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Onciul R, Brehar FM, Toader C, Covache-Busuioc RA, Glavan LA, Bratu BG, Costin HP, Dumitrascu DI, Serban M, Ciurea AV. Deciphering Glioblastoma: Fundamental and Novel Insights into the Biology and Therapeutic Strategies of Gliomas. Curr Issues Mol Biol 2024; 46:2402-2443. [PMID: 38534769 DOI: 10.3390/cimb46030153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/06/2024] [Accepted: 03/09/2024] [Indexed: 03/28/2024] Open
Abstract
Gliomas constitute a diverse and complex array of tumors within the central nervous system (CNS), characterized by a wide range of prognostic outcomes and responses to therapeutic interventions. This literature review endeavors to conduct a thorough investigation of gliomas, with a particular emphasis on glioblastoma (GBM), beginning with their classification and epidemiological characteristics, evaluating their relative importance within the CNS tumor spectrum. We examine the immunological context of gliomas, unveiling the intricate immune environment and its ramifications for disease progression and therapeutic strategies. Moreover, we accentuate critical developments in understanding tumor behavior, focusing on recent research breakthroughs in treatment responses and the elucidation of cellular signaling pathways. Analyzing the most novel transcriptomic studies, we investigate the variations in gene expression patterns in glioma cells, assessing the prognostic and therapeutic implications of these genetic alterations. Furthermore, the role of epigenetic modifications in the pathogenesis of gliomas is underscored, suggesting that such changes are fundamental to tumor evolution and possible therapeutic advancements. In the end, this comparative oncological analysis situates GBM within the wider context of neoplasms, delineating both distinct and shared characteristics with other types of tumors.
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Affiliation(s)
- Razvan Onciul
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Neurosurgery Department, Emergency University Hospital, 050098 Bucharest, Romania
| | - Felix-Mircea Brehar
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Neurosurgery, Clinical Emergency Hospital "Bagdasar-Arseni", 041915 Bucharest, Romania
| | - Corneliu Toader
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania
| | | | - Luca-Andrei Glavan
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Horia Petre Costin
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - David-Ioan Dumitrascu
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Matei Serban
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Alexandru Vlad Ciurea
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Neurosurgery Department, Sanador Clinical Hospital, 010991 Bucharest, Romania
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García Vicente AM, Amo-Salas M, Sandoval Valencia H, Lozano Setien E, Soriano Castrejón ÁM. Early Recurrence Detection of Glioma Using 18 F-Fluorocholine PET/CT : GliReDe Pilot Study. Clin Nucl Med 2022; 47:856-862. [PMID: 35835092 DOI: 10.1097/rlu.0000000000004329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the usefulness of 18 F-fluorocholine PET/CT in the early diagnosis of tumor recurrence, increasing the diagnosis confidence of MRI. METHODS Patients with a previous gross total resection of glioma and the first suspicious or doubtful for recurrence MRI were prospectively included and subjected to 18 F-fluorocholine PET/CT. An independent and combined assessment of 18 F-fluorocholine PET/CT and multimodal MRI was performed classifying the studies as positive or negative for tumor recurrence. Final diagnosis (recurrence or not) was obtained by histological confirmation or clinical and imaging follow-up. The relation of SUV max and tumor-to-background ratio with progression, the diagnostic performance of imaging techniques, and their concordance (κ Cohen) were analyzed. RESULTS Twenty-four studies on 21 patients were assessed. Recurrence was diagnosed in 20 cases. PET/CT was positive in 23 cases (3 false positive), whereas MRI was positive in 15 cases (1 false positive). MRI was false negative in 6 cases. There was no false negative on 18 F-fluorocholine PET/CT. Accuracy of PET/CT versus MRI was 87.5% and 70.8%, respectively. The combined evaluation of both techniques did not show any advantage with respect to PET/CT results alone. The concordance between both imaging techniques was low (κ = 0.135; P = 0.375). SUV max and tumor-to-background ratio were related to recurrence (areas under the curve of 0.844 [ P = 0.033] and 0.869 [ P = 0.022], respectively). CONCLUSIONS 18 F-fluorocholine PET/CT was helpful for increasing the diagnostic confidence in the cases of MRI doubtful for recurrence in order to avoid a delayed diagnosis.
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Affiliation(s)
| | - Mariano Amo-Salas
- Department of Mathematics, Castilla-La Mancha University, Ciudad Real
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3
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Bernstock JD, Gary SE, Klinger N, Valdes PA, Ibn Essayed W, Olsen HE, Chagoya G, Elsayed G, Yamashita D, Schuss P, Gessler FA, Peruzzi PP, Bag A, Friedman GK. Standard clinical approaches and emerging modalities for glioblastoma imaging. Neurooncol Adv 2022; 4:vdac080. [PMID: 35821676 PMCID: PMC9268747 DOI: 10.1093/noajnl/vdac080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Glioblastoma (GBM) is the most common primary adult intracranial malignancy and carries a dismal prognosis despite an aggressive multimodal treatment regimen that consists of surgical resection, radiation, and adjuvant chemotherapy. Radiographic evaluation, largely informed by magnetic resonance imaging (MRI), is a critical component of initial diagnosis, surgical planning, and post-treatment monitoring. However, conventional MRI does not provide information regarding tumor microvasculature, necrosis, or neoangiogenesis. In addition, traditional MRI imaging can be further confounded by treatment-related effects such as pseudoprogression, radiation necrosis, and/or pseudoresponse(s) that preclude clinicians from making fully informed decisions when structuring a therapeutic approach. A myriad of novel imaging modalities have been developed to address these deficits. Herein, we provide a clinically oriented review of standard techniques for imaging GBM and highlight emerging technologies utilized in disease characterization and therapeutic development.
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Affiliation(s)
- Joshua D Bernstock
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School , Boston, Massachusetts, USA
| | - Sam E Gary
- Medical Scientist Training Program, University of Alabama at Birmingham, Birmingham , AL, USA
| | - Neil Klinger
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School , Boston, Massachusetts, USA
| | - Pablo A Valdes
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School , Boston, Massachusetts, USA
| | - Walid Ibn Essayed
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School , Boston, Massachusetts, USA
| | - Hannah E Olsen
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School , Boston, Massachusetts, USA
| | - Gustavo Chagoya
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham , AL, USA
| | - Galal Elsayed
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham , AL, USA
| | - Daisuke Yamashita
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham , AL, USA
| | - Patrick Schuss
- Department of Neurosurgery, Unfallkrankenhaus Berlin , Berlin, Germany
| | | | - Pier Paolo Peruzzi
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School , Boston, Massachusetts, USA
| | - Asim Bag
- Department of Diagnostic Imaging, St. Jude Children’s Research Hospital , Memphis, TN USA
| | - Gregory K Friedman
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham , AL, USA
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham , Birmingham, AL, USA
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham , AL, USA
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4
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Nardone V, Desideri I, D’Ambrosio L, Morelli I, Visani L, Di Giorgio E, Guida C, Clemente A, Belfiore MP, Cioce F, Spadafora M, Vinciguerra C, Mansi L, Reginelli A, Cappabianca S. Nuclear medicine and radiotherapy in the clinical management of glioblastoma patients. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00495-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Introduction
The aim of the narrative review was to analyse the applications of nuclear medicine (NM) techniques such as PET/CT with different tracers in combination with radiotherapy for the clinical management of glioblastoma patients.
