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Galldiks N, Kaufmann TJ, Vollmuth P, Lohmann P, Smits M, Veronesi MC, Langen KJ, Rudà R, Albert NL, Hattingen E, Law I, Hutterer M, Soffietti R, Vogelbaum MA, Wen PY, Weller M, Tonn JC. Challenges, limitations, and pitfalls of PET and advanced MRI in patients with brain tumors: A report of the PET/RANO group. Neuro Oncol 2024; 26:1181-1194. [PMID: 38466087 PMCID: PMC11226881 DOI: 10.1093/neuonc/noae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Indexed: 03/12/2024] Open
Abstract
Brain tumor diagnostics have significantly evolved with the use of positron emission tomography (PET) and advanced magnetic resonance imaging (MRI) techniques. In addition to anatomical MRI, these modalities may provide valuable information for several clinical applications such as differential diagnosis, delineation of tumor extent, prognostication, differentiation between tumor relapse and treatment-related changes, and the evaluation of response to anticancer therapy. In particular, joint recommendations of the Response Assessment in Neuro-Oncology (RANO) Group, the European Association of Neuro-oncology, and major European and American Nuclear Medicine societies highlighted that the additional clinical value of radiolabeled amino acids compared to anatomical MRI alone is outstanding and that its widespread clinical use should be supported. For advanced MRI and its steadily increasing use in clinical practice, the Standardization Subcommittee of the Jumpstarting Brain Tumor Drug Development Coalition provided more recently an updated acquisition protocol for the widely used dynamic susceptibility contrast perfusion MRI. Besides amino acid PET and perfusion MRI, other PET tracers and advanced MRI techniques (e.g. MR spectroscopy) are of considerable clinical interest and are increasingly integrated into everyday clinical practice. Nevertheless, these modalities have shortcomings which should be considered in clinical routine. This comprehensive review provides an overview of potential challenges, limitations, and pitfalls associated with PET imaging and advanced MRI techniques in patients with gliomas or brain metastases. Despite these issues, PET imaging and advanced MRI techniques continue to play an indispensable role in brain tumor management. Acknowledging and mitigating these challenges through interdisciplinary collaboration, standardized protocols, and continuous innovation will further enhance the utility of these modalities in guiding optimal patient care.
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Affiliation(s)
- Norbert Galldiks
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM-3, INM-4), Research Center Juelich, Juelich, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
| | | | - Philipp Vollmuth
- Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Philipp Lohmann
- Institute of Neuroscience and Medicine (INM-3, INM-4), Research Center Juelich, Juelich, Germany
| | - Marion Smits
- Department of Radiology and Nuclear Medicine and Brain Tumour Center, Erasmus MC, Rotterdam, The Netherlands
| | - Michael C Veronesi
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-3, INM-4), Research Center Juelich, Juelich, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Roberta Rudà
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy
| | - Nathalie L Albert
- Department of Nuclear Medicine, LMU Hospital, Ludwig Maximilians-University of Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elke Hattingen
- Goethe University, Department of Neuroradiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Ian Law
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Markus Hutterer
- Department of Neurology with Acute Geriatrics, Saint John of God Hospital, Linz, Austria
| | - Riccardo Soffietti
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy
| | - Michael A Vogelbaum
- Department of Neuro-Oncology and Neurosurgery, Moffit Cancer Center, Tampa, Florida, USA
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, and University Hospital of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Joerg-Christian Tonn
- German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurosurgery, University Hospital of Munich (LMU), Munich, Germany
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2
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Chaban A, Waschulzik B, Bernhardt D, Delbridge C, Schmidt-Graf F, Wagner A, Wiestler B, Weber W, Yakushev I. Amino acid PET vs. RANO MRI for prediction of overall survival in patients with recurrent high grade glioma under bevacizumab therapy. Eur J Nucl Med Mol Imaging 2024; 51:1698-1702. [PMID: 38228970 PMCID: PMC11043199 DOI: 10.1007/s00259-024-06601-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE To summarize evidence on the comparative value of amino acid (AA) PET and conventional MRI for prediction of overall survival (OS) in patients with recurrent high grade glioma (rHGG) under bevacizumab therapy. METHODS Medical databases were screened for studies with individual data on OS, follow-up MRI, and PET findings in the same patient. MRI images were assessed according to the RANO criteria. A receiver operating characteristic curve analysis was used to predict OS at 9 months. RESULTS Five studies with a total of 72 patients were included. Median OS was significantly lower in the PET-positive than in the PET-negative group. PET findings predicted OS with a pooled sensitivity and specificity of 76% and 71%, respectively. Corresponding values for MRI were 32% and 82%. Area under the curve and sensitivity were significantly higher for PET than for MRI. CONCLUSION For monitoring of patients with rHGG under bevacizumab therapy, AA-PET should be preferred over RANO MRI.
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Affiliation(s)
- Artem Chaban
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Birgit Waschulzik
- Institute of AI and Informatics in Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Denise Bernhardt
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiation Oncology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Claire Delbridge
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Pathology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Friederike Schmidt-Graf
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Arthur Wagner
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Neurosurgery, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Benedikt Wiestler
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
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3
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Park SY, Lee MK, Han EJ, Jeon YW. Cerebrovascular Malformation Mimicking Recurrent Lymphoma on Dual Time-Point 18F-FDOPA PET. Clin Nucl Med 2024; 49:232-233. [PMID: 38306374 DOI: 10.1097/rlu.0000000000005023] [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: 02/04/2024]
Abstract
ABSTRACT Although 18F-FDG is the dominant radiotracer for PET imaging of hematological malignancies, radiolabeled amino acids have also been investigated to improve image quality in areas of high 18F-FDG uptake such as the central nervous system. We present a case of a 57-year-old woman who underwent an 18F-FDOPA scan for primary CNS lymphoma, which demonstrated an unexpected false-positive uptake in the right frontal lobe, due to a developmental venous anomaly.
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Affiliation(s)
| | | | - Eun Ji Han
- From the Division of Nuclear Medicine, Department of Radiology
| | - Young-Woo Jeon
- Department of Hematology, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Huang Y, Chen H, Zhang L, Xie Y, Li C, Yu Z, Jiang Z, Zheng W, Li Z, Ge X, Liang Y, Wu Z. Design of Novel 18F-Labeled Amino Acid Tracers Using Sulfur 18F-Fluoride Exchange Click Chemistry. ACS Med Chem Lett 2024; 15:294-301. [PMID: 38352831 PMCID: PMC10860173 DOI: 10.1021/acsmedchemlett.3c00557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Abstract
[18F]Gln-OSO2F, [18F]Arg-OSO2F, and [18F]FSY-OSO2F were designed by introducing sulfonyl 18F-fluoride onto glutamine, arginine, and tyrosine, respectively. [18F]FSY-OSO2F can be prepared directly by sulfur 18F-fluoride exchange, while [18F]Gln-OSO2F and [18F]Arg-OSO2F require a two-step labeling method. Those tracers retain their typical transport characteristics for unmodified amino acids. Both PET imaging and biodistribution confirmed that [18F]FSY-OSO2F visualized MCF-7 and 22Rv1 subcutaneous tumors with high contrast, and its tumor-to-muscle ratio was better than that of [18F]FET. However, [18F]Gln-OSO2F and [18F]Arg-OSO2F poorly image MCF-7 subcutaneous tumors, possibly due to differences in the types and amounts of transporters expressed in tumors. All three tracers can visualize the U87MG glioma. According to our biological evaluation, none of the tracers evaluated in this study exhibited obvious defluorination, and subtle structural changes led to different imaging characteristics, indicating that the application of sulfur 18F-fluoride exchange click chemistry in the design of radioactive sulfonyl fluoride amino acids is feasible and offers significant advantages.
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Affiliation(s)
- Yong Huang
- Department
of Nuclear Medicine, National Cancer Center, National Clinical Research
Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College, Shenzhen 518116, China
| | - Hualong Chen
- Beijing
Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry
of Science and Technology, Collaborative Innovation Center for Brain
Disorders, Capital Medical University, Beijing 100069, China
| | - Lu Zhang
- Beijing
Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry
of Science and Technology, Collaborative Innovation Center for Brain
Disorders, Capital Medical University, Beijing 100069, China
| | - Yi Xie
- Beijing
Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry
of Science and Technology, Collaborative Innovation Center for Brain
Disorders, Capital Medical University, Beijing 100069, China
| | - Chengze Li
- Department
of Nuclear Medicine, National Cancer Center, National Clinical Research
Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College, Shenzhen 518116, China
| | - Ziyue Yu
- Beijing
Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry
of Science and Technology, Collaborative Innovation Center for Brain
Disorders, Capital Medical University, Beijing 100069, China
| | - Zeng Jiang
- Beijing
Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry
of Science and Technology, Collaborative Innovation Center for Brain
Disorders, Capital Medical University, Beijing 100069, China
| | - Wei Zheng
- Beijing
Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry
of Science and Technology, Collaborative Innovation Center for Brain
Disorders, Capital Medical University, Beijing 100069, China
| | - Zhongjing Li
- Department
of Nuclear Medicine, National Cancer Center, National Clinical Research
Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College, Shenzhen 518116, China
| | - Xuan Ge
- Beijing
Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry
of Science and Technology, Collaborative Innovation Center for Brain
Disorders, Capital Medical University, Beijing 100069, China
| | - Ying Liang
- Department
of Nuclear Medicine, National Cancer Center, National Clinical Research
Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College, Shenzhen 518116, China
| | - Zehui Wu
- Beijing
Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry
of Science and Technology, Collaborative Innovation Center for Brain
Disorders, Capital Medical University, Beijing 100069, China
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5
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Albert NL, Galldiks N, Ellingson BM, van den Bent MJ, Chang SM, Cicone F, de Groot J, Koh ES, Law I, Le Rhun E, Mair MJ, Minniti G, Rudà R, Scott AM, Short SC, Smits M, Suchorska B, Tolboom N, Traub-Weidinger T, Tonn JC, Verger A, Weller M, Wen PY, Preusser M. PET-based response assessment criteria for diffuse gliomas (PET RANO 1.0): a report of the RANO group. Lancet Oncol 2024; 25:e29-e41. [PMID: 38181810 DOI: 10.1016/s1470-2045(23)00525-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 01/07/2024]
Abstract
Response Assessment in Neuro-Oncology (RANO) response criteria have been established and were updated in 2023 for MRI-based response evaluation of diffuse gliomas in clinical trials. In addition, PET-based imaging with amino acid tracers is increasingly considered for disease monitoring in both clinical practice and clinical trials. So far, a standardised framework defining timepoints for baseline and follow-up investigations and response evaluation criteria for PET imaging of diffuse gliomas has not been established. Therefore, in this Policy Review, we propose a set of criteria for response assessment based on amino acid PET imaging in clinical trials enrolling participants with diffuse gliomas as defined in the 2021 WHO classification of tumours of the central nervous system. These proposed PET RANO criteria provide a conceptual framework that facilitates the structured implementation of PET imaging into clinical research and, ultimately, clinical routine. To this end, the PET RANO 1.0 criteria are intended to encourage specific investigations of amino acid PET imaging of gliomas.
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Affiliation(s)
- Nathalie L Albert
- Department of Nuclear Medicine, LMU Hospital, LMU Munich, Munich, Germany
| | - Norbert Galldiks
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany; Center for Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, Cologne, Germany
| | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Susan M Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Francesco Cicone
- Nuclear Medicine Unit, Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - John de Groot
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Eng-Siew Koh
- Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centre, Liverpool, NSW, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Ian Law
- Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Emilie Le Rhun
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland; Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Maximilian J Mair
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Giuseppe Minniti
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy; IRCCS Neuromed, Pozzilli IS, Italy
| | - Roberta Rudà
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin and City of Health and Science of Turin, Turin, Italy
| | - Andrew M Scott
- Department of Molecular Imaging and Therapy, Austin Health and University of Melbourne, Melbourne, VIC, Australia; Olivia Newton-John Cancer Research Institute and School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia
| | - Susan C Short
- Leeds Institute of Medical Research at St James's, The University of Leeds, Leeds, UK
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, Netherlands; Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, Netherlands; Medical Delta, Delft, Netherlands
| | - Bogdana Suchorska
- Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Nelleke Tolboom
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, Netherlands
| | - Tatjana Traub-Weidinger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | | | - Antoine Verger
- Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy and IADI INSERM UMR 1254, Universitè de Lorraine, Nancy, France
| | - Michael Weller
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland; Department of Neurology, University of Zurich, Zurich, Switzerland
| | - Patrick Y Wen
- Center For Neuro-Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
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Manzarbeitia-Arroba B, Hodolic M, Pichler R, Osipova O, Soriano-Castrejón ÁM, García-Vicente AM. 18F-Fluoroethyl-L Tyrosine Positron Emission Tomography Radiomics in the Differentiation of Treatment-Related Changes from Disease Progression in Patients with Glioblastoma. Cancers (Basel) 2023; 16:195. [PMID: 38201621 PMCID: PMC10778283 DOI: 10.3390/cancers16010195] [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: 10/27/2023] [Revised: 12/10/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
The follow-up of glioma patients after therapeutic intervention remains a challenging topic, as therapy-related changes can emulate true progression in contrast-enhanced magnetic resonance imaging. 18F-fluoroethyl-tyrosine (18F-FET) is a radiopharmaceutical that accumulates in glioma cells due to an increased expression of L-amino acid transporters and, contrary to gadolinium, does not depend on blood-brain barrier disruption to reach tumoral cells. It has demonstrated a high diagnostic value in the differentiation of tumoral viability and pseudoprogression or any other therapy-related changes, especially when combining traditional visual analysis with modern radiomics. In this review, we aim to cover the potential role of 18F-FET positron emission tomography in everyday clinical practice when applied to the follow-up of patients after the first therapeutical intervention, early response evaluation, and the differential diagnosis between therapy-related changes and progression.
