Highlights
- •Progressive gliomas have higher SUVmax (3.57 vs. 1.60; p = 0.003) and TBRmax (3.00 vs. 1.36; p = 0.001) than stable gliomas.
- •Patients with tumors TBRmax < 2.0 have longer progression-free survival compared to patients with tumor TBRmax > 2.0.
- •FET-PET might eventually be able to prognosticate progression of adult BSG. Tumors with a TBRmax > 2.0 might progress more rapidly.
Abstract
Purpose
To investigate 18F-fluoro-ethyl-tyrosine positron emission tomography (FET-PET) imaging characteristics
of adult brainstem glioma (BSG).
Materials and methods
FET-PET imaging and progression-free survival (PFS) of 16 adult patients with BSG
was analyzed (9 high-grade gliomas, 7 low-grade gliomas). SUVmax, TBR, and time activity curves of FET-PET were calculated.
Results
Progressive gliomas had higher SUVmax (3.57 ± 1.47 vs. 1.60 ± 0.51; p = 0.003) and TBRmax (3.00 ± 1.12 vs. 1.36 ± 0.33; p = 0.001) than stable gliomas. Kaplan-Meier analysis showed longer PFS of tumors with
TBRmax < 2.0 compared to tumors with TBRmax > 2.0 (665 ± 32 days versus 220 ± 39 days; p < 0.001).
Conclusion
FET-PET uptake might be associated with disease progression in adult BSG.
Abbreviations:
ADC (apparent diffusion coefficient), BSG (brain stem glioma), Cho (choline), CT (computed tomography), DTI (diffusion tensor imaging), DWI (diffusion weighted imaging), FET (18F-fluoro-ethyl-tyrosine), FLAIR (fluid-attenuated inversion recovery), GBM (glioblastoma multiforme), IDH (isocitrate dehydrogenase), KFS (Karnofsky performance status), LOH (loss of heterozygosity), MCP (middle cerebellar peduncle), MGMT (O(6)-methlyguanine-DNA-methyltransferase), MR (magnetic resonance), MRS (magnetic resonance spectroscopy), NAA (N-acetylaspartate), PET (positron emission tomography), PFS (progression-free survival), PWI (perfusion-weighted imaging), RT (radiation therapy), SUVmax (maximum standardized uptake value), T1w (T1-weighted), T2w (T2-weighted), TAC (time activity curve), TBR (tumor-to-brain ratio), TMZ (temozolomide), VOI (volume of interest), WM (white matter)Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical ImagingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Brain stem gliomas: a classification system based on magnetic resonance imaging.Pediatr Neurosurg. 1990; 16: 73-83
- T1-weighted MR imaging of glioma at 3 T: a comparative study of 3D MPRAGE vs. conventional 2D spin-echo imaging.Clin Imaging. 2016; 40: 1257-1261
- Brainstem glioma: a review.Curr Neurol Neurosci Rep. 2013; 13: 346
- Adult brainstem gliomas.Neurology. 1998; 51: 1136-1139
- Clinical profile and outcomes in brainstem glioma: an institutional experience.Asian J Neurosurg. 2015; 10: 298-302
- Brainstem gliomas in adults: prognostic factors and classification.Brain. 2001; 124: 2528-2539
- Neuroimaging in neuro-oncology.Neurotherapeutics. 2009; 6: 465-477
- Imaging of adult brainstem gliomas.Eur J Radiol. 2015; 84: 709-720
- Adult brainstem gliomas.Oncologist. 2012; 17: 388-397
- Use of positron emission tomography in the evaluation of diffuse intrinsic brainstem gliomas in children.J Pediatr Hematol Oncol. 2011; 33: 369-373
- Conventional and advanced imaging of diffuse intrinsic pontine glioma.J Child Neurol. 2016; 31: 1386-1393
- Evaluation of 18F-FDG PET and MRI associations in pediatric diffuse intrinsic brain stem glioma: a report from the Pediatric Brain Tumor Consortium.J Nucl Med. 2011; 52: 188-195
- Positron emission tomography with O-(2-[18F]fluoroethyl)-l-tyrosine versus magnetic resonance imaging in the diagnosis of recurrent gliomas.Neurosurgery. 2005; 57 (discussion-11): 505-511
- O-(2-[18F]fluorethyl)-l-tyrosine PET in the clinical evaluation of primary brain tumours.Eur J Nucl Med Mol Imaging. 2005; 32: 422-429
- The use of 18F-FDG PET ratios in the differential diagnosis of common malignant brain tumors.Clin Imaging. 2015; 39: 970-974