Materials and methods
Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used.
Results
This paper contains a narrative report and a critical discussion of NM approaches in combination with radiotherapy in glioma patients.
Conclusions
NM can provide the Radiation Oncologist several aids that can be useful in the clinical management of glioblastoma patients. At the same, these results need to be validated in prospective and multicenter trials.
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Adhikari A, Singh P, Mahar KS, Adhikari M, Adhikari B, Zhang MR, Tiwari AK. Mapping of Translocator Protein (18 kDa) in Peripheral Sterile Inflammatory Disease and Cancer through PET Imaging. Mol Pharm 2021; 18:1507-1529. [PMID: 33645995 DOI: 10.1021/acs.molpharmaceut.1c00002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Positron emission tomography (PET) imaging of the translocator 18 kDa protein (TSPO) with radioligands has become an effective means of research in peripheral inflammatory conditions that occur in many diseases and cancers. The peripheral sterile inflammatory diseases (PSIDs) are associated with a diverse group of disorders that comprises numerous enduring insults including the cardiovascular, respiratory, gastrointestinal, or musculoskeletal system. TSPO has recently been introduced as a potential biomarker for peripheral sterile inflammatory diseases (PSIDs). The major critical issue related to PSIDs is its timely characterization and localization of inflammatory foci for proper therapy of patients. As an alternative to metabolic imaging, protein imaging expressed on immune cells after activation is of great importance. The five transmembrane domain translocator protein-18 kDa (TSPO) is upregulated on the mitochondrial cell surface of macrophages during inflammation, serving as a potential ligand for PET tracers. Additionally, the overexpressed TSPO protein has been positively correlated with various tumor malignancies. In view of the association of escalated TSPO expression in both disease conditions, it is an immensely important biomarker for PET imaging in oncology and PSIDs. In this review, we summarize the most outstanding advances on TSPO-targeted PSIDs and cancer in the development of TSPO ligands as a potential diagnostic tool, specifically discussing the last five years.
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Affiliation(s)
- Anupriya Adhikari
- Department of Chemistry, Babasaheb Bhimrao Ambedkar University, (A Central University), Lucknow, Uttar Pradesh 226025, India
| | - Priya Singh
- Department of Chemistry, Babasaheb Bhimrao Ambedkar University, A Central University, Lucknow, Uttar Pradesh 226025, India
| | - Kamalesh S Mahar
- Birbal Sahni Institute of Palaeosciences, Lucknow, Uttar Pradesh 226007, India
| | - Manish Adhikari
- The George Washington University, Washington, D.C. 20052, United States
| | - Bhawana Adhikari
- Plasma Bio-science Research Center, Kwangwoon University, Seoul 01897, South Korea
| | - Ming-Rong Zhang
- Department of Advanced Nuclear Medicine Sciences, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba 263-8555, Japan
| | - Anjani Kumar Tiwari
- Department of Chemistry, Babasaheb Bhimrao Ambedkar University, (A Central University), Lucknow, Uttar Pradesh 226025, India
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6
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Li L, Mu W, Wang Y, Liu Z, Liu Z, Wang Y, Ma W, Kong Z, Wang S, Zhou X, Wei W, Cheng X, Lin Y, Tian J. A Non-invasive Radiomic Method Using 18F-FDG PET Predicts Isocitrate Dehydrogenase Genotype and Prognosis in Patients With Glioma. Front Oncol 2019; 9:1183. [PMID: 31803608 PMCID: PMC6869373 DOI: 10.3389/fonc.2019.01183] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/21/2019] [Indexed: 01/15/2023] Open
Abstract
Purpose: We aimed to analyze 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) images via the radiomic method to develop a model and validate the potential value of features reflecting glioma metabolism for predicting isocitrate dehydrogenase (IDH) genotype and prognosis. Methods: PET images of 127 patients were retrospectively analyzed. A series of quantitative features reflecting the metabolic heterogeneity of the tumors were extracted, and a radiomic signature was generated using the support vector machine method. A combined model that included clinical characteristics and the radiomic signature was then constructed by multivariate logistic regression to predict the IDH genotype status, and the model was evaluated and verified by receiver operating characteristic (ROC) curves and calibration curves. Finally, Kaplan-Meier curves and log-rank tests were used to analyze overall survival (OS) according to the predicted result. Results: The generated radiomic signature was significantly associated with IDH genotype (p < 0.05) and could achieve large areas under the ROC curve of 0.911 and 0.900 on the training and validation cohorts, respectively, with the incorporation of age and type of tumor metabolism. The good agreement of the calibration curves in the validation cohort further validated the efficacy of the constructed model. Moreover, the predicted results showed a significant difference in OS between high- and low-risk groups (p < 0.001). Conclusions: Our results indicate that the 18F-FDG metabolism-related features could effectively predict the IDH genotype of gliomas and stratify the OS of patients with different prognoses.