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Affiliation(s)
| | - Marina Hodolic
- Nuclear Medicine Department, Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic;
| | - Robert Pichler
- Institute of Nuclear Medicine Kepler University Hospital—Neuromed Campus, 4020 Linz, Austria; (R.P.); (O.O.)
| | - Olga Osipova
- Institute of Nuclear Medicine Kepler University Hospital—Neuromed Campus, 4020 Linz, Austria; (R.P.); (O.O.)
| | | | - Ana María García-Vicente
- Nuclear Medicine Department, University Hospital of Toledo, 45007 Toledo, Spain; (B.M.-A.); (Á.M.S.-C.)
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7
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Huang Y, Liu Y, Li C, Li Z, Chen H, Zhang L, Liang Y, Wu Z. Evaluation of (2S,4S)-4-[ 18F]FEBGln as a Positron Emission Tomography Tracer for Tumor Imaging. Mol Pharm 2023; 20:5195-5205. [PMID: 37647563 DOI: 10.1021/acs.molpharmaceut.3c00544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Glutamine metabolism-related tracers have the potential to visualize numerous tumors because glutamine is the second largest source of energy for tumors. (2S,4S)-4-[18F]FEBGln was designed by introducing [18F]fluoroethoxy benzyl on carbon-4 of glutamine. The aim of this study was to investigate the pharmacokinetic properties and tumor positron emission tomography (PET) imaging characteristics of (2S,4S)-4-[18F]FEBGln in detail. The biodistribution results of nude mice bearing MCF-7 tumor showed that (2S,4S)-4-[18F]FEBGln had high initial tumor uptake, and a fast clearance rate, resulting in a high tumor-to-muscle ratio at 30 min postinjection. There was no obvious defluorination in vivo. The micro-PET-CT imaging results of (2S,4S)-4-[18F]FEBGln orthotopic MCF-7 tumor-bearing nude mice were consistent with the biological distribution results. Compared with (2S,4R)-4-[18F]FGln, (2S,4S)-4-[18F]FEBGln showed poor tumor retention, but its clearance in normal tissues was also fast, so it had better PET image contrast than the former. Unlike poor retention in MCF-7-bearing nude mice, (2S,4S)-4-[18F]FEBGln has good retention in NCI-h1975 and 22Rv1 tumor models. Since (2S,4S)-4-[18F]FEBGln has low uptake in normal lungs and high uptake in the bladder, it is expected to be used in the accurate diagnosis of lung cancer but cannot accurately determine prostate cancer. Consistent with the advantages of radiolabeled amino acids in the application of brain tumors, (2S,4S)-4-[18F]FEBGln accurately diagnoses U87MG glioma with higher contrast than [18F]FET and [18F]FDG, and there is a correlation between (2S,4S)-4-[18F]FEBGln uptake and tumor growth cycle. Further kinetic model analysis showed that (2S,4S)-4-[18F]FEBGln was similar to (2S,4R)-4-[18F]FGln, conforming to the one-compartment model and the Logan graphical model, and was expected to assess the size of the glutamine pool of the tumor. Therefore, (2S,4S)-4-[18F]FEBGln is expected to provide a strong imaging basis for the diagnosis, formulation of personalized plans, and efficacy evaluation of glioma, lung cancer, and breast cancer.
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Affiliation(s)
- Yong Huang
- Department of Nuclear Medicine, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China
| | - Yajing Liu
- School of Pharmaceutical Science, Capital Medical University, Beijing 100069, China
| | - Chengze Li
- Department of Nuclear Medicine, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China
| | - Zhongjing Li
- Department of Nuclear Medicine, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China
| | - Hualong Chen
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Lu Zhang
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Ying Liang
- Department of Nuclear Medicine, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China
| | - Zehui Wu
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100069, China
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8
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Wollring MM, Werner JM, Bauer EK, Tscherpel C, Ceccon GS, Lohmann P, Stoffels G, Kabbasch C, Goldbrunner R, Fink GR, Langen KJ, Galldiks N. Prediction of response to lomustine-based chemotherapy in glioma patients at recurrence using MRI and FET PET. Neuro Oncol 2023; 25:984-994. [PMID: 36215231 PMCID: PMC10158105 DOI: 10.1093/neuonc/noac229] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We evaluated O-(2-[18F]fluoroethyl)-l-tyrosine (FET) PET and MRI for early response assessment in recurrent glioma patients treated with lomustine-based chemotherapy. METHODS Thirty-six adult patients with WHO CNS grade 3 or 4 gliomas (glioblastoma, 69%) at recurrence (median number of recurrences, 1; range, 1-3) were retrospectively identified. Besides MRI, serial FET PET scans were performed at baseline and early after chemotherapy initiation (not later than two cycles). Tumor-to-brain ratios (TBR), metabolic tumor volumes (MTV), the occurrence of new distant hotspots with a mean TBR >1.6 at follow-up, and the dynamic parameter time-to-peak were derived from all FET PET scans. PET parameter thresholds were defined using ROC analyses to predict PFS of ≥6 months and OS of ≥12 months. MRI response assessment was based on RANO criteria. The predictive values of FET PET parameters and RANO criteria were subsequently evaluated using univariate and multivariate survival estimates. RESULTS After treatment initiation, the median follow-up time was 11 months (range, 3-71 months). Relative changes of TBR, MTV, and RANO criteria predicted a significantly longer PFS (all P ≤ .002) and OS (all P ≤ .045). At follow-up, the occurrence of new distant hotspots (n ≥ 1) predicted a worse outcome, with significantly shorter PFS (P = .005) and OS (P < .001). Time-to-peak changes did not predict a significantly longer survival. Multivariate survival analyses revealed that new distant hotspots at follow-up FET PET were most potent in predicting non-response (P < .001; HR, 8.578). CONCLUSIONS Data suggest that FET PET provides complementary information to RANO criteria for response evaluation of lomustine-based chemotherapy early after treatment initiation.
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Affiliation(s)
- Michael M Wollring
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany
| | - Jan-Michael Werner
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elena K Bauer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Caroline Tscherpel
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany
| | - Garry S Ceccon
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Philipp Lohmann
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany
- Department of Stereotaxy and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gabriele Stoffels
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany
| | - Christoph Kabbasch
- Institute of Radiology, Division of Neuroradiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roland Goldbrunner
- Department of General Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, Germany
| | - Gereon R Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany
- Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany
- Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, Germany
| | - Norbert Galldiks
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany
- Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, Germany
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9
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Galldiks N, Lohmann P, Fink GR, Langen KJ. Amino Acid PET in Neurooncology. J Nucl Med 2023; 64:693-700. [PMID: 37055222 DOI: 10.2967/jnumed.122.264859] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/10/2023] [Indexed: 04/15/2023] Open
Abstract
For decades, several amino acid PET tracers have been used to optimize diagnostics in patients with brain tumors. In clinical routine, the most important clinical indications for amino acid PET in brain tumor patients are differentiation of neoplasm from nonneoplastic etiologies, delineation of tumor extent for further diagnostic and treatment planning (i.e., diagnostic biopsy, resection, or radiotherapy), differentiation of treatment-related changes such as pseudoprogression or radiation necrosis after radiation or chemoradiation from tumor progression at follow-up, and assessment of response to anticancer therapy, including prediction of patient outcome. This continuing education article addresses the diagnostic value of amino acid PET for patients with either glioblastoma or metastatic brain cancer.
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Affiliation(s)
- Norbert Galldiks
- Department of Neurology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany;
- Institute of Neuroscience and Medicine, Research Center Juelich, Juelich, Germany
- Center for Integrated Oncology, Universities of Aachen, Bonn, Cologne, and Duesseldorf, Germany; and
| | - Philipp Lohmann
- Institute of Neuroscience and Medicine, Research Center Juelich, Juelich, Germany
| | - Gereon R Fink
- Department of Neurology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine, Research Center Juelich, Juelich, Germany
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine, Research Center Juelich, Juelich, Germany
- Center for Integrated Oncology, Universities of Aachen, Bonn, Cologne, and Duesseldorf, Germany; and
- Department of Nuclear Medicine, RWTH University Hospital Aachen, Aachen, Germany
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10
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Yahia-Cherif M, Luce S, De Witte O, Sadeghi-Meibodi N, Leurquin-Sterk G, Lefranc F. Late-line treatment with bevacizumab alone or in combination with chemotherapy in recurrent high-grade gliomas. Acta Neurochir (Wien) 2023; 165:693-699. [PMID: 36781461 DOI: 10.1007/s00701-023-05524-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Bevacizumab's use in recurrent high-grade glioma is controversial. This study evaluates outcomes in recurrent high-grade glioma patients receiving bevacizumab alone or combined with chemotherapy as a late-line treatment. METHODS We retrospectively analyzed patients treated with bevacizumab alone or combined with chemotherapy for high-grade gliomas who showed tumor progression after multiple treatment attempts. Overall survival (OS) and progression-free survival (PFS) were analyzed with Kaplan-Meier curves. Predictors of PFS according to prognostic variables were assessed with regression analysis. RESULTS Between 2010 and 2022, 31 consecutive patients received bevacizumab alone or combined with chemotherapy as a late-line treatment for recurrent high-grade gliomas. Of these patients, 14 (45.2%) were responders according to RANO criteria, and 17 (54.8%) showed progressive or stable disease. OS at 3, 6, and 12 months was 80.3%, 62.1%, and 43.5. PFS was 48.4%, 34.3%, and 21.8%, respectively. In the multivariate survival analysis, the only factor independently associated with PFS was smaller 2D tumor size in post-contrast T1-weighted MRI at bevacizumab initiation (p = 0.02). Median time-to-progression was 3 months (95%CI: 1-4) in the unmethylated MGMT promoter group and 6 (95%CI: 1-11) in the methylated MGMT promoter group. This difference was not statistically significant (p = 0.37). CONCLUSIONS Bevacizumab alone or in combination with chemotherapy could be beneficial as a late-line therapy in a subset of patients with recurrent high-grade glioma. Small 2D tumor size in post-contrast T1 weighted MRI at bevacizumab initiation was independently associated with prolonged time to progression.
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Affiliation(s)
- Mehdi Yahia-Cherif
- Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium
| | - Sylvie Luce
- Department of Oncology, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium
| | - Olivier De Witte
- Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium
| | - Niloufar Sadeghi-Meibodi
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium
| | - Gil Leurquin-Sterk
- Department of Nuclear Medicine, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium
| | - Florence Lefranc
- Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium.
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11
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Kertels O, Krauß J, Monoranu CM, Samnick S, Dierks A, Kircher M, Mihovilovic MI, Pham M, Buck AK, Eyrich M, Schlegel PG, Frühwald MC, Bison B, Lapa C. [ 18F]FET-PET in children and adolescents with central nervous system tumors: does it support difficult clinical decision-making? Eur J Nucl Med Mol Imaging 2023; 50:1699-1708. [PMID: 36670283 PMCID: PMC10119036 DOI: 10.1007/s00259-023-06114-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023]
Abstract
PURPOSE Positron emission tomography (PET) with O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET) is a well-established tool for non-invasive assessment of adult central nervous system (CNS) tumors. However, data on its diagnostic utility and impact on clinical management in children and adolescents are limited. METHODS Twenty-one children and young adults (13 males; mean age, 8.6 ± 5.2 years; range, 1-19 at initial diagnosis) with either newly diagnosed (n = 5) or pretreated (n = 16) CNS tumors were retrospectively analyzed. All patients had previously undergone neuro-oncological work-up including cranial magnetic resonance imaging. In all cases, [18F]FET-PET was indicated in a multidisciplinary team conference. The impact of PET imaging on clinical decision-making was assessed. Histopathology (n = 12) and/or clinical and imaging follow-up (n = 9) served as the standard of reference. RESULTS The addition of [18F]FET-PET to the available information had an impact on further patient management in 14 out of 21 subjects, with avoidance of invasive surgery or biopsy in four patients, biopsy guidance in four patients, change of further treatment in another five patients, and confirmation of diagnosis in one patient. CONCLUSION [18F]FET-PET may provide important additional information for treatment guidance in pediatric and adolescent patients with CNS tumors.