- In vivo 18F-fluorodeoxyglucose positron emission tomography imaging provides a noninvasive measure of carotid plaque inflammation in patients.J Am Coll Cardiol. 2006; 48: 1818-1824
- Diagnostic performance of 18F-FET PET in newly diagnosed cerebral lesions suggestive of glioma.J Nucl Med. 2013; 54: 229-235
- O-(2-[18F]fluoroethyl)-l-tyrosine PET combined with MRI improves the diagnostic assessment of cerebral gliomas.Brain. 2005; 128: 678-687
- The use of O-(2-18F-fluoroethyl)-l-tyrosine PET in the diagnosis of gliomas located in the brainstem and spinal cord.Neuro Oncol. 2017; 19: 710-718
- Brain tumors: an update on clinical PET research in gliomas.Semin Nucl Med. 2017; 47: 5-17
- Modified criteria for radiographic response assessment in glioblastoma clinical trials.Neurotherapeutics. 2017; 14: 307-320
- Response assessment in neuro-oncology (a report of the RANO group): assessment of outcome in trials of diffuse low-grade gliomas.Lancet Oncol. 2011; 12: 583-593
- The use of dynamic O-(2-18F-fluoroethyl)-l-tyrosine PET in the diagnosis of patients with progressive and recurrent glioma.Neuro Oncol. 2015; 17: 1293-1300
- Performance of 18F-fluoro-ethyl-tyrosine (18F-FET) PET for the differential diagnosis of primary brain tumor: a systematic review and metaanalysis.J Nucl Med. 2012; 53: 207-214
- Quantifying PET.in: von Schulthess G.K. Molecular anatomic imaging. Lippincott Williams & Wilkins, Philadelphia2007: 85-89
- Variability of average SUV from several hottest voxels is lower than that of SUVmax and SUVpeak.Eur Radiol. 2014; 24: 1964-1970
- Repeatability of FDG quantification in tumor imaging: averaged SUVs are superior to SUVmax.Nucl Med Biol. 2012; 39: 666-670
- German guidelines for brain tumour imaging by PET and SPECT using labelled amino acids.Nuklearmedizin. 2011; 50: 167-173
- Stereotactic comparison among cerebral blood volume, methionine uptake, and histopathology in brain glioma.AJNR Am J Neuroradiol. 2007; 28: 455-461
- Value of O-(2-[18F]fluoroethyl)-l-tyrosine PET for the diagnosis of recurrent glioma.Eur J Nucl Med Mol Imaging. 2004; 31: 1464-1470
- Dynamic O-(2-[18F]fluoroethyl)-l-tyrosine (F-18 FET) PET for glioma grading: assessment of individual probability of malignancy.Clin Nucl Med. 2011; 36: 841-847
- Analysis of 18F-FET PET for grading of recurrent gliomas: is evaluation of uptake kinetics superior to standard methods?.J Nucl Med. 2006; 47: 393-403
- The 2007 WHO classification of tumours of the central nervous system.Acta Neuropathol. 2007; 114: 97-109
- MRI-suspected low-grade glioma: is there a need to perform dynamic FET PET?.Eur J Nucl Med Mol Imaging. 2012; 39: 1021-1029
- Combination of MRI and dynamic FET PET for initial glioma grading.Nuklearmedizin. 2014; 53: 155-161
- Serial stereotactic biopsy of brainstem lesions in adults improves diagnostic accuracy compared with MRI only.J Neurol Neurosurg Psychiatry. 2009; 80: 1134-1139
- Correlation among magnetic resonance imaging findings, prognostic factors for survival, and histological diagnosis of intrinsic brainstem lesions in children.J Neurosurg Pediatr. 2011; 8: 539-543
- Prognostic value of O-(2-18F-fluoroethyl)-l-tyrosine PET and MRI in low-grade glioma.J Nucl Med. 2007; 48: 519-527
- Assessment of treatment response in patients with glioblastoma using O-(2-18F-fluoroethyl)-l-tyrosine PET in comparison to MRI.J Nucl Med. 2012; 53: 1048-1057
- Conventional MRI cannot predict survival in childhood diffuse intrinsic pontine glioma.J Neurooncol. 2008; 86: 313-319
- Statistical aspects of prognostic factor studies in oncology.Br J Cancer. 1994; 69: 979-985
Article Info
Publication History
Published online: February 07, 2018
Accepted:
January 29,
2018
Received in revised form:
January 25,
2018
Received:
October 27,
2017
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