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Affiliation(s)
- Longfei Li
- Collaborative Innovation Center for Internet Healthcare, Zhengzhou University, Zhengzhou, China.,CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Wei Mu
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Yaning Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhenyu Liu
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Zehua Liu
- Collaborative Innovation Center for Internet Healthcare, Zhengzhou University, Zhengzhou, China.,CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Yu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ziren Kong
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuo Wang
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Xuezhi Zhou
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Wei Wei
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China.,School of Electronics and Information, Xi'an Polytechnic University, Xi'an, China
| | - Xin Cheng
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yusong Lin
- Collaborative Innovation Center for Internet Healthcare, Zhengzhou University, Zhengzhou, China.,School of Software, Zhengzhou University, Zhengzhou, China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China.,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, China
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7
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Moreau A, Febvey O, Mognetti T, Frappaz D, Kryza D. Contribution of Different Positron Emission Tomography Tracers in Glioma Management: Focus on Glioblastoma. Front Oncol 2019; 9:1134. [PMID: 31737567 PMCID: PMC6839136 DOI: 10.3389/fonc.2019.01134] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 10/10/2019] [Indexed: 12/19/2022] Open
Abstract
Although rare, glioblastomas account for the majority of primary brain lesions, with a dreadful prognosis. Magnetic resonance imaging (MRI) is currently the imaging method providing the higher resolution. However, it does not always succeed in distinguishing recurrences from non-specific temozolomide, have been shown to improve -related changes caused by the combination of radiotherapy, chemotherapy, and targeted therapy, also called pseudoprogression. Strenuous attempts to overcome this issue is highly required for these patients with a short life expectancy for both ethical and economic reasons. Additional reliable information may be obtained from positron emission tomography (PET) imaging. The development of this technique, along with the emerging of new classes of tracers, can help in the diagnosis, prognosis, and assessment of therapies. We reviewed the current data about the commonly used tracers, such as 18F-fluorodeoxyglucose (18F-FDG) and radiolabeled amino acids, as well as different PET tracers recently investigated, to report their strengths, limitations, and relevance in glioblastoma management.
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Affiliation(s)
| | | | | | | | - David Kryza
- UNIV Lyon - Université Claude Bernard Lyon 1, LAGEPP UMR 5007 CNRS Villeurbanne, Villeurbanne, France
- Hospices Civils de Lyon, Lyon, France
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8
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Kong Z, Li J, Liu Z, Liu Z, Zhao D, Cheng X, Li L, Lin Y, Wang Y, Tian J, Ma W. Radiomics signature based on FDG-PET predicts proliferative activity in primary glioma. Clin Radiol 2019; 74:815.e15-815.e23. [DOI: 10.1016/j.crad.2019.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/26/2019] [Indexed: 01/04/2023]
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9
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Kong Z, Lin Y, Jiang C, Li L, Liu Z, Wang Y, Dai C, Liu D, Qin X, Wang Y, Liu Z, Cheng X, Tian J, Ma W. 18F-FDG-PET-based Radiomics signature predicts MGMT promoter methylation status in primary diffuse glioma. Cancer Imaging 2019; 19:58. [PMID: 31426864 PMCID: PMC6701097 DOI: 10.1186/s40644-019-0246-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 08/05/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The methylation status of the O6-methylguanine-DNA methyltransferase (MGMT) promoter has emerged as a favorable independent prognostic and predictive biomarker in glioma. This study aimed to build a radiomics signature based on 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for noninvasive measurement of the MGMT promoter methylation status in glioma. METHODS One hundred and seven pathology-confirmed primary diffuse glioma patients were retrospectively included and randomly assigned to the primary (n = 71) or validation cohort (n = 36). The MGMT promoter methylation status was measured by pyrosequencing. A total of 1561 radiomics features were extracted from the three-dimensional region of interest (ROI) on the standard uptake value (SUV) maps that were generated from the original 18F-FDG PET data. A radiomics signature, a clinical signature and a fusion signature that combined the clinical and radiomics features together were generated. The performance of the three signatures was evaluated by receiver operating characteristic (ROC) curve analysis, and the patient prognosis was stratified based on the MGMT promoter methylation status and the signature with the best performance. RESULTS Five radiomics features were selected to construct the radiomics signature, and displayed the best performance with area under the receiver operating characteristic (ROC) curve (AUC) reaching 0.94 and 0.86 in the primary and validation cohorts, respectively, which outweigh the performances of clinical signature and fusion signature. With a median follow-up time of 32.4 months, the radiomics signature stratified the glioma patients into two risk groups with significantly different prognoses (p = 0.04). CONCLUSIONS 18F-FDG-PET-based radiomics is a promising approach for preoperatively evaluating the MGMT promoter methylation status in glioma and predicting the prognosis of glioma patients noninvasively.
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Affiliation(s)
- Ziren Kong
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Yusong Lin
- Collaborative Innovation Center for Internet Healthcare, Zhengzhou University, No.75 Daxue Road, Erqi District, Zhengzhou, Henan China
- School of Software, Zhengzhou University, No.75 Daxue Road, Erqi District, Zhengzhou, Henan China
| | - Chendan Jiang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Longfei Li
- Collaborative Innovation Center for Internet Healthcare, Zhengzhou University, No.75 Daxue Road, Erqi District, Zhengzhou, Henan China
| | - Zehua Liu
- Collaborative Innovation Center for Internet Healthcare, Zhengzhou University, No.75 Daxue Road, Erqi District, Zhengzhou, Henan China
| | - Yuekun Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Congxin Dai
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Delin Liu
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Xuying Qin
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
- Key Laboratory of Industrial Microbiology, Tianjin University of Science and Technology, No. 1038 Dagu Nanlu, Hexi District, Tianjin, China
| | - Yu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Zhenyu Liu
- Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Science, No.80 East Zhongguancun Road, Haidian District, Beijing, China
- University of Chinese Academy of Sciences, No.80 East Zhongguancun Road, Haidian District, Beijing, China
| | - Xin Cheng
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Jie Tian
- Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Science, No.80 East Zhongguancun Road, Haidian District, Beijing, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing, China
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi’an, Shaanxi China
- University of Chinese Academy of Sciences, No.80 East Zhongguancun Road, Haidian District, Beijing, China
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
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10
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Takei H, Shinoda J, Ikuta S, Maruyama T, Muragaki Y, Kawasaki T, Ikegame Y, Okada M, Ito T, Asano Y, Yokoyama K, Nakayama N, Yano H, Iwama T. Usefulness of positron emission tomography for differentiating gliomas according to the 2016 World Health Organization classification of tumors of the central nervous system. J Neurosurg 2019; 133:1010-1019. [PMID: 31419796 DOI: 10.3171/2019.5.jns19780] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/17/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Positron emission tomography (PET) is important in the noninvasive diagnostic imaging of gliomas. There are many PET studies on glioma diagnosis based on the 2007 WHO classification; however, there are no studies on glioma diagnosis using the new classification (the 2016 WHO classification). Here, the authors investigated the relationship between uptake of 11C-methionine (MET), 11C-choline (CHO), and 18F-fluorodeoxyglucose (FDG) on PET imaging and isocitrate dehydrogenase (IDH) status (wild-type [IDH-wt] or mutant [IDH-mut]) in astrocytic and oligodendroglial tumors according to the 2016 WHO classification. METHODS In total, 105 patients with newly diagnosed cerebral gliomas (6 diffuse astrocytomas [DAs] with IDH-wt, 6 DAs with IDH-mut, 7 anaplastic astrocytomas [AAs] with IDH-wt, 24 AAs with IDH-mut, 26 glioblastomas [GBMs] with IDH-wt, 5 GBMs with IDH-mut, 19 oligodendrogliomas [ODs], and 12 anaplastic oligodendrogliomas [AOs]) were included. All OD and AO patients had both IDH-mut and 1p/19q codeletion. The maximum standardized uptake value (SUV) of the tumor/mean SUV of normal cortex (T/N) ratios for MET, CHO, and FDG were calculated, and the mean T/N ratios of DA, AA, and GBM with IDH-wt and IDH-mut were compared. The diagnostic accuracy for distinguishing gliomas with IDH-wt from those with IDH-mut was assessed using receiver operating characteristic (ROC) curve analysis of the mean T/N ratios for the 3 PET tracers. RESULTS There were significant differences in the mean T/N ratios for all 3 PET tracers between the IDH-wt and IDH-mut groups of all histological classifications (p < 0.001). Among the 27 gliomas with mean T/N ratios higher than the cutoff values for all 3 PET tracers, 23 (85.2%) were classified into the IDH-wt group using ROC analysis. In DA, there were no significant differences in the T/N ratios for MET, CHO, and FDG between the IDH-wt and IDH-mut groups. In AA, the mean T/N ratios of all 3 PET tracers in the IDH-wt group were significantly higher than those in the IDH-mut group (p < 0.01). In GBM, the mean T/N ratio in the IDH-wt group was significantly higher than that in the IDH-mut group for both MET (p = 0.034) and CHO (p = 0.01). However, there was no significant difference in the ratio for FDG. CONCLUSIONS PET imaging using MET, CHO, and FDG was suggested to be informative for preoperatively differentiating gliomas according to the 2016 WHO classification, particularly for differentiating IDH-wt and IDH-mut tumors.