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Affiliation(s)
- Olivia Kertels
- Institute of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany
| | - Jürgen Krauß
- Section Pediatric Neurosurgery, Department of Neurosurgery, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany
| | - Camelia Maria Monoranu
- Department of Neuropathology, Institute for Pathology, University of Würzburg, Josef-Schneider-Strasse 2, 97080 Würzburg, Germany
| | - Samuel Samnick
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany
| | - Alexander Dierks
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany
- Nuclear Medicine, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Malte Kircher
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany
- Nuclear Medicine, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Milena I. Mihovilovic
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany
| | - Mirko Pham
- Institute of Diagnostic and Interventional Neuroradiology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Andreas K. Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany
| | - Matthias Eyrich
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Children’s Hospital, University of Würzburg, Josef-Schneider- Str. 2, 97080 Würzburg, Germany
| | - Paul-Gerhardt Schlegel
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Children’s Hospital, University of Würzburg, Josef-Schneider- Str. 2, 97080 Würzburg, Germany
| | - Michael C. Frühwald
- Paediatric and Adolescent Medicine, University Medical Center Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Brigitte Bison
- Diagnostic and Interventional Neuroradiology, Neuroradiological Reference Center for Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, Faculty of Medicine, University of Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany
| | - Constantin Lapa
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany
- Nuclear Medicine, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
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12
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Muthukumar S, Darden J, Crowley J, Witcher M, Kiser J. A Comparison of PET Tracers in Recurrent High-Grade Gliomas: A Systematic Review. Int J Mol Sci 2022; 24:ijms24010408. [PMID: 36613852 PMCID: PMC9820099 DOI: 10.3390/ijms24010408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
Humans with high-grade gliomas have a poor prognosis, with a mean survival time of just 12-18 months for patients who undergo standard-of-care tumor resection and adjuvant therapy. Currently, surgery and chemoradiotherapy serve as standard treatments for this condition, yet these can be complicated by the tumor location, growth rate and recurrence. Currently, gadolinium-based, contrast-enhanced magnetic resonance imaging (CE-MRI) serves as the predominant imaging modality for recurrent high-grade gliomas, but it faces several drawbacks, including its inability to distinguish tumor recurrence from treatment-related changes and its failure to reveal the entirety of tumor burden (de novo or recurrent) due to limitations inherent to gadolinium contrast. As such, alternative imaging modalities that can address these limitations, including positron emission tomography (PET), are worth pursuing. To this end, the identification of PET-based markers for use in imaging of recurrent high-grade gliomas is paramount. This review will highlight several PET radiotracers that have been implemented in clinical practice and provide a comparison between them to assess the efficacy of these tracers.
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Affiliation(s)
| | - Jordan Darden
- Carilion Clinic Neurosurgery, Roanoke, VA 24016, USA
| | | | - Mark Witcher
- Carilion Clinic Neurosurgery, Roanoke, VA 24016, USA
| | - Jackson Kiser
- Carilion Clinic Radiology, Roanoke, VA 24016, USA
- Correspondence:
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13
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Castello A, Castellani M, Florimonte L, Ciccariello G, Mansi L, Lopci E. PET radiotracers in glioma: a review of clinical indications and evidence. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00523-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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14
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Huang Y, Zhang L, Wang M, Li C, Zheng W, Chen H, Liang Y, Wu Z. Optimization of Precursor Synthesis Conditions of (2S,4S)4–[18F]FPArg and Its Application in Glioma Imaging. Pharmaceuticals (Basel) 2022; 15:ph15080946. [PMID: 36015094 PMCID: PMC9416586 DOI: 10.3390/ph15080946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 01/27/2023] Open
Abstract
Although the tracer (2S,4S)4–[18F]FPArg is expected to provide a powerful imaging method for the diagnosis and treatment of clinical tumors, it has not been realized due to the low yield of chemical synthesis and radiolabeling. A simple synthetic method for the radiolabeled precursor of (2S,4S)4–[18F]FPArg in stable yield was obtained by adjusting the sequence of the synthetic steps. Furthermore, the biodistribution experiments confirmed that (2S,4S)4–[18F]FPArg could be cleared out quickly in wild type mouse. Cell uptake experiments and U87MG tumor mouse microPET–CT imaging experiments showed that the tumor had high uptake of (2S,4S)4–[18F]FPArg and the clearance was slow, but (2S,4S)4–[18F]FPArg was rapidly cleared in normal brain tissue. MicroPET–CT imaging of nude mice bearing orthotopic HS683–Luc showed that (2S,4S)4–[18F]FPArg can penetrate blood–brain barrier and image gliomas with a high contrast. Therefore, (2S,4S)4–[18F]FPArg is expected to be further applied in the diagnosis and efficacy evaluation of clinical glioma.
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Affiliation(s)
- Yong Huang
- Department of Nuclear Medicine, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China; (Y.H.); (C.L.)
| | - Lu Zhang
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100069, China; (L.Z.); (W.Z.); (H.C.)
| | - Meng Wang
- GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
| | - Chengze Li
- Department of Nuclear Medicine, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China; (Y.H.); (C.L.)
| | - Wei Zheng
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100069, China; (L.Z.); (W.Z.); (H.C.)
| | - Hualong Chen
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100069, China; (L.Z.); (W.Z.); (H.C.)
| | - Ying Liang
- Department of Nuclear Medicine, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China; (Y.H.); (C.L.)
- Correspondence: (Y.L.); (Z.W.)
| | - Zehui Wu
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100069, China; (L.Z.); (W.Z.); (H.C.)
- Correspondence: (Y.L.); (Z.W.)
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15
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Khavinson V, Linkova N, Kozhevnikova E, Dyatlova A, Petukhov M. Transport of Biologically Active Ultrashort Peptides Using POT and LAT Carriers. Int J Mol Sci 2022; 23:ijms23147733. [PMID: 35887081 PMCID: PMC9323678 DOI: 10.3390/ijms23147733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/27/2023] Open
Abstract
Ultrashort peptides (USPs), consisting of 2–7 amino-acid residues, are a group of signaling molecules that regulate gene expression and protein synthesis under normal conditions in various diseases and ageing. USPs serve as a basis for the development of drugs with a targeted mechanism of action. The purpose of this review is to systematize the available data on USP transport involving POT and LAT transporters in various organs and tissues under normal, pathological and ageing conditions. The carriers of the POT family (PEPT1, PEPT2, PHT1, PHT2) transport predominantly di- and tripeptides into the cell. Methods of molecular modeling and physicochemistry have demonstrated the ability of LAT1 to transfer not only amino acids but also some di- and tripeptides into the cell and out of it. LAT1 and 2 are involved in the regulation of the antioxidant, endocrine, immune and nervous systems’ functions. Analysis of the above data allows us to conclude that, depending on their structure, di- and tripeptides can be transported into the cells of various tissues by POT and LAT transporters. This mechanism is likely to underlie the tissue specificity of peptides, their geroprotective action and effectiveness in the case of neuroimmunoendocrine system disorders.
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Affiliation(s)
- Vladimir Khavinson
- Department of Biogerontology, Saint Petersburg Institute of Bioregulation and Gerontology, 197110 Saint Petersburg, Russia; (N.L.); (E.K.); (A.D.)
- Group of Peptide Regulation of Aging, Pavlov Institute of Physiology of Russian Academy of Sciences, 199034 Saint Petersburg, Russia
- Correspondence: or ; Tel.: +7-(921)-9110800
| | - Natalia Linkova
- Department of Biogerontology, Saint Petersburg Institute of Bioregulation and Gerontology, 197110 Saint Petersburg, Russia; (N.L.); (E.K.); (A.D.)
- The Laboratory “Problems of Aging”, Belgorod National Research University, 308015 Belgorod, Russia
| | - Ekaterina Kozhevnikova
- Department of Biogerontology, Saint Petersburg Institute of Bioregulation and Gerontology, 197110 Saint Petersburg, Russia; (N.L.); (E.K.); (A.D.)
| | - Anastasiia Dyatlova
- Department of Biogerontology, Saint Petersburg Institute of Bioregulation and Gerontology, 197110 Saint Petersburg, Russia; (N.L.); (E.K.); (A.D.)
| | - Mikhael Petukhov
- Petersburg Nuclear Physics Institute Named after B.P. Konstantinov, NRC “Kurchatov Institute”, 188300 Gatchina, Russia;
- Peter the Great St. Petersburg Group of Biophysics, Higher Engineering and Technical School, Peter the Great St. Petersburg Polytechnic University, 195251 Saint Petersburg, Russia
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16
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Cicone F, Galldiks N, Papa A, Langen KJ, Cascini GL, Minniti G. Repeated amino acid PET imaging for longitudinal monitoring of brain tumors. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00504-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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17
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Borja AJ, Saini J, Raynor WY, Ayubcha C, Werner TJ, Alavi A, Revheim ME, Nagaraj C. Role of Molecular Imaging with PET/MR Imaging in the Diagnosis and Management of Brain Tumors. PET Clin 2022; 17:431-451. [PMID: 35662494 DOI: 10.1016/j.cpet.2022.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Gliomas are the most common primary brain tumors. Hybrid PET/MR imaging has revolutionized brain tumor imaging, allowing for noninvasive, simultaneous assessment of morphologic, functional, metabolic, and molecular parameters within the brain. Molecular information obtained from PET imaging may aid in the detection, classification, prognostication, and therapeutic decision making for gliomas. 18F-fluorodeoxyglucose (FDG) has been widely used in the setting of brain tumor imaging, and multiple techniques may be employed to optimize this methodology. More recently, a number of non-18F-FDG-PET radiotracers have been applied toward brain tumor imaging and are used in clinical practice.
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Affiliation(s)
- Austin J Borja
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Jitender Saini
- Department of Neuro Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, Karnataka 560-029, India
| | - William Y Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Cyrus Ayubcha
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Mona-Elisabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Sognsvannsveien 20, Oslo 0372, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Problemveien 7, Oslo 0315, Norway
| | - Chandana Nagaraj
- Department of Neuro Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, Karnataka 560-029, India.
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18
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The Use of 18F-FET-PET-MRI in Neuro-Oncology: The Best of Both Worlds—A Narrative Review. Diagnostics (Basel) 2022; 12:diagnostics12051202. [PMID: 35626357 PMCID: PMC9140561 DOI: 10.3390/diagnostics12051202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/22/2022] [Accepted: 04/28/2022] [Indexed: 02/05/2023] Open
Abstract
Gliomas are the most frequent primary tumors of the brain. They can be divided into grade II-IV astrocytomas and grade II-III oligodendrogliomas, based on their histomolecular profile. The prognosis and treatment is highly dependent on grade and well-identified prognostic and/or predictive molecular markers. Multi-parametric MRI, including diffusion weighted imaging, perfusion, and MR spectroscopy, showed increasing value in the non-invasive characterization of specific molecular subsets of gliomas. Radiolabeled amino-acid analogues, such as 18F-FET, have also been proven valuable in glioma imaging. These tracers not only contribute in the diagnostic process by detecting areas of dedifferentiation in diffuse gliomas, but this technique is also valuable in the follow-up of gliomas, as it can differentiate pseudo-progression from real tumor progression. Since multi-parametric MRI and 18F-FET PET are complementary imaging techniques, there may be a synergistic role for PET-MRI imaging in the neuro-oncological imaging of primary brain tumors. This could be of value for both primary staging, as well as during treatment and follow-up.
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19
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Santo G, Laudicella R, Linguanti F, Nappi AG, Abenavoli E, Vergura V, Rubini G, Sciagrà R, Arnone G, Schillaci O, Minutoli F, Baldari S, Quartuccio N, Bisdas S. The Utility of Conventional Amino Acid PET Radiotracers in the Evaluation of Glioma Recurrence also in Comparison with MRI. Diagnostics (Basel) 2022; 12:diagnostics12040844. [PMID: 35453892 PMCID: PMC9027186 DOI: 10.3390/diagnostics12040844] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 02/07/2023] Open
Abstract
AIM In this comprehensive review we present an update on the most relevant studies evaluating the utility of amino acid PET radiotracers for the evaluation of glioma recurrence as compared to magnetic resonance imaging (MRI). METHODS A literature search extended until June 2020 on the PubMed/MEDLINE literature database was conducted using the terms "high-grade glioma", "glioblastoma", "brain tumors", "positron emission tomography", "PET", "amino acid PET", "[11C]methyl-l-methionine", "[18F]fluoroethyl-tyrosine", "[18F]fluoro-l-dihydroxy-phenylalanine", "MET", "FET", "DOPA", "magnetic resonance imaging", "MRI", "advanced MRI", "magnetic resonance spectroscopy", "perfusion-weighted imaging", "diffusion-weighted imaging", "MRS", "PWI", "DWI", "hybrid PET/MR", "glioma recurrence", "pseudoprogression", "PSP", "treatment-related change", and "radiation necrosis" alone and in combination. Only original articles edited in English and about humans with at least 10 patients were included. RESULTS Forty-four articles were finally selected. Conventional amino acid PET tracers were demonstrated to be reliable diagnostic techniques in differentiating tumor recurrence thanks to their high uptake from tumor tissue and low background in normal grey matter, giving additional and early information to standard modalities. Among them, MET-PET seems to present the highest diagnostic value but its use is limited to on-site cyclotron facilities. [18F]labelled amino acids, such as FDOPA and FET, were developed to provide a more suitable PET tracer for routine clinical applications, and demonstrated similar diagnostic performance. When compared to the gold standard MRI, amino acid PET provides complementary and comparable information to standard modalities and seems to represent an essential tool in the differentiation between tumor recurrence and other entities such as pseudoprogression, radiation necrosis, and pseudoresponse. CONCLUSIONS Despite the introduction of new advanced imaging techniques, the diagnosis of glioma recurrence remains challenging. In this scenario, the growing knowledge about imaging techniques and analysis, such as the combined PET/MRI and the application of artificial intelligence (AI) and machine learning (ML), could represent promising tools to face this difficult and debated clinical issue.
