Francesco Cicone1,2, Luciano Carideo3, Claudia Scaringi4,5, Antonietta Arcella6, Felice Giangaspero6,7, Francesco Scopinaro3, Giuseppe Minniti5,6. 1. Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland. f.cicone@iol.it. 2. Nuclear Medicine, Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy. f.cicone@iol.it. 3. Nuclear Medicine, Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy. 4. Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Radiotherapy, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy. 5. Radiation Oncology Unit, UPMC Hillman Cancer Center, San Pietro Hospital FBF, Rome, Italy. 6. IRCCS Neuromed, Pozzilli, IS, Italy. 7. Department of Radiological, Oncological and Anatomo Pathological Sciences, Sapienza University of Rome, Rome, Italy.
Abstract
OBJECTIVE: The role of amino acid positron emission tomography (PET) in glioma grading and outcome prognostication has not yet been well established. This is particularly true in the context of the new WHO 2016 classification, which introduced a definition of glioma subtypes primarily based on molecular fingerprints. The aim of the present study was to correlate 3,4‑dihydroxy‑6‑[18F]‑fluoro-L‑phenylalanine (F-DOPA) uptake parameters with IDH mutation, 1p/19q status, and survival outcomes in patients with glioma. METHODS: The study population consisted of 33 patients (17 M/16 F, mean age: 46 ± 13 years) who underwent F-DOPA PET/CT for the evaluation of tumor extent before the start of chemo or radiotherapy. The presence of IDH mutation and 1p/19q status was assessed in all the cases. Tumor volume and semiquantitative uptake parameters, namely SUVmax, tumor-to-normal brain ratio and tumor-to-normal striatum ratio, were calculated for each tumor. Imaging-derived parameters were compared between patients stratified according to molecular fingerprints, using parametric or non-parametric tests, where appropriate. The Kaplan-Meier method was used to assess differences of overall survival (OS) and progression-free survival (PFS) between groups. PET parameters were also tested as prognostic factors in univariate Cox survival regression models. RESULTS: There were 12 IDH-wild-type and 21 IDH-mutant patients. Stratification according to 1p/19q co-deletion resulted in 20 non-co-deleted and 13 co-deleted patients. Median follow-up time from PET/CT exam was 30.5 months (range 3.5-74 months). Semiquantitative uptake parameters did correlate neither with IDH mutation nor with 1p/19q status. Uptake was similar in low-grade and high-grade tumors, respectively. In addition, F-DOPA uptake parameters, macroscopic tumor volume, or tumor grade did not stratify OS, while a correlation between SUVmax and PFS was shown in the subgroup of astrocytomas. On the other hand, IDH mutation status and presence of 1p/19q co-deletion had a significant impact on survival outcomes. The prognostic value of IDH mutation status was also confirmed in the subgroup of patients with astrocytic tumors. CONCLUSIONS: F-DOPA uptake parameters do not correlate with tumor molecular and histological characteristics. The predictive value of PET-derived parameters on outcomes of survival is limited.
OBJECTIVE: The role of amino acid positron emission tomography (PET) in glioma grading and outcome prognostication has not yet been well established. This is particularly true in the context of the new WHO 2016 classification, which introduced a definition of glioma subtypes primarily based on molecular fingerprints. The aim of the present study was to correlate 3,4‑dihydroxy‑6‑[18F]‑fluoro-L‑phenylalanine (F-DOPA) uptake parameters with IDH mutation, 1p/19q status, and survival outcomes in patients with glioma. METHODS: The study population consisted of 33 patients (17 M/16 F, mean age: 46 ± 13 years) who underwent F-DOPA PET/CT for the evaluation of tumor extent before the start of chemo or radiotherapy. The presence of IDH mutation and 1p/19q status was assessed in all the cases. Tumor volume and semiquantitative uptake parameters, namely SUVmax, tumor-to-normal brain ratio and tumor-to-normal striatum ratio, were calculated for each tumor. Imaging-derived parameters were compared between patients stratified according to molecular fingerprints, using parametric or non-parametric tests, where appropriate. The Kaplan-Meier method was used to assess differences of overall survival (OS) and progression-free survival (PFS) between groups. PET parameters were also tested as prognostic factors in univariate Cox survival regression models. RESULTS: There were 12 IDH-wild-type and 21 IDH-mutant patients. Stratification according to 1p/19q co-deletion resulted in 20 non-co-deleted and 13 co-deleted patients. Median follow-up time from PET/CT exam was 30.5 months (range 3.5-74 months). Semiquantitative uptake parameters did correlate neither with IDH mutation nor with 1p/19q status. Uptake was similar in low-grade and high-grade tumors, respectively. In addition, F-DOPA uptake parameters, macroscopic tumor volume, or tumor grade did not stratify OS, while a correlation between SUVmax and PFS was shown in the subgroup of astrocytomas. On the other hand, IDH mutation status and presence of 1p/19q co-deletion had a significant impact on survival outcomes. The prognostic value of IDH mutation status was also confirmed in the subgroup of patients with astrocytic tumors. CONCLUSIONS:F-DOPA uptake parameters do not correlate with tumor molecular and histological characteristics. The predictive value of PET-derived parameters on outcomes of survival is limited.
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: Francesco Cicone; Luciano Carideo; Claudia Scaringi; Andrea Romano; Marcelo Mamede; Annalisa Papa; Anna Tofani; Giuseppe Lucio Cascini; Alessandro Bozzao; Francesco Scopinaro; Giuseppe Minniti Journal: Neuro Oncol Date: 2021-06-01 Impact factor: 12.300
Authors: Hiroyuki Tatekawa; Hiroyuki Uetani; Akifumi Hagiwara; Jingwen Yao; Talia C Oughourlian; Issei Ueda; Catalina Raymond; Albert Lai; Timothy F Cloughesy; Phioanh L Nghiemphu; Linda M Liau; Shadfar Bahri; Whitney B Pope; Noriko Salamon; Benjamin M Ellingson Journal: J Neurooncol Date: 2021-03-11 Impact factor: 4.130
Authors: Hiroyuki Tatekawa; Jingwen Yao; Talia C Oughourlian; Akifumi Hagiwara; Chencai Wang; Catalina Raymond; Albert Lai; Timothy F Cloughesy; Phioanh L Nghiemphu; Linda M Liau; Noriko Salamon; Benjamin M Ellingson Journal: Clin Nucl Med Date: 2020-12 Impact factor: 10.782
Authors: Jingwen Yao; Akifumi Hagiwara; Catalina Raymond; Soroush Shabani; Whitney B Pope; Noriko Salamon; Albert Lai; Matthew Ji; Phioanh L Nghiemphu; Linda M Liau; Timothy F Cloughesy; Benjamin M Ellingson Journal: Sci Rep Date: 2020-07-17 Impact factor: 4.379
Authors: Antoine Girard; Pierre-Jean Le Reste; Alice Metais; Nibras Chaboub; Anne Devillers; Hervé Saint-Jalmes; Florence Le Jeune; Xavier Palard-Novello Journal: Front Med (Lausanne) Date: 2021-07-09