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Affiliation(s)
- Hiroaki Takei
- 1Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu
- 4Neurosurgery, Gifu University Graduate School of Medicine, Gifu; and
| | - Jun Shinoda
- 1Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu
- 2Departments of Clinical Brain Sciences and
| | - Soko Ikuta
- 3Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Takashi Maruyama
- 3Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoshihiro Muragaki
- 3Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomohiro Kawasaki
- 1Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu
- 4Neurosurgery, Gifu University Graduate School of Medicine, Gifu; and
| | - Yuka Ikegame
- 1Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu
- 2Departments of Clinical Brain Sciences and
| | - Makoto Okada
- 1Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu
| | - Takeshi Ito
- 1Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu
| | - Yoshitaka Asano
- 1Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu
- 2Departments of Clinical Brain Sciences and
| | - Kazutoshi Yokoyama
- 1Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu
| | - Noriyuki Nakayama
- 4Neurosurgery, Gifu University Graduate School of Medicine, Gifu; and
| | - Hirohito Yano
- 4Neurosurgery, Gifu University Graduate School of Medicine, Gifu; and
| | - Toru Iwama
- 4Neurosurgery, Gifu University Graduate School of Medicine, Gifu; and
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Gao L, Xu W, Li T, Zheng J, Chen G. Accuracy of 11C-choline positron emission tomography in differentiating glioma recurrence from radiation necrosis: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e11556. [PMID: 30024551 PMCID: PMC6086532 DOI: 10.1097/md.0000000000011556] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Distinguishing glioma recurrence from the necrosis after radiation therapy and/or chemotherapy is a crucial clinical issue, for the different diagnosis will lead to divergent treatments. The accurate judgment is barely achieved by conventional imaging methods. We therefore assume it is of need to exert a meta-analysis to evaluate the diagnostic accuracy of 11C-choline positron emission tomography (PET), to achieve this goal. MATERIAL AND METHODS We searched the PubMed, Embase, and Chinese Biomedical databases comprehensively to select eligible studies and assessed the quality of each article included (up to May 31, 2018). Fixed-effects models were used. Summary diagnostic accuracy of 11C-choline PET was obtained from pooled analysis. RESULTS Five articles comprising 6 studies with total 118 patients (134 scans) were enrolled for the meta-analysis. There was no heterogeneity or publication bias among the included studies. The pooled sensitivity and specificity were 0.87 (95% confidence interval [CI]: 0.78, 0.93) and 0.820 (95% CI: 0.69, 0.91), respectively. The pooled diagnostic odds ratio was 35.50 (95% CI: 11.70, 107.75). The area under the curve was 0.9170 (95% CI: 0.8504, 0.9836), with Q* index equaling to 0.8499. The diagnostic accuracy of each subgroup showed no statistical differences with that of the overall group. CONCLUSIONS This meta-analysis indicated 11C-choline has high diagnostic accuracy for the identification of tumor relapse from radiation induced necrosis in gliomas.
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12
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Chiang GC, Kovanlikaya I, Choi C, Ramakrishna R, Magge R, Shungu DC. Magnetic Resonance Spectroscopy, Positron Emission Tomography and Radiogenomics-Relevance to Glioma. Front Neurol 2018; 9:33. [PMID: 29459844 PMCID: PMC5807339 DOI: 10.3389/fneur.2018.00033] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/15/2018] [Indexed: 12/22/2022] Open
Abstract
Advances in metabolic imaging techniques have allowed for more precise characterization of gliomas, particularly as it relates to tumor recurrence or pseudoprogression. Furthermore, the emerging field of radiogenomics where radiographic features are systemically correlated with molecular markers has the potential to achieve the holy grail of neuro-oncologic neuro-radiology, namely molecular diagnosis without requiring tissue specimens. In this section, we will review the utility of metabolic imaging and discuss the current state of the art related to the radiogenomics of glioblastoma.