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Affiliation(s)
- Giulia Santo
- Nuclear Medicine Unit, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.S.); (A.G.N.); (G.R.)
| | - Riccardo Laudicella
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy; (R.L.); (F.M.); (S.B.)
| | - Flavia Linguanti
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (F.L.); (E.A.); (V.V.); (R.S.)
| | - Anna Giulia Nappi
- Nuclear Medicine Unit, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.S.); (A.G.N.); (G.R.)
| | - Elisabetta Abenavoli
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (F.L.); (E.A.); (V.V.); (R.S.)
| | - Vittoria Vergura
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (F.L.); (E.A.); (V.V.); (R.S.)
| | - Giuseppe Rubini
- Nuclear Medicine Unit, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.S.); (A.G.N.); (G.R.)
| | - Roberto Sciagrà
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (F.L.); (E.A.); (V.V.); (R.S.)
| | - Gaspare Arnone
- Nuclear Medicine Unit, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, 90127 Palermo, Italy; (G.A.); (N.Q.)
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Tor Vergata, 00133 Rome, Italy;
| | - Fabio Minutoli
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy; (R.L.); (F.M.); (S.B.)
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy; (R.L.); (F.M.); (S.B.)
| | - Natale Quartuccio
- Nuclear Medicine Unit, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, 90127 Palermo, Italy; (G.A.); (N.Q.)
| | - Sotirios Bisdas
- Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London WC1N 3BG, UK
- Correspondence:
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Brighi C, Puttick S, Li S, Keall P, Neville K, Waddington D, Bourgeat P, Gillman A, Fay M. A novel semiautomated method for background activity and biological tumour volume definition to improve standardisation of 18F-FET PET imaging in glioblastoma. EJNMMI Phys 2022; 9:9. [PMID: 35122529 PMCID: PMC8818070 DOI: 10.1186/s40658-022-00438-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Multicentre clinical trials evaluating the role of 18F-Fluoroethyl-l-tyrosine (18F-FET) PET as a diagnostic biomarker in glioma management have highlighted a need for standardised methods of data analysis. 18F-FET uptake normalised against background in the contralateral brain is a standard imaging technique to delineate the biological tumour volume (BTV). Quantitative analysis of 18F-FET PET images requires a consistent and robust background activity. Currently, defining background activity involves the manual selection of an arbitrary region of interest, a process that is subject to large variability. This study aims to eliminate methodological errors in background activity definition through the introduction of a semiautomated method for region of interest selection. A new method for background activity definition, involving the semiautomated generation of mirror-image (MI) reference regions, was compared with the current state-of-the-art method, involving manually drawing crescent-shape (gCS) reference regions. The MI and gCS methods were tested by measuring values of background activity and resulting BTV of 18F-FET PET scans of ten patients with recurrent glioblastoma multiforme generated from inputs provided by seven readers. To assess intra-reader variability, each scan was evaluated six times by each reader. Intra- and inter-reader variability in background activity and BTV definition was assessed by means of coefficient of variation. Results Compared to the gCS method, the MI method showed significantly lower intra- and inter-reader variability both in background activity and in BTV definition. Conclusions The proposed semiautomated MI method minimises intra- and inter-reader variability, providing a valuable approach for standardisation of 18F-FET PET quantitative parameters. Trial registration ANZCTR, ACTRN12618001346268. Registered 9 August 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374253 Supplementary Information The online version contains supplementary material available at 10.1186/s40658-022-00438-2.
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Affiliation(s)
- Caterina Brighi
- ACRF Image X Institute, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Simon Puttick
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organization, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Shenpeng Li
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organization, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Paul Keall
- ACRF Image X Institute, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - David Waddington
- ACRF Image X Institute, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Pierrick Bourgeat
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organization, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Ashley Gillman
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organization, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Michael Fay
- GenesisCare, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
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21
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Lombardi G, Spimpolo A, Berti S, Campi C, Anglani MG, Simeone R, Evangelista L, Causin F, Zorzi G, Gorgoni G, Caccese M, Padovan M, Zagonel V, Cecchin D. PET/MR in recurrent glioblastoma patients treated with regorafenib: [ 18F]FET and DWI-ADC for response assessment and survival prediction. Br J Radiol 2022; 95:20211018. [PMID: 34762492 PMCID: PMC8722234 DOI: 10.1259/bjr.20211018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective: The use of regorafenib in recurrent glioblastoma patients has been recently approved by the Italian Medicines Agency (AIFA) and added to the National Comprehensive Cancer Network (NCCN) 2020 guidelines as a preferred regimen. Given its complex effects at the molecular level, the most appropriate imaging tools to assess early response to treatment is still a matter of debate. Diffusion-weighted imaging and O-(2-18F-fluoroethyl)-L-tyrosine positron emission tomography ([18F]FET PET) are promising methodologies providing additional information to the currently used RANO criteria. The aim of this study was to evaluate the variations in diffusion-weighted imaging/apparent diffusion coefficient (ADC) and [18F]FET PET-derived parameters in patients who underwent PET/MR at both baseline and after starting regorafenib. Methods: We retrospectively reviewed 16 consecutive GBM patients who underwent [18F]FET PET/MR before and after two cycles of regorafenib. Patients were sorted into stable (SD) or progressive disease (PD) categories in accordance with RANO criteria. We were also able to analyze four SD patients who underwent a third PET/MR after another four cycles of regorafenib. [18F]FET uptake greater than 1.6 times the mean background activity was used to define an area to be superimposed on an ADC map at baseline and after treatment. Several metrics were then derived and compared. Log-rank test was applied for overall survival analysis. Results: Percentage difference in FET volumes correlates with the corresponding percentage difference in ADC (R = 0.54). Patients with a twofold increase in FET after regorafenib showed a significantly higher increase in ADC pathological volume than the remaining subjects (p = 0.0023). Kaplan–Meier analysis, performed to compare the performance in overall survival prediction, revealed that the percentage variations of FET- and ADC-derived metrics performed at least as well as RANO criteria (p = 0.02, p = 0.024 and p = 0.04 respectively) and in some cases even better. TBR Max and TBR mean are not able to accurately predict overall survival. Conclusion In recurrent glioblastoma patients treated with regorafenib, [18F]FET and ADC metrics, are able to predict overall survival and being obtained from completely different measures as compared to RANO, could serve as semi-quantitative independent biomarkers of response to treatment. Advances in knowledge Simultaneous evaluation of [18F]FET and ADC metrics using PET/MR allows an early and reliable identification of response to treatment and predict overall survival.
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Affiliation(s)
- Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology - IRCCS, Padua, Italy
| | - Alessandro Spimpolo
- Nuclear Medicine Unit, Department of Medicine - DIMED, Padua University Hospital, Padua, Italy
| | - Sara Berti
- Nuclear Medicine Unit, Department of Medicine - DIMED, Padua University Hospital, Padua, Italy
| | - Cristina Campi
- Department of Mathematics, University of Genoa, Genoa, Italy
| | | | - Rossella Simeone
- Nuclear Medicine Unit, Department of Medicine - DIMED, Padua University Hospital, Padua, Italy
| | - Laura Evangelista
- Nuclear Medicine Unit, Department of Medicine - DIMED, Padua University Hospital, Padua, Italy
| | - Francesco Causin
- Neuroradiology Unit, Azienda Ospedaliera di Padova, Padua, Italy
| | - Giovanni Zorzi
- Department of Neurosciences (DNS), University of Padua, Padua, Italy
| | - Giancarlo Gorgoni
- Radiopharmacy, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Mario Caccese
- Department of Oncology, Oncology 1, Veneto Institute of Oncology - IRCCS, Padua, Italy
| | - Marta Padovan
- Department of Oncology, Oncology 1, Veneto Institute of Oncology - IRCCS, Padua, Italy
| | - Vittorina Zagonel
- Department of Oncology, Oncology 1, Veneto Institute of Oncology - IRCCS, Padua, Italy
| | - Diego Cecchin
- Nuclear Medicine Unit, Department of Medicine - DIMED, Padua University Hospital, Padua, Italy
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22
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Abstract
This article reviews recent advances in the use of standard and advanced imaging techniques for diagnosis and treatment of central nervous system (CNS) tumors, including glioma and brain metastasis. Following the recent transition from a histology-based approach in classifying CNS tumors to one that integrates histology with the molecular information of tumor, the approaches for imaging CNS tumors have also been adapted to this new framework. Some challenges related to the diagnosis and treatment of CNS tumors, such as differentiating tumor from treatment-related imaging changes, require further progress to implement advanced imaging for clinical use.
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Affiliation(s)
- Raymond Y Huang
- Department of Neuroradiology, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Whitney B Pope
- Radiology, Section of Neuroradiology, Brain Tumor Imaging, UCLA Medical Center, Los Angeles, CA, USA; Department of Radiological Sciences, David Geffen School of Medicine, University of California-Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA
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23
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Hughes KL, O'Neal CM, Andrews BJ, Westrup AM, Battiste JD, Glenn CA. A systematic review of the utility of amino acid PET in assessing treatment response to bevacizumab in recurrent high-grade glioma. Neurooncol Adv 2021; 3:vdab003. [PMID: 34409294 PMCID: PMC8369430 DOI: 10.1093/noajnl/vdab003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Currently, bevacizumab (BEV), an antiangiogenic agent, is used as an adjunctive therapy to re-irradiation and surgery in patients with recurrent high-grade gliomas (rHGG). BEV has shown to decrease enhancement on MRI, but it is often unclear if these changes are due to tumor response to BEV or treatment-induced changes in the blood brain barrier. Preliminary studies show that amino acid PET can aid in distinguishing these changes on MRI. Methods. The authors performed a systematic review of PubMed and Embase through July 2020 with the search terms ‘bevacizumab’ or ‘Avastin’ and ‘recurrent glioma’ and ‘PET,’ yielding 38 papers, with 14 meeting inclusion criteria. Results. Thirteen out of fourteen studies included in this review used static PET and three studies used dynamic PET to evaluate the use of BEV in rHGG. Six studies used the amino acid tracer [18F]FET, four studies used [11C]MET, and four studies used [18F]FDOPA. Conclusion. [18F]FET, [11C]MET, and [18F]FDOPA PET in combination with MRI have shown promising results for improving accuracy in diagnosing tumor recurrence, detecting early treatment failure, and distinguishing between tumor progression and treatment-induced changes in patients with rHGG treated with BEV.
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Affiliation(s)
- Kendall L Hughes
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Christen M O'Neal
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Bethany J Andrews
- Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Alison M Westrup
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - James D Battiste
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Chad A Glenn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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24
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Di Giorgio E, Cuocolo A, Mansi L, Sicignano M, Squame F, Gaudieri V, Giordano P, Giugliano FM, Mazzaferro MP, Negro A, Villa A, Spadafora M. Assessment of therapy response to Regorafenib by 18F-DOPA-PET/CT in patients with recurrent high-grade gliomas: a case series. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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25
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Castellano A, Bailo M, Cicone F, Carideo L, Quartuccio N, Mortini P, Falini A, Cascini GL, Minniti G. Advanced Imaging Techniques for Radiotherapy Planning of Gliomas. Cancers (Basel) 2021; 13:cancers13051063. [PMID: 33802292 PMCID: PMC7959155 DOI: 10.3390/cancers13051063] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023] Open
Abstract
The accuracy of target delineation in radiation treatment (RT) planning of cerebral gliomas is crucial to achieve high tumor control, while minimizing treatment-related toxicity. Conventional magnetic resonance imaging (MRI), including contrast-enhanced T1-weighted and fluid-attenuated inversion recovery (FLAIR) sequences, represents the current standard imaging modality for target volume delineation of gliomas. However, conventional sequences have limited capability to discriminate treatment-related changes from viable tumors, owing to the low specificity of increased blood-brain barrier permeability and peritumoral edema. Advanced physiology-based MRI techniques, such as MR spectroscopy, diffusion MRI and perfusion MRI, have been developed for the biological characterization of gliomas and may circumvent these limitations, providing additional metabolic, structural, and hemodynamic information for treatment planning and monitoring. Radionuclide imaging techniques, such as positron emission tomography (PET) with amino acid radiopharmaceuticals, are also increasingly used in the workup of primary brain tumors, and their integration in RT planning is being evaluated in specialized centers. This review focuses on the basic principles and clinical results of advanced MRI and PET imaging techniques that have promise as a complement to RT planning of gliomas.
