki; D Taieb; O Chinot; D Figarella-Branger; E Guedj Journal: Eur J Nucl Med Mol Imaging Date: 2017-03-14 Impact factor: 9.236
Authors: Ian Law; Nathalie L Albert; Javier Arbizu; Ronald Boellaard; Alexander Drzezga; Norbert Galldiks; Christian la Fougère; Karl-Josef Langen; Egesta Lopci; Val Lowe; Jonathan McConathy; Harald H Quick; Bernhard Sattler; David M Schuster; Jörg-Christian Tonn; Michael Weller Journal: Eur J Nucl Med Mol Imaging Date: 2018-12-05 Impact factor: 9.236