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Affiliation(s)
- Gloria C Chiang
- Department of Neuroradiology, Weill Cornell Medical College, New York, NY, United States
| | - Ilhami Kovanlikaya
- Department of Neuroradiology, Weill Cornell Medical College, New York, NY, United States
| | - Changho Choi
- Radiology, Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Rohan Ramakrishna
- Department of Neurological Surgery, Weill Cornell Medical College, New York, NY, United States
| | - Rajiv Magge
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Dikoma C Shungu
- Department of Neuroradiology, Weill Cornell Medical College, New York, NY, United States
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13
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Abstract
A previous review published in 2012 demonstrated the role of clinical PET for diagnosis and management of brain tumors using mainly FDG, amino acid tracers, and 18F-fluorothymidine. This review provides an update on clinical PET studies, most of which are motivated by prediction of prognosis and planning and monitoring of therapy in gliomas. For FDG, there has been additional evidence supporting late scanning, and combination with 13N ammonia has yielded some promising results. Large neutral amino acid tracers have found widespread applications mostly based on 18F-labeled compounds fluoroethyltyrosine and fluorodopa for targeting biopsies, therapy planning and monitoring, and as outcome markers in clinical trials. 11C-alpha-methyltryptophan (AMT) has been proposed as an alternative to 11C-methionine, and there may also be a role for cyclic amino acid tracers. 18F-fluorothymidine has shown strengths for tumor grading and as an outcome marker. Studies using 18F-fluorocholine (FCH) and 68Ga-labeled compounds are promising but have not yet clearly defined their role. Studies on radiotherapy planning have explored the use of large neutral amino acid tracers to improve the delineation of tumor volume for irradiation and the use of hypoxia markers, in particular 18F-fluoromisonidazole. Many studies employed the combination of PET with advanced multimodal MR imaging methods, mostly demonstrating complementarity and some potential benefits of hybrid PET/MR.
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Affiliation(s)
- Karl Herholz
- The University of Manchester, Division of Neuroscience and Experimental Psychology Wolfson Molecular Imaging Centre, Manchester, England, United Kingdom.
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14
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Chiang GC, Galla N, Ferraro R, Kovanlikaya I. The Added Prognostic Value of Metabolic Tumor Size on FDG-PET at First Suspected Recurrence of Glioblastoma Multiforme. J Neuroimaging 2016; 27:243-247. [DOI: 10.1111/jon.12386] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Gloria C. Chiang
- Department of Radiology, Division of Neuroradiology, Weill Cornell Medical College; NewYork-Presbyterian Hospital; New York NY
| | - Naveen Galla
- Department of Radiology, Division of Neuroradiology, Weill Cornell Medical College; NewYork-Presbyterian Hospital; New York NY
| | - Richard Ferraro
- Department of Radiology, Division of Neuroradiology, Weill Cornell Medical College; NewYork-Presbyterian Hospital; New York NY
| | - Ilhami Kovanlikaya
- Department of Radiology, Division of Neuroradiology, Weill Cornell Medical College; NewYork-Presbyterian Hospital; New York NY
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15
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Fouke SJ, Benzinger T, Gibson D, Ryken TC, Kalkanis SN, Olson JJ. The role of imaging in the management of adults with diffuse low grade glioma: A systematic review and evidence-based clinical practice guideline. J Neurooncol 2015; 125:457-79. [PMID: 26530262 DOI: 10.1007/s11060-015-1908-9] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 08/29/2015] [Indexed: 01/24/2023]
Abstract
QUESTION What is the optimal imaging technique to be used in the diagnosis of a suspected low grade glioma, specifically: which anatomic imaging sequences are critical for most accurately identifying or diagnosing a low grade glioma (LGG) and do non-anatomic imaging methods and/or sequences add to the diagnostic specificity of suspected low grade gliomas? TARGET POPULATION These recommendations apply to adults with a newly diagnosed lesion with a suspected or histopathologically proven LGG. RECOMMENDATION LEVEL II In patients with a suspected brain tumor, the minimum magnetic resonance imaging (MRI) exam should be an anatomic exam with both T2 weighted and pre- and post-gadolinium contrast enhanced T1 weighted imaging. CRITICAL IMAGING FOR THE IDENTIFICATION AND DIAGNOSIS OF LOW GRADE GLIOMA: LEVEL II In patients with a suspected brain tumor, anatomic imaging sequences should include T1 and T2 weighted and Fluid Attenuation Inversion Recovery (FLAIR) MR sequences and will include T1 weighted imaging after the administration of gadolinium based contrast. Computed tomography (CT) can provide additional information regarding calcification or hemorrhage, which may narrow the differential diagnosis. At a minimum, these anatomic sequences can help identify a lesion as well as its location, and potential for surgical intervention. IMPROVEMENT OF DIAGNOSTIC SPECIFICITY WITH THE ADDITION OF NON-ANATOMIC (PHYSIOLOGIC AND ADVANCED IMAGING) TO ANATOMIC IMAGING: LEVEL II Class II evidence from multiple studies and a significant number of Class III series support the addition of diffusion and perfusion weighted MR imaging in the assessment of suspected LGGs, for the purposes of discriminating the potential for tumor subtypes and identification of suspicion of higher grade diagnoses. LEVEL III Multiple series offer Class III evidence to support the potential for magnetic resonance spectroscopy (MRS) and nuclear medicine methods including positron emission tomography and single-photon emission computed tomography imaging to offer additional diagnostic specificity although these are less well defined and their roles in clinical practice are still being defined. QUESTION Which imaging sequences or parameters best predict the biological behavior or prognosis for patients with LGG? TARGET POPULATION These recommendations apply to adults with a newly diagnosed lesion with a suspected or histopathologically proven LGG. RECOMMENDATION Anatomic and advanced imaging methods and prognostic stratification LEVEL III Multiple series suggest a role for anatomic and advanced sequences to suggest prognostic stratification among low grade gliomas. Perfusion weighted imaging, particularly when obtained as a part of diagnostic evaluation (as recommended above) can play a role in consideration of prognosis. Other imaging sequences remain investigational in terms of their role in consideration of tumor prognosis as there is insufficient evidence to support more formal recommendations as to their use at this time. QUESTION What is the optimal imaging technique to be used in the follow-up of a suspected (or biopsy proven) LGG? TARGET POPULATION This recommendation applies to adults with a newly diagnosed low grade glioma. RECOMMENDATIONS LEVEL II In patients with a diagnosis of LGG, anatomic imaging sequences should include T2/FLAIR MR sequences and T1 weighted imaging before and after the administration of gadolinium based contrast. Serial imaging should be performed to identify new areas of contrast enhancement or significant change in tumor size, which may signify transformation to a higher grade. LEVEL III Advanced imaging utility may depend on tumor subtype. Multicenter clinical trials with larger cohorts are needed. For astrocytic tumors, baseline and longitudinal elevations in tumor perfusion as assessed by dynamic susceptibility contrast perfusion MRI are associated with shorter time to tumor progression, but can be difficult to standardize in clinical practice. For oligodendrogliomas and mixed gliomas, MRS may be helpful for identification of progression.