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Affiliation(s)
- Antonella Castellano
- Neuroradiology Unit, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.C.); (A.F.)
| | - Michele Bailo
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.B.); (P.M.)
| | - Francesco Cicone
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, and Nuclear Medicine Unit, University Hospital “Mater Domini”, 88100 Catanzaro, Italy;
- Correspondence: ; Tel.: +39-0-961-369-4155
| | - Luciano Carideo
- National Cancer Institute, G. Pascale Foundation, 80131 Naples, Italy;
| | - Natale Quartuccio
- A.R.N.A.S. Ospedale Civico Di Cristina Benfratelli, 90144 Palermo, Italy;
| | - Pietro Mortini
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.B.); (P.M.)
| | - Andrea Falini
- Neuroradiology Unit, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.C.); (A.F.)
| | - Giuseppe Lucio Cascini
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, and Nuclear Medicine Unit, University Hospital “Mater Domini”, 88100 Catanzaro, Italy;
| | - Giuseppe Minniti
- Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, 53100 Siena, Italy;
- IRCCS Neuromed, 86077 Pozzilli (IS), Italy
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26
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Stegmayr C, Stoffels G, Filß C, Heinzel A, Lohmann P, Willuweit A, Ermert J, Coenen HH, Mottaghy FM, Galldiks N, Langen KJ. Current trends in the use of O-(2-[ 18F]fluoroethyl)-L-tyrosine ([ 18F]FET) in neurooncology. Nucl Med Biol 2021; 92:78-84. [PMID: 32113820 DOI: 10.1016/j.nucmedbio.2020.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/16/2020] [Indexed: 12/14/2022]
Abstract
The diagnostic potential of PET using the amino acid analogue O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET) in brain tumor diagnostics has been proven in many studies during the last two decades and is still the subject of multiple studies every year. In addition to standard magnetic resonance imaging (MRI), positron emission tomography (PET) using [18F]FET provides important diagnostic data concerning brain tumor delineation, therapy planning, treatment monitoring, and improved differentiation between treatment-related changes and tumor recurrence. The pharmacokinetics, uptake mechanisms and metabolism have been well described in various preclinical studies. The accumulation of [18F]FET in most benign lesions and healthy brain tissue has been shown to be low, thus providing a high contrast between tumor tissue and benign tissue alterations. Based on logistic advantages of F-18 labelling and convincing clinical results, [18F]FET has widely replaced short lived amino acid tracers such as L-[11C]methyl-methionine ([11C]MET) in many centers across Western Europe. This review summarizes the basic knowledge on [18F]FET and its contribution to the care of patients with brain tumors. In particular, recent studies about specificity, possible pitfalls, and the utility of [18F]FET PET in tumor grading and prognostication regarding the revised WHO classification of brain tumors are addressed.
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Affiliation(s)
- Carina Stegmayr
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany
| | - Gabriele Stoffels
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany
| | - Christian Filß
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany; Dept. of Nuclear Medicine, RWTH University Hospital, Aachen, Germany
| | - Alexander Heinzel
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany; Dept. of Nuclear Medicine, RWTH University Hospital, Aachen, Germany; Juelich-Aachen Research Alliance (JARA) - Section JARA-Brain, Germany
| | - Philipp Lohmann
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany
| | - Antje Willuweit
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany
| | - Johannes Ermert
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany
| | - Heinz H Coenen
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany
| | - Felix M Mottaghy
- Dept. of Nuclear Medicine, RWTH University Hospital, Aachen, Germany; Juelich-Aachen Research Alliance (JARA) - Section JARA-Brain, Germany; Center of Integrated Oncology (CIO), University of Aachen, Bonn, Cologne and Duesseldorf, Germany; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Norbert Galldiks
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany; Dept. of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Center of Integrated Oncology (CIO), University of Aachen, Bonn, Cologne and Duesseldorf, Germany
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-3, INM-4, INM-5), Forschungszentrum Juelich, Juelich, Germany; Dept. of Nuclear Medicine, RWTH University Hospital, Aachen, Germany; Juelich-Aachen Research Alliance (JARA) - Section JARA-Brain, Germany; Center of Integrated Oncology (CIO), University of Aachen, Bonn, Cologne and Duesseldorf, Germany.
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27
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Wirsching HG, Roelcke U, Weller J, Hundsberger T, Hottinger AF, von Moos R, Caparrotti F, Conen K, Remonda L, Roth P, Ochsenbein A, Tabatabai G, Weller M. MRI and 18FET-PET Predict Survival Benefit from Bevacizumab Plus Radiotherapy in Patients with Isocitrate Dehydrogenase Wild-type Glioblastoma: Results from the Randomized ARTE Trial. Clin Cancer Res 2020; 27:179-188. [PMID: 32967939 DOI: 10.1158/1078-0432.ccr-20-2096] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/09/2020] [Accepted: 09/17/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE To explore a prognostic or predictive role of MRI and O-(2-18F-fluoroethyl)-L-tyrosine (18FET) PET parameters for outcome in the randomized multicenter trial ARTE that compared bevacizumab plus radiotherapy with radiotherpay alone in elderly patients with glioblastoma. PATIENTS AND METHODS Patients with isocitrate dehydrogenase wild-type glioblastoma ages 65 years or older were included in this post hoc analysis. Tumor volumetric and apparent diffusion coefficient (ADC) analyses of serial MRI scans from 67 patients and serial 18FET-PET tumor-to-brain intensity ratios (TBRs) from 31 patients were analyzed blinded for treatment arm and outcome. Multivariate Cox regression analysis was done to account for established prognostic factors and treatment arm. RESULTS Overall survival benefit from bevacizumab plus radiotherapy compared with radiotherapy alone was observed for larger pretreatment MRI contrast-enhancing tumor [HR per cm3 0.94; 95% confidence interval (CI), 0.89-0.99] and for higher ADC (HR 0.18; CI, 0.05-0.66). Higher 18FET-TBR on pretreatment PET scans was associated with inferior overall survival in both arms. Response assessed by standard MRI-based Response Assessment in Neuro-Oncology criteria was associated with overall survival in the bevacizumab plus radiotherapy arm by trend only (P = 0.09). High 18FET-TBR of noncontrast-enhancing tumor portions during bevacizumab therapy was associated with inferior overall survival on multivariate analysis (HR 5.97; CI, 1.16-30.8). CONCLUSIONS Large pretreatment contrast-enhancing tumor mass and higher ADCs identify patients who may experience a survival benefit from bevacizumab plus radiotherapy. Persistent 18FET-PET signal of no longer contrast-enhancing tumor after concomitant bevacizumab plus radiotherapy suggests pseudoresponse and predicts poor outcome.
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Affiliation(s)
- Hans-Georg Wirsching
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
| | - Ulrich Roelcke
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Jonathan Weller
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Thomas Hundsberger
- Department of Neurology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Andreas F Hottinger
- Departments of Clinical Neurosciences and Medical Oncology, University Hospital Lausanne, Lausanne, Switzerland
| | - Roger von Moos
- Department of Medical Oncology, Cantonal Hospital Graubuenden, Chur, Switzerland
| | - Francesca Caparrotti
- Department of Radiation Oncology, University Hospital Geneva, Geneva, Switzerland
| | - Katrin Conen
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Luca Remonda
- Department of Neuroradiology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Patrick Roth
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Adrian Ochsenbein
- Department of Medical Oncology, Inselspital, Berne University Hospital, University of Berne, Berne, Switzerland
| | - Ghazaleh Tabatabai
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Michael Weller
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
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Bashir A, Mathilde Jacobsen S, Mølby Henriksen O, Broholm H, Urup T, Grunnet K, Andrée Larsen V, Møller S, Skjøth-Rasmussen J, Skovgaard Poulsen H, Law I. Recurrent glioblastoma versus late posttreatment changes: diagnostic accuracy of O-(2-[18F]fluoroethyl)-L-tyrosine positron emission tomography (18F-FET PET). Neuro Oncol 2020; 21:1595-1606. [PMID: 31618420 DOI: 10.1093/neuonc/noz166] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Diagnostic accuracy in previous studies of O-(2-[18F]-fluoroethyl)-L-tyrosine (18F-FET) PET in patients with suspected recurrent glioma may be influenced by prolonged dynamic PET acquisitions, heterogeneous populations, different non-standard-of-care therapies, and PET scans performed at different time points post radiotherapy. We investigated the diagnostic accuracy of a 20-minute 18F-FET PET scan in MRI-suspected recurrent glioblastoma 6 months after standard radiotherapy and its ability to prognosticate overall survival (OS). METHODS In total, 146 glioblastoma patients with 168 18F-FET PET scans were reviewed retrospectively. Patients with MRI responses to bevacizumab or undergoing re-irradiation or immunotherapy after 18F-FET PET were excluded. Maximum and mean tumor-to-background ratios (TBRmax, TBRmean) and biological tumor volume (BTV) were recorded and verified by histopathology or clinical/radiological follow-up. Thresholds of 18F-FET parameters were determined by receiver operating characteristic (ROC) analysis. Prognostic factors were investigated in Cox proportional hazards models. RESULTS Surgery was performed after 104 18F-FET PET scans, while clinical/radiological surveillance was used following 64, identifying 152 glioblastoma recurrences and 16 posttreatment changes. ROC analysis yielded thresholds of 2.0 for TBRmax, 1.8 for TBRmean, and 0.55 cm3 for BTV in differentiating recurrent glioblastoma from posttreatment changes with the best performance of TBRmax (sensitivity 99%, specificity 94%; P < 0.0001) followed by BTV (sensitivity 98%, specificity 94%; P < 0.0001). Using these thresholds, 166 18F-FET PET scans were correctly classified. Increasing BTV was associated with shorter OS (P < 0.0001). CONCLUSION A 20-minute 18F-FET PET scan is a powerful tool to distinguish posttreatment changes from recurrent glioblastoma 6-month postradiotherapy, and predicts OS.
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Affiliation(s)
- Asma Bashir
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Otto Mølby Henriksen
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Helle Broholm
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Urup
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kirsten Grunnet
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Vibeke Andrée Larsen
- Department of Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Søren Møller
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jane Skjøth-Rasmussen
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Hans Skovgaard Poulsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Wang K, Qiao Z, Zhao X, Li X, Wang X, Wu T, Chen Z, Fan D, Chen Q, Ai L. Individualized discrimination of tumor recurrence from radiation necrosis in glioma patients using an integrated radiomics-based model. Eur J Nucl Med Mol Imaging 2020; 47:1400-1411. [PMID: 31773234 PMCID: PMC7188738 DOI: 10.1007/s00259-019-04604-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 11/05/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE To develop and validate an integrated model for discriminating tumor recurrence from radiation necrosis in glioma patients. METHODS Data from 160 pathologically confirmed glioma patients were analyzed. The diagnostic model was developed in a primary cohort (n = 112). Textural features were extracted from postoperative 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET), 11C-methionine (11C-MET) PET, and magnetic resonance images. The least absolute shrinkage and selection operator regression model was used for feature selection and radiomics signature building. Multivariable logistic regression analysis was used to develop a model for predicting tumor recurrence. The radiomics signature, quantitative PET parameters, and clinical risk factors were incorporated in the model. The clinical value of the model was then assessed in an independent validation cohort using the remaining 48 glioma patients. RESULTS The integrated model consisting of 15 selected features was significantly associated with postoperative tumor recurrence (p < 0.001 for both primary and validation cohorts). Predictors contained in the individualized diagnosis model included the radiomics signature, the mean of tumor-background ratio (TBR) of 18F-FDG, maximum of TBR of 11C-MET PET, and patient age. The integrated model demonstrated good discrimination, with an area under the curve (AUC) of 0.988, with a 95% confidence interval (CI) of 0.975-1.000. Application in the validation cohort showed good differentiation (AUC of 0.914 and 95% CI of 0.881-0.945). Decision curve analysis showed that the integrated diagnosis model was clinically useful. CONCLUSIONS Our developed model could be used to assist the postoperative individualized diagnosis of tumor recurrence in patients with gliomas.
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Affiliation(s)
- Kai Wang
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119, West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Zhen Qiao
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119, West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Xiaobin Zhao
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119, West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Xiaotong Li
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119, West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Xin Wang
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119, West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Tingfan Wu
- Department of PET/MR Advanced Application, GE Healthcare, Beijing, China
| | - Zhongwei Chen
- Department of PET/MR Advanced Application, GE Healthcare, Beijing, China
| | - Di Fan
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119, West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Qian Chen
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119, West Road of South 4th Ring, Fengtai District, Beijing, China
| | - Lin Ai
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, 119, West Road of South 4th Ring, Fengtai District, Beijing, China.
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Zaragori T, Ginet M, Marie PY, Roch V, Grignon R, Gauchotte G, Rech F, Blonski M, Lamiral Z, Taillandier L, Imbert L, Verger A. Use of static and dynamic [ 18F]-F-DOPA PET parameters for detecting patients with glioma recurrence or progression. EJNMMI Res 2020; 10:56. [PMID: 32472232 PMCID: PMC7260331 DOI: 10.1186/s13550-020-00645-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/13/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Static [18F]-F-DOPA PET images are currently used for identifying patients with glioma recurrence/progression after treatment, although the additional diagnostic value of dynamic parameters remains unknown in this setting. The aim of this study was to evaluate the performances of static and dynamic [18F]-F-DOPA PET parameters for detecting patients with glioma recurrence/progression as well as assess further relationships with patient outcome. METHODS Fifty-one consecutive patients who underwent an [18F]-F-DOPA PET for a suspected glioma recurrence/progression at post-resection MRI, were retrospectively included. Static parameters, including mean and maximum tumor-to-normal-brain (TBR) ratios, tumor-to-striatum (TSR) ratios, and metabolic tumor volume (MTV), as well as dynamic parameters with time-to-peak (TTP) values and curve slope, were tested for predicting the following: (1) glioma recurrence/progression at 6 months after the PET exam and (2) survival on longer follow-up. RESULTS All static parameters were significant predictors of glioma recurrence/progression (accuracy ≥ 94%) with all parameters also associated with mean progression-free survival (PFS) in the overall population (all p < 0.001, 29.7 vs. 0.4 months for TBRmax, TSRmax, and MTV). The curve slope was the sole dynamic PET predictor of glioma recurrence/progression (accuracy = 76.5%) and was also associated with mean PFS (p < 0.001, 18.0 vs. 0.4 months). However, no additional information was provided relative to static parameters in multivariate analysis. CONCLUSION Although patients with glioma recurrence/progression can be detected by both static and dynamic [18F]-F-DOPA PET parameters, most of this diagnostic information can be achieved by conventional static parameters.