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Affiliation(s)
- Sarah Jost Fouke
- Swedish Neuroscience Institute, 751 Northeast Blakely Drive, Suite 4020, Seattle, WA, USA.
| | | | - Daniel Gibson
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Timothy C Ryken
- Department of Neurosurgery, Kansas University Medical Center, Kansas City, KS, USA
| | - Steven N Kalkanis
- Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA
| | - Jeffrey J Olson
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA
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16
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Buck JR, McKinley ET, Fu A, Abel TW, Thompson RC, Chambless L, Watchmaker JM, Harty JP, Cooper MK, Manning HC. Preclinical TSPO Ligand PET to Visualize Human Glioma Xenotransplants: A Preliminary Study. PLoS One 2015; 10:e0141659. [PMID: 26517124 PMCID: PMC4627825 DOI: 10.1371/journal.pone.0141659] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 10/12/2015] [Indexed: 11/18/2022] Open
Abstract
Current positron emission tomography (PET) imaging biomarkers for detection of infiltrating gliomas are limited. Translocator protein (TSPO) is a novel and promising biomarker for glioma PET imaging. To validate TSPO as a potential target for molecular imaging of glioma, TSPO expression was assayed in a tumor microarray containing 37 high-grade (III, IV) gliomas. TSPO staining was detected in all tumor specimens. Subsequently, PET imaging was performed with an aryloxyanilide-based TSPO ligand, [18F]PBR06, in primary orthotopic xenograft models of WHO grade III and IV gliomas. Selective uptake of [18F]PBR06 in engrafted tumor was measured. Furthermore, PET imaging with [18F]PBR06 demonstrated infiltrative glioma growth that was undetectable by traditional magnetic resonance imaging (MRI). Preliminary PET with [18F]PBR06 demonstrated a preferential tumor-to-normal background ratio in comparison to 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG). These results suggest that TSPO PET imaging with such high-affinity radiotracers may represent a novel strategy to characterize distinct molecular features of glioma growth, as well as better define the extent of glioma infiltration for therapeutic purposes.
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Affiliation(s)
- Jason R. Buck
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Eliot T. McKinley
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Allie Fu
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Ty W. Abel
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Reid C. Thompson
- Vanderbilt-Ingram Cancer Center (VICC), Vanderbilt University Medical Center, Nashville, TN, United States of America
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Lola Chambless
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Jennifer M. Watchmaker
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, TN, United States of America
- Program in Chemical and Physical Biology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - James P. Harty
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Michael K. Cooper
- Vanderbilt-Ingram Cancer Center (VICC), Vanderbilt University Medical Center, Nashville, TN, United States of America
- Neurology Service, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, United States of America
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - H. Charles Manning
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, TN, United States of America
- Vanderbilt-Ingram Cancer Center (VICC), Vanderbilt University Medical Center, Nashville, TN, United States of America
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, United States of America
- Program in Chemical and Physical Biology, Vanderbilt University Medical Center, Nashville, TN, United States of America
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States of America
- * E-mail:
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17
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Bell C, Dowson N, Puttick S, Gal Y, Thomas P, Fay M, Smith J, Rose S. Increasing feasibility and utility of (18)F-FDOPA PET for the management of glioma. Nucl Med Biol 2015; 42:788-95. [PMID: 26162582 DOI: 10.1016/j.nucmedbio.2015.06.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/27/2015] [Accepted: 06/03/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Despite radical treatment therapies, glioma continues to carry with it a uniformly poor prognosis. Patients diagnosed with WHO Grade IV glioma (glioblastomas; GBM) generally succumb within two years, even those with WHO Grade III anaplastic gliomas and WHO Grade II gliomas carry prognoses of 2-5 and 2 years, respectively. PET imaging with (18)F-FDOPA allows in vivo assessment of the metabolism of glioma relative to surrounding tissues. The high sensitivity of (18)F-DOPA imaging grants utility for a number of clinical applications. METHODS A collection of published work about (18)F-FDOPA PET was made and a critical review was discussed and written. RESULTS A number of research papers have been published demonstrating that in conjunction with MRI, (18)F-FDOPA PET provides greater sensitivity and specificity than these modalities in detection, grading, prognosis and validation of treatment success in both primary and recurrent gliomas. In further comparisons with (11)C-MET, (18)F-FLT, (18)F-FET and MRI, (18)F-FDOPA has shown similar or better efficacy. Recently synthesis cassettes have become available, making (18)F-FDOPA more accessible. CONCLUSIONS According to the available data, (18)F-FDOPA PET is a viable radiotracer for imaging and treatment planning of gliomas. ADVANCES IN KNOWLEDGE AND IMPLICATION FOR PATIENT CARE (18)F-FDOPA PET appears to be a viable radiopharmaceutical for the diagnosis and treatment planning of gliomas cases, improving on that of MRI and (18)F-FDG PET.
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Affiliation(s)
- Christopher Bell
- CSIRO Preventative Health Flagship, CSIRO Computational Informatics, The Australian e-Health Research Centre, Herston QLD 4029, Australia; The University of Queensland, School of Medicine, St. Lucia QLD 4072, Australia
| | - Nicholas Dowson
- CSIRO Preventative Health Flagship, CSIRO Computational Informatics, The Australian e-Health Research Centre, Herston QLD 4029, Australia
| | - Simon Puttick
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia QLD 4072, Australia
| | - Yaniv Gal
- The University of Queensland, Centre for Medical Diagnostic Technologies in Queensland, St. Lucia QLD 4072, Australia
| | - Paul Thomas
- Department of Radiation Oncology, Royal Brisbane and Women's Hospital, Herston QLD 4029, Australia
| | - Mike Fay
- The University of Queensland, School of Medicine, St. Lucia QLD 4072, Australia; Genesis Cancer Care, Lake Macquarie Private Hospital, 36 Pacific Highway, Gateshead NSW 2290, Australia; Specialised PET Services Queensland, Royal Brisbane and Women's Hospital, Herston QLD 4029, Australia
| | - Jye Smith
- The University of Queensland, School of Medicine, St. Lucia QLD 4072, Australia; Specialised PET Services Queensland, Royal Brisbane and Women's Hospital, Herston QLD 4029, Australia
| | - Stephen Rose
- CSIRO Preventative Health Flagship, CSIRO Computational Informatics, The Australian e-Health Research Centre, Herston QLD 4029, Australia.
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18
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Zhao X, Bai HX, Zou Y, Yang L. Letter: Reoperation for recurrent high-grade glioma: does tumor genetics play a role? Neurosurgery 2015; 76:E496-7. [PMID: 25635893 DOI: 10.1227/neu.0000000000000666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Xin Zhao
- *Department of Neurology, The Second Xiangya Hospital of Central South University, Changsha, China ‡Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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20
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Li W, Ma L, Wang X, Sun J, Wang S, Hu X. 11C-choline PET/CT tumor recurrence detection and survival prediction in post-treatment patients with high-grade gliomas. Tumour Biol 2014; 35:12353-60. [DOI: 10.1007/s13277-014-2549-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 08/25/2014] [Indexed: 11/30/2022] Open
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21
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Zhao F, Cui Y, Li M, Fu Z, Chen Z, Kong L, Yang G, Yu J. Prognostic value of 3′-Deoxy-3′-18F-Fluorothymidine ([18F] FLT PET) in patients with recurrent malignant gliomas. Nucl Med Biol 2014; 41:710-5. [DOI: 10.1016/j.nucmedbio.2014.04.134] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 04/25/2014] [Accepted: 04/30/2014] [Indexed: 10/25/2022]
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22
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Li D, Zhao X, Zhang L, Li F, Ji N, Gao Z, Wang J, Kang P, Liu Z, Shi J, Chen X, Zhu Z. (68)Ga-PRGD2 PET/CT in the evaluation of Glioma: a prospective study. Mol Pharm 2014; 11:3923-9. [PMID: 25093246 PMCID: PMC4224544 DOI: 10.1021/mp5003224] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
![]()
Integrin αvβ3 is overexpressed
in both neovasculature and glioma cells. We aimed to evaluate 68gallium-BNOTA-PRGD2 (68Ga-PRGD2) as a new reagent
for noninvasive integrin αvβ3 imaging
in glioma patients. With informed consent, 12 patients with suspicious
brain glioma, as diagnosed by enhanced magnetic resonance imaging
(MRI) scanning, were enrolled to undergo 68Ga-PRGD2 PET/CT
and 18F-FDG PET/CT scans before surgery. The preoperative
images were compared and correlated with the pathologically determined
WHO grade. Next, the expression of integrin αvβ3, CD34, and Ki-67 were determined
by immunohistochemical staining of the resected brain tumor tissue.
Our findings demonstrated that 68Ga-PRGD2 specifically
accumulated in the brain tumors that were rich of integrin αvβ3 and other neovasculature markers, but
not in the brain parenchyma other than the choroid plexus. Therefore, 68Ga-PRGD2 PET/CT was able to evaluate the glioma demarcation
more specifically than 18F-FDG PET/CT. The maximum standardized
uptake values (SUVmax) of 68Ga-PRGD2, rather than those
of 18F-FDG, were significantly correlated with the glioma
grading. The maximum tumor-to-brain ratios (TBRmax) of both tracers
were significantly correlated with glioma grading, whereas 68Ga-PRGD2 seemed to be more superior to 18F-FDG in differentiating
high-grade glioma (HGG) from low-grade glioma (LGG). Moreover, 68Ga-PRGD2 PET/CT showed different accumulation patterns for
HGG of WHO grades III and IV. This is the first noninvasive integrin
imaging study, to the best of our knowledge, conducted in preoperative
patients with different grades of glioma, and it preliminarily indicated
the effectiveness of this novel method for evaluating glioma grading
and demarcation.
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Affiliation(s)
- Deling Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University ; China National Clinical Research Center for Neurological Diseases (NCRC-ND); Beijing Key Laboratory of Brian Tumor, Beijing, China
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23
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Perfusion-metabolism coupling in recurrent gliomas: a prospective validation study with 13N-ammonia and 18F-fluorodeoxyglucose PET/CT. Neuroradiology 2014; 56:893-902. [PMID: 24989883 DOI: 10.1007/s00234-014-1389-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/03/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION We assessed the validity of "perfusion-metabolism coupling" hypothesis in recurrent glioma with 13N-ammonia (13N-NH3) PET/CT and 18F-fluorodeoxyglucose (18F-FDG) PET/CT. METHODS Fifty-six consecutive patients (age, 38.8 ± 12.1 years; 62.5% males) with histologically proven and previously treated glioma presenting with clinical suspicion of recurrence were prospectively enrolled and evaluated with 13N-NH3 PET/CT and 18F-FDG PET/CT. PET/CT images were evaluated both qualitatively and semiquantitatively. Tumor to white matter uptake ratio (T/W) and tumor to gray matter uptake ratio (T/G) were calculated and analyzed for both the modalities. A combination of clinico-radiological follow-up, repeated imaging, and biopsy (when available) were considered as the reference standard. RESULTS Based on the reference standard, 27/56 patients had recurrence. 13N-NH3 PET/CT and 18F-FDG PET/CT were concordant in 55/56 patients. Overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 13N-NH3PET/CT were 77.8, 86.2, 84.0, 80.7, and 82.1%, respectively, and for 18F-FDG PET/CT were 77.8, 89.7, 87.5, 81.2, and 83.9%, respectively. There was excellent agreement between results of 13N-NH3 PET/CT and 18F-FDG PET/CT (ĸ = 0.964; P < 0.001). The performances of 13N-NH3 PET/CT and 18F-FDG PET/CT were not significantly different between high-grade and low-grade glioma (P = 1.000). A strong positive correlation was noted between the uptake ratios derived on the two modalities (ρ = 0.866, P < 0.001 for T/W; ρ = 0.918, P < 0.001 for T/G). CONCLUSION A combination of 13N-NH3 PET/CT and 18F-FDG PET/CT demonstrates that perfusion and metabolism are coupled in recurrent gliomas. These tracers target two different but interrelated aspects of the same pathologic process and can be used as surrogates for each other.
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24
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Williams LM, Morandi F, Osborne DR, Narak J, LeBlanc AK. Kinetic analysis of 2-([(18)F]fluoro)-2-deoxy-d-glucose uptake in brains of anesthetized healthy dogs. Am J Vet Res 2014; 75:588-94. [PMID: 24866515 DOI: 10.2460/ajvr.75.6.588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess kinetic 2-([(18)F]fluoro)-2-deoxy-d-glucose ((18)FDG) uptake in the brain of anesthetized healthy adult dogs by use of positron emission tomography (PET) and to determine whether (18)FDG uptake differs among anatomic regions of the brain. ANIMALS 5 healthy Beagles. PROCEDURES Each isoflurane-anesthetized dog was administered (18)FDG IV (dose range, 3.0 to 5.2 mCi), and PET data were acquired for 2 hours. A CT scan (without contrast agent administration) was performed to allow more precise neuroanatomic localization. Defined regions of interest within the brain were drawn on reconstructed image data. Standard uptake values (SUVs) for (18)FDG were calculated to generate time-activity curves and determine time to peak uptake. RESULTS Time-activity curve analysis identified 4 regional uptake patterns: olfactory, gray matter, white matter, and other (brainstem, cerebellum, and occipital and frontal regions). The highest maximum SUVs were identified in the olfactory bulbs and cerebral gray matter, and the lowest maximum SUV was identified in cerebral white matter. Mean time to peak uptake ranged from 37.8 minutes in white matter to 82.7 minutes in the olfactory bulbs. CONCLUSIONS AND CLINICAL RELEVANCE Kinetic analysis of (18)FDG uptake revealed differences in uptake values among anatomic areas of the brain in dogs. These data provide a baseline for further investigation of (18)FDG uptake in dogs with immune-mediated inflammatory brain disease and suggest that (18)FDG-PET scanning has potential use for antemortem diagnosis without histologic analysis and for monitoring response to treatment. In clinical cases, a 1-hour period of PET scanning should provide sufficient pertinent data.