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Affiliation(s)
- Timothée Zaragori
- Department of Nuclear Medicine & Nancyclotep Imaging platform, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France.,IADI, INSERM, UMR 1254, Université de Lorraine, F-54000, Nancy, France
| | - Merwan Ginet
- Department of Nuclear Medicine & Nancyclotep Imaging platform, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France
| | - Pierre-Yves Marie
- Department of Nuclear Medicine & Nancyclotep Imaging platform, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France.,INSERM, U1116, Université de Lorraine, F-54000, Nancy, France
| | - Véronique Roch
- Department of Nuclear Medicine & Nancyclotep Imaging platform, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France
| | - Rachel Grignon
- Department of Nuclear Medicine & Nancyclotep Imaging platform, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France
| | - Guillaume Gauchotte
- Department of Pathology, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France.,INSERM U1256, Université de Lorraine, F-54000, Nancy, France
| | - Fabien Rech
- Department of Neurosurgery, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France.,Centre de Recherche en Automatique de Nancy CRAN, CNRS UMR 7039, Université de Lorraine, F-54000, Nancy, France
| | - Marie Blonski
- Centre de Recherche en Automatique de Nancy CRAN, CNRS UMR 7039, Université de Lorraine, F-54000, Nancy, France.,Department of Neuro-oncology, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France
| | - Zohra Lamiral
- INSERM, U1116, Université de Lorraine, F-54000, Nancy, France
| | - Luc Taillandier
- Centre de Recherche en Automatique de Nancy CRAN, CNRS UMR 7039, Université de Lorraine, F-54000, Nancy, France.,Department of Neuro-oncology, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France
| | - Laëtitia Imbert
- Department of Nuclear Medicine & Nancyclotep Imaging platform, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France.,IADI, INSERM, UMR 1254, Université de Lorraine, F-54000, Nancy, France
| | - Antoine Verger
- Department of Nuclear Medicine & Nancyclotep Imaging platform, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France. .,IADI, INSERM, UMR 1254, Université de Lorraine, F-54000, Nancy, France.
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Kertels O, Kessler AF, Mihovilovic MI, Stolzenburg A, Linsenmann T, Samnick S, Brändlein S, Monoranu CM, Ernestus RI, Buck AK, Löhr M, Lapa C. Prognostic Value of O-(2-[ 18F]Fluoroethyl)-L-Tyrosine PET/CT in Newly Diagnosed WHO 2016 Grade II and III Glioma. Mol Imaging Biol 2020; 21:1174-1181. [PMID: 30977078 DOI: 10.1007/s11307-019-01357-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The use of [18F]fluoroethyl)-L-tyrosine ([18F]FET) positron emission tomography/computed tomography (PET/CT) has proven valuable in brain tumor management. This study aimed to investigate the prognostic value of radiotracer uptake in newly diagnosed grade II or III gliomas according to the current 2016 World Health Organization (WHO) classification. PROCEDURES A total of 35 treatment-naive patients (mean age, 48 ± 17 years) with histologically proven WHO grade II or III gliomas as defined by the current 2016 WHO classification were included. Static PET/CT imaging was performed 20 min after intravenous [18F]FET injection. Images were assessed visually and semi-quantitatively using regions of interest for both tumor (SUVmax, SUVmean) and background (BKGmean) to calculate tumor-to-background (TBR) ratios. The association among histological results, molecular markers (including isocitrate dehydrogenase enzyme and methylguanine-DNA methyltransferase status), clinical features (age), and PET findings was tested and compared with outcome (progression-free [PFS] and overall survival [OS]). RESULTS Fourteen patients presented with grade II (diffuse astrocytoma n = 10, oligodendroglioma n = 4) and 21 patients with grade III glioma (anaplastic astrocytoma n = 15, anaplastic oligodendroglioma n = 6). Twenty-seven out of the 35 patients were PET-positive (grade II n = 8/14, grade III n = 19/21), with grade III tumors exhibiting significantly higher amino acid uptake (TBRmean and TBRmax; p = 0.03 and p = 0.02, respectively). PET-negative lesions demonstrated significantly prolonged PFS (p = 0.003) as compared to PET-positive gliomas. PET-positive disease had a complementary value in prognostication in addition to patient age, glioma grade, and molecular markers. CONCLUSIONS Amino acid uptake as assessed by [18F]FET-PET/CT imaging is useful as non-invasive read-out for tumor biology and prognosis in newly diagnosed, treatment-naive gliomas according to the 2016 WHO classification.
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Affiliation(s)
- Olivia Kertels
- Institute of Diagnostic Radiology, University Hospital Würzburg, Wurzburg, Germany
| | - Almuth F Kessler
- Department of Neurosurgery, University Hospital Würzburg, Wurzburg, Germany
| | - Milena I Mihovilovic
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Wurzburg, Germany
| | - Antje Stolzenburg
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Wurzburg, Germany
| | - Thomas Linsenmann
- Department of Neurosurgery, University Hospital Würzburg, Wurzburg, Germany
| | - Samuel Samnick
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Wurzburg, Germany
| | - Stephanie Brändlein
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Wurzburg, Germany
| | - Camelia Maria Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Wurzburg, Germany
| | - Ralf-Ingo Ernestus
- Department of Neurosurgery, University Hospital Würzburg, Wurzburg, Germany
| | - Andreas K Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Wurzburg, Germany
| | - Mario Löhr
- Department of Neurosurgery, University Hospital Würzburg, Wurzburg, Germany
| | - Constantin Lapa
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Wurzburg, Germany.
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Werner JM, Lohmann P, Fink GR, Langen KJ, Galldiks N. Current Landscape and Emerging Fields of PET Imaging in Patients with Brain Tumors. Molecules 2020; 25:E1471. [PMID: 32213992 PMCID: PMC7146177 DOI: 10.3390/molecules25061471] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/17/2020] [Accepted: 03/20/2020] [Indexed: 02/07/2023] Open
Abstract
The number of positron-emission tomography (PET) tracers used to evaluate patients with brain tumors has increased substantially over the last years. For the management of patients with brain tumors, the most important indications are the delineation of tumor extent (e.g., for planning of resection or radiotherapy), the assessment of treatment response to systemic treatment options such as alkylating chemotherapy, and the differentiation of treatment-related changes (e.g., pseudoprogression or radiation necrosis) from tumor progression. Furthermore, newer PET imaging approaches aim to address the need for noninvasive assessment of tumoral immune cell infiltration and response to immunotherapies (e.g., T-cell imaging). This review summarizes the clinical value of the landscape of tracers that have been used in recent years for the above-mentioned indications and also provides an overview of promising newer tracers for this group of patients.
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Affiliation(s)
- Jan-Michael Werner
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, Germany; (J.-M.W.); (G.R.F.)
| | - Philipp Lohmann
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Leo-Brandt-St., 52425 Juelich, Germany; (P.L.); (K.-J.L.)
| | - Gereon R. Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, Germany; (J.-M.W.); (G.R.F.)
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Leo-Brandt-St., 52425 Juelich, Germany; (P.L.); (K.-J.L.)
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Leo-Brandt-St., 52425 Juelich, Germany; (P.L.); (K.-J.L.)
- Department of Nuclear Medicine, University Hospital Aachen, 52074 Aachen, Germany
| | - Norbert Galldiks
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, Germany; (J.-M.W.); (G.R.F.)
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Leo-Brandt-St., 52425 Juelich, Germany; (P.L.); (K.-J.L.)
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33
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Liu S, Wu R, Sun Y, Ploessl K, Zhang Y, Liu Y, Wu Z, Zhu L, Kung HF. Design, synthesis and evaluation of a novel glutamine derivative (2 S,4 R)-2-amino-4-cyano-4-[ 18F]fluorobutanoic acid. NEW J CHEM 2020. [DOI: 10.1039/d0nj00410c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A new glutamine derivative (2S,4R)-2-amino-4-cyano-4-[18F]fluorobutanoic acid (2S,4R)-4-[18F]FCABA ([18F]1) and its labeled precursor can be converted into (2S,4R)-4-[18F]FGln and (2S,4R)4-[18F]FGlu by changing the labeling conditions.
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Affiliation(s)
- Song Liu
- Beijing Institute of Brain Disorders
- Laboratory of Brain Disorders
- Ministry of Science and Technology
- Collaborative Innovation Center for Brain Disorders
- Capital Medical University
| | - Renbo Wu
- Beijing Institute of Brain Disorders
- Laboratory of Brain Disorders
- Ministry of Science and Technology
- Collaborative Innovation Center for Brain Disorders
- Capital Medical University
| | - Yuli Sun
- Beijing Institute of Brain Disorders
- Laboratory of Brain Disorders
- Ministry of Science and Technology
- Collaborative Innovation Center for Brain Disorders
- Capital Medical University
| | - Karl Ploessl
- Department of Radiology
- University of Pennsylvania
- Philadelphia
- USA
| | - Yan Zhang
- College of Chemistry
- Beijing Normal University
- Beijing
- China
| | - Yajing Liu
- School of Pharmaceutical Science, Capital Medical University
- Beijing 100069
- China
| | - Zehui Wu
- Beijing Institute of Brain Disorders
- Laboratory of Brain Disorders
- Ministry of Science and Technology
- Collaborative Innovation Center for Brain Disorders
- Capital Medical University
| | - Lin Zhu
- College of Chemistry
- Beijing Normal University
- Beijing
- China
| | - Hank F. Kung
- Beijing Institute of Brain Disorders
- Laboratory of Brain Disorders
- Ministry of Science and Technology
- Collaborative Innovation Center for Brain Disorders
- Capital Medical University
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Dissaux G, Basse V, Schick U, EL Kabbaj O, Auberger B, Magro E, Kassoul A, Abgral R, Salaun PY, Bourhis D, Querellou S. Prognostic value of 18F-FET PET/CT in newly diagnosed WHO 2016 high-grade glioma. Medicine (Baltimore) 2020; 99:e19017. [PMID: 32000446 PMCID: PMC7004648 DOI: 10.1097/md.0000000000019017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
O-(2-[F]fluoroethyl)-L-tyrosine positron-emission tomography/computed tomography (F-FET PET/CT) is well known in brain tumor management. Our study aimed to identify the prognostic value of F-FET PET/CT in high-grade gliomas (HGG) according the current 2016 World Health Organization (WHO) classification.Patients with histologically proven WHO 2016 HGG were prospectively included. A dynamic F-FET PET/CT was performed allowing to obtain 2 static PET frames (static frame 1: 20-40 minutes and static frame 2: 2-22 minutes). We analyzed static parameters (standard uptake value [SUV]max, SUVmean, SUVpeak, TBRmax, TBRmean, tumoral lesion glycolysis, and metabolic tumoral volume) for various isocontours (from 10% to 90%). PET parameters, clinical features, and molecular biomarkers were compared with progression-free survival (PFS) and overall survival (OS) in univariate and multivariate analysis.Twenty-nine patients were included (grade III n = 3, grade IV n = 26). Mean PFS and OS were, respectively, 8.8 and 13.9 months. According to univariate analysis, SUVmean, SUVpeak, TBRmax, and TBRmean were significantly correlated with OS. In static 1 analysis, TBRmax seemed to be the best OS prognostic parameter (P = .004). In static 2 analysis, TBRmean was the best parameter (P = .01). In static 1 analysis, only SUVpeak was significant (P = .05) for PFS. Good performance status (PS < 2; P < .0001) and extent of resection (P = .019) identified the subgroup of patients with the best OS. Only TBRmax (P = .026) and extent of resection (P = .025) remained significant parameters in multivariate analysis.Our data suggested that high TBRmax seemed to be the most significant OS independent prognostic factor in patients with newly diagnosed HGG.