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Affiliation(s)
- Lindsay M Williams
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996
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25
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Yeung TPC, Yartsev S, Lee TY, Wong E, He W, Fisher B, VanderSpek LL, Macdonald D, Bauman G. Relationship of computed tomography perfusion and positron emission tomography to tumour progression in malignant glioma. J Med Radiat Sci 2014; 61:4-13. [PMID: 26229630 PMCID: PMC4175825 DOI: 10.1002/jmrs.37] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/21/2013] [Accepted: 11/27/2013] [Indexed: 12/23/2022] Open
Abstract
IntroductionThis study aimed to explore the potential for computed tomography (CT) perfusion and 18-Fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting sites of future progressive tumour on a voxel-by-voxel basis after radiotherapy and chemotherapy. MethodsTen patients underwent pre-radiotherapy magnetic resonance (MR), FDG-PET and CT perfusion near the end of radiotherapy and repeated post-radiotherapy follow-up MR scans. The relationships between these images and tumour progression were assessed using logistic regression. Cross-validation with receiver operating characteristic (ROC) analysis was used to assess the value of these images in predicting sites of tumour progression. ResultsPre-radiotherapy MR-defined gross tumour; near-end-of-radiotherapy CT-defined enhancing lesion; CT perfusion blood flow (BF), blood volume (BV) and permeability-surface area (PS) product; FDG-PET standard uptake value (SUV); and SUV:BF showed significant associations with tumour progression on follow-up MR imaging (P < 0.0001). The mean sensitivity (±standard deviation), specificity and area under the ROC curve (AUC) of PS were 0.64 ± 0.15, 0.74 ± 0.07 and 0.72 ± 0.12 respectively. This mean AUC was higher than that of the pre-radiotherapy MR-defined gross tumour and near-end-of-radiotherapy CT-defined enhancing lesion (both AUCs = 0.6 ± 0.1, P ≤ 0.03). The multivariate model using BF, BV, PS and SUV had a mean AUC of 0.8 ± 0.1, but this was not significantly higher than the PS only model. ConclusionPS is the single best predictor of tumour progression when compared to other parameters, but voxel-based prediction based on logistic regression had modest sensitivity and specificity.
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Affiliation(s)
- Timothy P C Yeung
- London Regional Cancer Program, London Health Sciences Centre Ontario, Canada, N6A 4L6 ; Robarts Research Institute, The University of Western Ontario Ontario, Canada, N6A 5B7 ; Department of Medical Biophysics, The University of Western Ontario Ontario, Canada, N6A 5C1
| | - Slav Yartsev
- London Regional Cancer Program, London Health Sciences Centre Ontario, Canada, N6A 4L6 ; Department of Medical Biophysics, The University of Western Ontario Ontario, Canada, N6A 5C1 ; Department of Oncology, The University of Western Ontario, London Health Sciences Centre, London Regional Cancer Program Ontario, Canada, N6A 4L6
| | - Ting-Yim Lee
- Robarts Research Institute, The University of Western Ontario Ontario, Canada, N6A 5B7 ; Department of Medical Biophysics, The University of Western Ontario Ontario, Canada, N6A 5C1 ; Department of Oncology, The University of Western Ontario, London Health Sciences Centre, London Regional Cancer Program Ontario, Canada, N6A 4L6 ; Department of Medical Imaging, The University of Western Ontario, London Health Sciences Centre, Victoria Hospital Ontario, Canada, N6A 5W9 ; Lawson Health Research Institute, St. Joseph's Health Care London Ontario, Canada, N6A 4V2
| | - Eugene Wong
- London Regional Cancer Program, London Health Sciences Centre Ontario, Canada, N6A 4L6 ; Department of Oncology, The University of Western Ontario, London Health Sciences Centre, London Regional Cancer Program Ontario, Canada, N6A 4L6 ; Department of Physics and Astronomy, The University of Western Ontario Ontario, Canada, N6A 3K7
| | - Wenqing He
- Department of Statistical and Actuarial Sciences, The University of Western Ontario Ontario, Canada, N6A 5B7
| | - Barbara Fisher
- London Regional Cancer Program, London Health Sciences Centre Ontario, Canada, N6A 4L6 ; Department of Oncology, The University of Western Ontario, London Health Sciences Centre, London Regional Cancer Program Ontario, Canada, N6A 4L6
| | - Lauren L VanderSpek
- London Regional Cancer Program, London Health Sciences Centre Ontario, Canada, N6A 4L6 ; Department of Oncology, The University of Western Ontario, London Health Sciences Centre, London Regional Cancer Program Ontario, Canada, N6A 4L6
| | - David Macdonald
- London Regional Cancer Program, London Health Sciences Centre Ontario, Canada, N6A 4L6 ; Department of Oncology, The University of Western Ontario, London Health Sciences Centre, London Regional Cancer Program Ontario, Canada, N6A 4L6 ; Department of Clinical Neurological Sciences, The University of Western Ontario, London Health Sciences Centre, University Hospital Ontario, Canada, N6A 5A5
| | - Glenn Bauman
- London Regional Cancer Program, London Health Sciences Centre Ontario, Canada, N6A 4L6 ; Department of Medical Biophysics, The University of Western Ontario Ontario, Canada, N6A 5C1 ; Department of Oncology, The University of Western Ontario, London Health Sciences Centre, London Regional Cancer Program Ontario, Canada, N6A 4L6
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Karunanithi S, Sharma P, Kumar A, Gupta DK, Khangembam BC, Ballal S, Kumar R, Kumar R, Bal C. Can 18F-FDOPA PET/CT predict survival in patients with suspected recurrent glioma? A prospective study. Eur J Radiol 2014; 83:219-25. [DOI: 10.1016/j.ejrad.2013.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 09/01/2013] [Accepted: 09/04/2013] [Indexed: 11/29/2022]
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