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Affiliation(s)
| | - Victor Basse
- Oncology Department, University Hospital Morvan, Brest Cedex
| | | | | | | | - Elsa Magro
- Neurosurgery Department University Hospital Cavale Blanche
| | - Aboubakr Kassoul
- Nuclear Medicine Department, University Hospitam Morvan, Brest cedex
| | - Ronan Abgral
- Nuclear Medicine Department, University Hospitam Morvan, Brest cedex
- EA 3878 GETBO IFR 148
- University of Bretagne Occidentale, Brest, France
| | - Pierre-Yves Salaun
- Nuclear Medicine Department, University Hospitam Morvan, Brest cedex
- EA 3878 GETBO IFR 148
- University of Bretagne Occidentale, Brest, France
| | - David Bourhis
- Nuclear Medicine Department, University Hospitam Morvan, Brest cedex
- EA 3878 GETBO IFR 148
- University of Bretagne Occidentale, Brest, France
| | - Solène Querellou
- Nuclear Medicine Department, University Hospitam Morvan, Brest cedex
- EA 3878 GETBO IFR 148
- University of Bretagne Occidentale, Brest, France
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Graham MS, Krebs S, Bale T, Domfe K, Lobaugh SM, Zhang Z, Dunphy MP, Kaley T, Young RJ. Value of [ 18F]-FDG positron emission tomography in patients with recurrent glioblastoma receiving bevacizumab. Neurooncol Adv 2020; 2:vdaa050. [PMID: 32642703 PMCID: PMC7236386 DOI: 10.1093/noajnl/vdaa050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Treatment of recurrent glioblastoma (GBM) with bevacizumab can induce MRI changes that confound the determination of progression. We sought to determine the value of [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) in GBM patients receiving bevacizumab at the time of suspected progression and, thereby, its utility as a potential prognostic adjunct in progressive disease. METHODS This retrospective study included patients who underwent brain FDG PET within 4 weeks of receiving bevacizumab for recurrent GBM with suspected progression. Volumes-of-interest were placed over the reference lesion with measurement of maximum standardized uptake value (SUVmax), peak standardized uptake value (SUVpeak), metabolic tumor volume, total lesion glycolysis (TLG), and tumor-to-normal contralateral white matter ratios (TNR-WM). Tumors were additionally categorized as non-avid or avid based on qualitative FDG uptake. Associations between baseline variables and overall survival (OS) were examined using univariable and multivariable Cox proportional hazards regression, with P < .05 considered significant. RESULTS Thirty-one patients were analyzed. Qualitative FDG uptake was significantly associated with OS (P = .03), with a median OS of 9.0 months in non-avid patients versus 4.5 months in avid patients. SUVmax, SUVpeak, TNR-WM, and TLG were significantly associated with OS (P < .001, TLG: P = .009). FDG avidity and SUVmax remained significantly associated with OS (P = .046 and .048, respectively) in the multivariable analysis including age, KPS, and MGMT status. Dichotomizing patients using an SUVmax cutoff of 15.3 was associated with OS (adjusted P = .048). CONCLUSION FDG PET is a promising imaging tool to further stratify prognosis in recurrent GBM patients on antiangiogenic therapy.
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Affiliation(s)
- Maya S Graham
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- The Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Simone Krebs
- Department of Radiology, Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Tejus Bale
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kwaku Domfe
- College of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Stephanie M Lobaugh
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Zhigang Zhang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mark P Dunphy
- Department of Radiology, Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Thomas Kaley
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- The Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Robert J Young
- Department of Radiology, Neuroradiology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- The Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Langen KJ, Heinzel A, Lohmann P, Mottaghy FM, Galldiks N. Advantages and limitations of amino acid PET for tracking therapy response in glioma patients. Expert Rev Neurother 2019; 20:137-146. [DOI: 10.1080/14737175.2020.1704256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-3, INM-4), Forschungszentrum Juelich, Juelich, Germany
- Department of Nuclear Medicine, University of Aachen, Aachen, Germany
- Section JARA-Brain, Juelich-Aachen Research Alliance (JARA), Juelich-Aachen, Germany
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Alexander Heinzel
- Department of Nuclear Medicine, University of Aachen, Aachen, Germany
- Section JARA-Brain, Juelich-Aachen Research Alliance (JARA), Juelich-Aachen, Germany
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Philipp Lohmann
- Institute of Neuroscience and Medicine (INM-3, INM-4), Forschungszentrum Juelich, Juelich, Germany
| | - Felix M. Mottaghy
- Department of Nuclear Medicine, University of Aachen, Aachen, Germany
- Section JARA-Brain, Juelich-Aachen Research Alliance (JARA), Juelich-Aachen, Germany
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Centre of Integrated Oncology (CIO), Universities of Aachen, Düsseldorf, Germany
| | - Norbert Galldiks
- Institute of Neuroscience and Medicine (INM-3, INM-4), Forschungszentrum Juelich, Juelich, Germany
- Department of Neurology1, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- Centre of Integrated Oncology (CIO), Universities of Aachen, Düsseldorf, Germany
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Wu R, Liu S, Liu Y, Sun Y, Cheng X, Huang Y, Yang Z, Wu Z. Synthesis and biological evaluation of [18F](2S,4S)4-(3-fluoropropyl) arginine as a tumor imaging agent. Eur J Med Chem 2019; 183:111730. [DOI: 10.1016/j.ejmech.2019.111730] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/21/2019] [Accepted: 09/21/2019] [Indexed: 12/31/2022]
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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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Metabolic Tumor Volume Response Assessment Using (11)C-Methionine Positron Emission Tomography Identifies Glioblastoma Tumor Subregions That Predict Progression Better Than Baseline or Anatomic Magnetic Resonance Imaging Alone. Adv Radiat Oncol 2019; 5:53-61. [PMID: 32051890 PMCID: PMC7004943 DOI: 10.1016/j.adro.2019.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/05/2019] [Indexed: 02/08/2023] Open
Abstract
Purpose To evaluate whether response assessment of newly diagnosed glioblastoma at 3 months using 11C-methionine-positron emission tomography (MET-PET) is better associated with patient outcome compared with baseline MET-PET or anatomic magnetic resonance imaging alone. Methods and Materials Patients included were participants in a phase I/II trial of dose-escalated chemoradiation based on anatomic magnetic resonance imaging. Automated segmentation of metabolic tumor volume (MTV) was performed at a threshold of 1.5 times mean cerebellar uptake. Progression-free (PFS) and overall survival were estimated with the Kaplan-Meier method and compared with log-rank tests. Multivariate analysis for PFS and overall survival was performed using Cox proportional hazards, and spatial overlap between imaging and recurrence volumes were analyzed. Results Among 37 patients, 15 had gross total resection, of whom 10 (67%) had residual MTV, 16 subtotal resection, and 6 biopsy alone. Median radiation therapy dose was 75 Gy (range, 66-81). Median baseline T1 Gd-enhanced tumor volume (GTV-Gd) was 38.0 cm3 (range, 8.0-81.5). Median pre-CRT MTV was 4.9 cm3 (range, 0-43.8). Among 25 patients with 3-month MET-PET, MTV was only 2.4 cm3 (range, 0.004-18.0) in patients with uptake. Patients with MTV = 0 cm3 at 3 months had superior PFS (18.2 vs 10.1 months, P = .03). On multivariate analysis, larger 3-month MTV (hazard ratio [HR] 2.4, 95% confidence interval [CI], 1.4-4.3, P = .03), persistent MET-PET subvolume (overlap of pre-CRT and 3 month MTV; HR 2.0, 95% CI, 1.2-3.4, P = .06), and increase in MTV (HR 1.8, 95% CI, 1.1-3.1, P = .09) were the only imaging factors significant for worse PFS. GTV-Gd at recurrence encompassed 97% of the persistent MET-PET subvolume (interquartile range 72%-100%), versus 71% (interquartile range 39%-93%) of baseline MTV, 54% of baseline GTV-Gd (18%-87%), and 78% of 3-month MTV (47%-95%). Conclusions The majority of patients with apparent gross total resection of glioblastoma have measurable postoperative MTV. Total and persisting MTV 3 months post-CRT were significant predictors of PFS, and persistent MET-PET subvolume was the strongest predictor for localizing tumor recurrence.
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Baguet T, Verhoeven J, De Vos F, Goethals I. Cost-Effectiveness of [ 18F] Fluoroethyl-L-Tyrosine for Temozolomide Therapy Assessment in Patients With Glioblastoma. Front Oncol 2019; 9:814. [PMID: 31555584 PMCID: PMC6722181 DOI: 10.3389/fonc.2019.00814] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/08/2019] [Indexed: 01/10/2023] Open
Abstract
Background and Purpose: Glioblastomas are the most aggressive of all gliomas. The prognosis of these gliomas, which are classified as grade IV tumors by the World Health Organization (WHO), is poor. Combination therapy, including surgery, radiotherapy, and chemotherapy has variable outcomes and is expensive. In light of rising healthcare costs, there are societal demands for the justification of medical expenses. Therefore, we calculated the cost-effectiveness of follow-up [18F] fluoroethyl-L-tyrosine ([18F] FET) positron emission tomography (PET) scans performed on patients with glioblastoma after surgery and before commencing temozolomide maintenance treatment. Materials and Methods: To determine the cost-effectiveness of follow-up [18F] FET PET procedures, we examined published clinical data and calculated the associated costs in the context of Belgian healthcare. We subsequently performed one-way deterministic sensitivity analysis and Monte Carlo analysis on the calculated ratios. Results: The decision tree based on overall survival rates showed that the number of non-responders identified using PET was 57.14% higher than the number of non-responders identified using conventional MRI. Further, the decision tree based on progression-free survival rates revealed a comparable increase of 57.50% non-responders identified. The calculated cost of two required PET scans per patient during the follow-up treatment phase was 780.50 euros. Two cost-effectiveness ratios were determined for overall survival and progression-free survival rates. Both of these calculations yielded very similar results: incremental cost-effectiveness ratios of 1,365.86 and 1,357.38 euros, respectively, for each identified non-responder. The findings of the sensitivity analysis supported the calculated results, confirming that the obtained data were robust. Conclusion: Our comparative study of conventional MRI and [18F] FET PET revealed that the latter is a valuable tool for predicting the treatment responses of patients with glioblastomas to follow-up temozolomide maintenance treatment while considering its cost-effectiveness. Thus, [18F] FET PET scans enable clinical outcomes to be predicted accurately and at a low cost. Moreover, given the robustness of the data in the sensitivity analyses, the level of certainty of this outcome is acceptable.
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Affiliation(s)
- Tristan Baguet
- Laboratory of Radiopharmacy, Ghent University, Ghent, Belgium
| | | | - Filip De Vos
- Laboratory of Radiopharmacy, Ghent University, Ghent, Belgium
| | - Ingeborg Goethals
- Department of Nuclear Medicine, University Hospital Ghent, Ghent, Belgium
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Clinical Utility of Different Approaches for Detection of Late Pseudoprogression in Glioblastoma With O-(2-[18F]Fluoroethyl)-l-Tyrosine PET. Clin Nucl Med 2019; 44:695-701. [DOI: 10.1097/rlu.0000000000002652] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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PET biomarkers and probes for treatment response assessment in glioblastoma: a work in progress. Clin Transl Imaging 2019. [DOI: 10.1007/s40336-019-00329-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Galldiks N, Lohmann P, Albert NL, Tonn JC, Langen KJ. Current status of PET imaging in neuro-oncology. Neurooncol Adv 2019; 1:vdz010. [PMID: 32642650 PMCID: PMC7324052 DOI: 10.1093/noajnl/vdz010] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Over the past decades, a variety of PET tracers have been used for the evaluation of patients with brain tumors. For clinical routine, the most important clinical indications for PET imaging in patients with brain tumors are the identification of neoplastic tissue including the delineation of tumor extent for the further diagnostic and therapeutic management (ie, biopsy, resection, or radiotherapy planning), the assessment of response to a certain anticancer therapy including its (predictive) effect on the patients’ outcome and the differentiation of treatment-related changes (eg, pseudoprogression and radiation necrosis) from tumor progression at follow-up. To serve medical professionals of all disciplines involved in the diagnosis and care of patients with brain tumors, this review summarizes the value of PET imaging for the latter-mentioned 3 clinically relevant indications in patients with glioma, meningioma, and brain metastases.
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Affiliation(s)
- Norbert Galldiks
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany.,Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, Germany
| | - Philipp Lohmann
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Juelich, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, Ludwig Maximilians-University of Munich, Munich, Germany
| | - Jörg C Tonn
- Department of Neurosurgery, Ludwig Maximilians-University of Munich, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Karl-Josef Langen
- Department of Nuclear Medicine, University Hospital Aachen, Aachen, Germany
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Nowosielski M, Gorlia T, Bromberg JEC, Sahm F, Harting I, Kickingereder P, Brandes AA, Taphoorn MJB, Taal W, Domont J, Idbaih A, Campone M, Clement PM, Weller M, Fabbro M, Le Rhun E, Platten M, Golfinopoulos V, van den Bent MJ, Bendszus M, Wick W. Imaging necrosis during treatment is associated with worse survival in EORTC 26101 study. Neurology 2019; 92:e2754-e2763. [PMID: 31076534 DOI: 10.1212/wnl.0000000000007643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 02/05/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Imaging necrosis on MRI scans was assessed and compared to outcome measures of the European Organisation for Research and Treatment of Cancer 26101 phase III trial that compared single-agent lomustine with lomustine plus bevacizumab in patients with progressive glioblastoma. METHODS MRI in this post hoc analysis was available for 359 patients (lomustine = 127, lomustine + bevacizumab = 232). First, imaging necrosis at baseline being formally measurable (>10 × 10 mm, given 2 slices) was assessed. At weeks 6 and 12 of treatment, it was analyzed whether this necrosis remained stable or increased >25% calculated by 2 perpendicular diameters or whether necrosis developed de novo. Univariate and multivariate associations of baseline necrosis with overall survival (OS) and progression-free survival (PFS) were tested by log-rank test. Hazard ratios (HR) with 95% confidence interval were calculated by Cox model. RESULTS Imaging necrosis at baseline was detected in 191 patients (53.2%) and was associated with worse OS and PFS in univariate, but not in multivariate analysis. Baseline necrosis was predictive for OS in the lomustine-only group (HR 1.46, p = 0.018). At weeks 6 and 12 of treatment, increase of baseline necrosis and de novo necrosis were strongly associated with worse OS and PFS in univariate and multivariate analysis (PFS both p < 0.001, OS univariate p < 0.001, multivariate p = 0.0046). CONCLUSION Increase of and new development of imaging necrosis during treatment is a negative prognostic factor for patients with progressive glioblastoma. These data call for consideration of integrating the assessment of imaging necrosis as a separate item into the MRI response assessment criteria.
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Affiliation(s)
- Martha Nowosielski
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria.
| | - Thierry Gorlia
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Jacoline E C Bromberg
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Felix Sahm
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Inga Harting
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Philipp Kickingereder
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Alba A Brandes
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Martin J B Taphoorn
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Walter Taal
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Julien Domont
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Ahmed Idbaih
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Mario Campone
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Paul M Clement
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Michael Weller
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Michel Fabbro
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Emilie Le Rhun
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Michael Platten
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Vassilis Golfinopoulos
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Martin J van den Bent
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Martin Bendszus
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria
| | - Wolfgang Wick
- From the University Medical Center & German Cancer Research Center (M.N., F.S., I.H., P.K., M.P., M.B., W.W.), Heidelberg, Germany; EORTC Headquarters (T.G., V.G.), Brussels, Belgium; Brain Tumor Center at Erasmus MC Cancer Institute (J.E.C.B., W.T., M.J.v.d.B.), Rotterdam, the Netherlands; Medical Oncology Department (A.A.B.), AUSL-Bologna-IRCCS Scienze Neurologiche, Bologna, Italy; Haaglanden Medical Center (M.J.B.T.), the Hague; Leiden University Medical Center (M.J.B.T.), the Netherlands; Institut Gustave Roussy (J.D.), Villejuif; Sorbonne Université (A.I.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris; Institut de Cancerologie de l'Ouest (ICO)-Centre Rene Gauducheau (M.C.), Saint-Herblain, France; Leuven Cancer Institute-KU Leuven (P.M.C.), Belgium; Department of Neurology and Brain Tumor Center (M.W.), University Hospital and University of Zurich, Switzerland; Institut Régional du Cancer Montpellier (M.F.); University of Lille (E.L.R.), U-1192, Inserm; CHU Lille (E.L.R.), General and Stereotaxic Neurosurgery Service; Oscar Lambret Center (E.L.R.), Neurology, Lille, France; Department of Neurology (M.P.), Medical Faculty Mannheim, Heidelberg University, Germany; and Department of Neurology (M.N.), Medical University Innsbruck, Austria.
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Huang Y, Liu S, Wu R, Zhang L, Zhang Y, Hong H, Zhang A, Xiao H, Liu Y, Wu Z, Zhu L, Kung HF. Synthesis and preliminary evaluation of a novel glutamine derivative: (2S,4S)4-[ 18F]FEBGln. Bioorg Med Chem Lett 2019; 29:1047-1050. [PMID: 30871772 DOI: 10.1016/j.bmcl.2019.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/04/2019] [Accepted: 03/10/2019] [Indexed: 12/22/2022]
Abstract
We report the preparation of a novel glutamine derivative, (2S,4S)-2,5-diamino-4-(4-(2-fluoroethoxy)benzyl)-5-oxopentanoic acid, (2S, 4S)4-[18F]FEBGln ([18F]4), through efficient organic and radiosyntheses. In vitro assays of [18F]4 using MCF-7 cells showed that it entered cells via multiple amino acid transporter systems including system L and ASC2 transporters but not through the system A transporter. [18F]4 showed promising properties for tumor imaging and may serve as a lead compound for further optimizing and targeting the system L transporter associated with enhanced glutamine metabolism in cancer cells.
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Affiliation(s)
- Yong Huang
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Song Liu
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Renbo Wu
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Lifang Zhang
- College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Yan Zhang
- College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Haiyan Hong
- College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Aili Zhang
- College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Hao Xiao
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Yajing Liu
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Zehui Wu
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China.
| | - Lin Zhu
- College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Hank F Kung
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China; Department of Radiology, University of Pennsylvania, Philadelphia 19104, United States.
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Comparisons Between PET With 11C-Methyl-L-Methionine and Arterial Spin Labeling Perfusion Imaging in Recurrent Glioblastomas Treated With Bevacizumab. Clin Nucl Med 2019; 44:186-193. [PMID: 30562194 DOI: 10.1097/rlu.0000000000002417] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to clarify whether arterial spin labeling (ASL) perfusion imaging can assess biological effects from bevacizumab (BEV) therapy as reliably as PET with C-methyl-L-methionine (C-met-PET). MATERIALS AND METHODS Twenty-four patients with recurrent glioblastoma were examined using both ASL and C-met-PET before and 4 and 8 weeks after starting BEV treatment. Tumor-to-normal brain (T/N) ratios, fluctuations in T/N ratio, and tumor volumes were compared between ASL and C-met-PET. Accuracy of predicting patient with long progression-free survival (PFS) was assessed for T/N ratios and fluctuations for ASL and C-met-PET in each phase and in each period using receiver operating characteristic curves. Between 2 groups of patients assigned by cutoff values from receiver operating characteristic curves, PFS was compared in each phase or in each period. RESULTS T/N ratios, fluctuations in ratio, and tumor volumes correlated significantly between ASL and C-met-PET at all time points and all periods. Arterial spin labeling was eligible as a predictor for long PFS only in assessment of fluctuations in T/N ratio. However, the most accurate predictors for long PFS were T/N ratio from C-met-PET at 8 weeks and the fluctuation from baseline to 4 weeks in T/N ratio from C-met-PET. CONCLUSIONS Blood flows on ASL correlated with accumulations of C-met on PET in recurrent glioblastoma under BEV treatment. Although C-met-PET offered superior accuracy for predicting patients with long PFS from time points, ASL offered reliable prediction of long PFS, provided that fluctuations in T/N ratio between consecutive scans are assessed.
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Abstract
PURPOSE OF REVIEW The aim of this study was to give an update on the emerging role of PET using radiolabelled amino acids in the diagnostic workup and management of patients with cerebral gliomas and brain metastases. RECENT FINDINGS Numerous studies have demonstrated the potential of PET using radiolabelled amino acids for differential diagnosis of brain tumours, delineation of tumour extent for treatment planning and biopsy guidance, differentiation between tumour progression and recurrence versus treatment-related changes, and for monitoring of therapy. The Response Assessment in Neuro-Oncology (RANO) working group - an international effort to develop new standardized response criteria for clinical trials in brain tumours - has recently recommended the use of amino acid PET imaging for brain tumour management in addition to MRI at every stage of disease. With the introduction of F-18 labelled amino acids, a broader clinical application has become possible, but is still hampered by the lack of regulatory approval and of reimbursement in many countries. SUMMARY PET using radiolabelled amino acids is a rapidly evolving method that can significantly enhance the diagnostic value of MRI in brain tumours. Current developments suggest that this imaging technique will become an indispensable tool in neuro-oncological centres in the near future.
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[ 18F]FET PET is a useful tool for treatment evaluation and prognosis prediction of anti-angiogenic drug in an orthotopic glioblastoma mouse model. Lab Anim Res 2019; 34:248-256. [PMID: 30671112 PMCID: PMC6333614 DOI: 10.5625/lar.2018.34.4.248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 11/21/2022] Open
Abstract
O-2-18F-fluoroethyl-l-tyrosine ([18F]FET) has been widely used for glioblastomas (GBM) in clinical practice, although evaluation of its applicability in non-clinical research is still lacking. The objective of this study was to examine the value of [18F]FET for treatment evaluation and prognosis prediction of anti-angiogenic drug in an orthotopic mouse model of GBM. Human U87MG cells were implanted into nude mice and then bevacizumab, a representative anti-angiogenic drug, was administered. We monitored the effect of anti-angiogenic agents using multiple imaging modalities, including bioluminescence imaging (BLI), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET/CT). Among these imaging methods analyzed, only [18F]FET uptake showed a statistically significant decrease in the treatment group compared to the control group (P=0.02 and P=0.03 at 5 and 20 mg/kg, respectively). This indicates that [18F]FET PET is a sensitive method to monitor the response of GBM bearing mice to anti-angiogenic drug. Moreover, [18F]FET uptake was confirmed to be a significant parameter for predicting the prognosis of anti-angiogenic drug (P=0.041 and P=0.007, on Days 7 and 12, respectively, on Pearson's correlation; P=0.048 and P=0.030, on Days 7 and 12, respectively, on Cox regression analysis). However, results of BLI or MRI were not significantly associated with survival time. In conclusion, this study suggests that [18F]FET PET imaging is a pertinent imaging modality for sensitive monitoring and accurate prediction of treatment response to anti-angiogenic agents in an orthotopic model of GBM.
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Law I, Albert NL, Arbizu J, Boellaard R, Drzezga A, Galldiks N, la Fougère C, Langen KJ, Lopci E, Lowe V, McConathy J, Quick HH, Sattler B, Schuster DM, Tonn JC, Weller M. Joint EANM/EANO/RANO practice guidelines/SNMMI procedure standards for imaging of gliomas using PET with radiolabelled amino acids and [ 18F]FDG: version 1.0. Eur J Nucl Med Mol Imaging 2018; 46:540-557. [PMID: 30519867 PMCID: PMC6351513 DOI: 10.1007/s00259-018-4207-9] [Citation(s) in RCA: 325] [Impact Index Per Article: 54.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 10/29/2018] [Indexed: 01/12/2023]
Abstract
These joint practice guidelines, or procedure standards, were developed collaboratively by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neurooncology (EANO), and the working group for Response Assessment in Neurooncology with PET (PET-RANO). Brain PET imaging is being increasingly used to supplement MRI in the clinical management of glioma. The aim of these standards/guidelines is to assist nuclear medicine practitioners in recommending, performing, interpreting and reporting the results of brain PET imaging in patients with glioma to achieve a high-quality imaging standard for PET using FDG and the radiolabelled amino acids MET, FET and FDOPA. This will help promote the appropriate use of PET imaging and contribute to evidence-based medicine that may improve the diagnostic impact of this technique in neurooncological practice. The present document replaces a former version of the guidelines published in 2006 (Vander Borght et al. Eur J Nucl Med Mol Imaging. 33:1374–80, 2006), and supplements a recent evidence-based recommendation by the PET-RANO working group and EANO on the clinical use of PET imaging in patients with glioma (Albert et al. Neuro Oncol. 18:1199–208, 2016). The information provided should be taken in the context of local conditions and regulations.
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Affiliation(s)
- Ian Law
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, 9, Blegdamsvej, 2100-DK, Copenhagen Ø, Denmark.
| | - Nathalie L Albert
- Department of Nuclear Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Javier Arbizu
- Department of Nuclear Medicine, Clínica Universidad de Navarra, University of Navarre, Pamplona, Spain
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.,Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Norbert Galldiks
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,Institute of Neuroscience and Medicine (INM-3, -4), Forschungszentrum Julich, Julich, Germany
| | - Christian la Fougère
- Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, University of Tübingen, Tübingen, Germany
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-3, -4), Forschungszentrum Julich, Julich, Germany.,Department of Nuclear Medicine, RWTH University Aachen, Aachen, Germany
| | - Egesta Lopci
- Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Val Lowe
- Department of Radiology, Nuclear Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jonathan McConathy
- Division of Molecular Imaging and Therapeutics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Harald H Quick
- High-Field and Hybrid MR Imaging, University Hospital Essen, Essen, Germany
| | - Bernhard Sattler
- Department for Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - David M Schuster
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Jörg-Christian Tonn
- Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Weller
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
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Voxel-Wise Analysis of Fluoroethyltyrosine PET and MRI in the Assessment of Recurrent Glioblastoma During Antiangiogenic Therapy. AJR Am J Roentgenol 2018; 211:1342-1347. [PMID: 30332289 DOI: 10.2214/ajr.18.19988] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE In MRI of patients with recurrent glioblastoma, bevacizumab-induced normalization of tumor vascularity can be difficult to differentiate from antitumor effects. The aim of this study was to assess the utility of 18F-fluoroethyl-L-tyrosine (FET) PET in the evaluation of recurrent glioblastoma treated with bevacizumab. SUBJECTS AND METHODS MRI and FET PET were performed before and after administration of two doses of bevacizumab to 11 patients with recurrent glioblastoma. The ratio between normalized FET uptake at follow-up and baseline of the entire (volume of T2 FLAIR abnormality) and enhancing tumor were assessed for prediction of progression-free survival (PFS) and overall survival (OS). Voxel-wise Spearman correlation between normalized FET uptake and contrast-enhanced T1 signal intensity was assessed and tested as a predictor of PFS and OS. RESULTS Mean Spearman correlation between FET uptake and contrast-enhanced T1 signal intensity before therapy was 0.65 and after therapy was 0.61 (p = 0.256). The median PFS after initiation of bevacizumab therapy was 111 days, and the OS was 223 days. A post-treatment to pretreatment PET uptake ratio (mean and 90th percentile) greater than 0.7 for both entire and enhancing tumor was associated with lower PFS and OS (p < 0.001-0.049). The increase in correlation between PET uptake and contrast-enhanced T1 intensity after treatment was associated with lower PFS (p < 0.001) and OS (p = 0.049). CONCLUSION There is only a moderate correlation between FET PET uptake and contrast-enhanced T1 signal intensity. High posttreatment-to-pretreatment FET PET uptake ratio and increase in correlation between PET uptake and contrast-enhanced T1 signal intensity after bevacizumab treatment are associated with poor PFS and OS.
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