Biological tumour volumes of gliomas in early and standard 20–40 min 18F-FET PET images differ according to IDH mutation status

Winkelmann, I.; Suchorska, Bogdana; Giese, Armin; Wenter, Vera; Kreth, Friedrich-Wilhelm; Herms, Jochen; Bartenstein, Peter; Tonn, Jörg‐Christian; Albert, Nathalie L.

doi:10.1007/s00259-018-3969-4

Cited by 31 publications

(14 citation statements)

References 31 publications

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“…Recently,11C-MET and18F-FET PET were proved to allow a better delineation of tumor margins and improve targeting of biopsy and radiotherapy, suggesting the application of biological tumor volume defined by SUV value in radiotherapy of gliomas. 47,48 However, a meta-analysis comparing the diagnostic ACC of different imaging technique to delineate diffuse gliomas reported that for LGGs, the area under the hsROC curve was higher for MRS (0.781) than T2/FLAIR (0.774), followed by PET-MET (0.668) and PET-FET (0.649). The false-positive rate was lower in MRS (36.1%) than in PET-FET (38.5%); the true-positive rate was highest for MRS (87.3%), followed by T2/FLAIR (65.8%) and PET-FET (60%).…”

Section: Discussionmentioning

confidence: 99%

Prediction of IDH Status Through MRI Features and Enlightened Reflection on the Delineation of Target Volume in Low-Grade Gliomas

Ding

Huang

et al. 2019

Technol Cancer Res Treat

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Isocitrate dehydrogenase mutational status defines distinct biologic behavior and clinical outcomes in low-grade gliomas. We sought to determine magnetic resonance imaging characteristics associated with isocitrate dehydrogenase mutational status to evaluate the predictive roles of magnetic resonance imaging features in isocitrate dehydrogenase mutational status and therefore their potential impact on the determination of clinical target volume in radiotherapy. Forty-eight isocitrate dehydrogenase-mutant and 28 isocitrate dehydrogenase–wild-type low-grade gliomas were studied. Isocitrate dehydrogenase mutation was related to more frequency of cortical involvement compared to isocitrate dehydrogenase–wild-type group (34/46 vs 6/24, P = .0001). Peritumoral edema was less frequent in isocitrate dehydrogenase–mutant tumors (32.6% vs 58.3% for isocitrate dehydrogenase–wild-type tumors, P = .0381). Isocitrate dehydrogenase–wild-type tumors were more likely to have a nondefinable border, while isocitrate dehydrogenase–mutant tumors had well-defined borders (66.7% vs 39.1%, P = .0287). Only 8 (17.4%) of 46 of the isocitrate dehydrogenase–mutant tumors demonstrated marked enhancement, while this was 66.7% in isocitrate–wild-type tumors ( P < .0001). Choline–creatinine ratio for isocitrate dehydrogenase–wild-type tumors was significantly higher than that for isocitrate dehydrogenase–mutant tumors. In conclusion, frontal location, well-defined border, cortical involvement, less peritumoral edema, lack of enhancement, and low choline–creatinine ratio were predictive for the definition of isocitrate dehydrogenase–mutant low-grade gliomas. Magnetic resonance imaging can provide an advantage in the detection of isocitrate dehydrogenase status indirectly and indicate the need to explore new design for treatment planning in gliomas. Choline–creatinine ratio in magnetic resonance spectroscopy could be a potential more reasonable reference for the new design of delineation of target volume in low-grade gliomas.

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Section: Discussionmentioning

confidence: 99%

Prediction of IDH Status Through MRI Features and Enlightened Reflection on the Delineation of Target Volume in Low-Grade Gliomas

Ding

Huang

et al. 2019

Technol Cancer Res Treat

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“…The biological tumor volume of early glioma differs from the standard 20-40 min FDG-PET to determine IDH status [24]. Moreover, several studies revealed an association between the FDG uptake and the status of IDH mutation or the prognosis of glioma [24,25], as SUVmax or different ratio based on SUV showed its diagnostic value.…”

Section: Introductionmentioning

confidence: 99%

“…MET-PET/MRI has been reported to predict the IDH mutation of gliomas, by calculating the maximum tumor-brain ratio of MET uptake, and the receiver operating characteristic (ROC) analysis showed high AUC of 0.79 [23]. The biological tumor volume of early glioma differs from the standard 20-40 min FDG-PET to determine IDH status [24]. Moreover, several studies revealed an association between the FDG uptake and the status of IDH mutation or the prognosis of glioma [24,25], as SUVmax or different ratio based on SUV showed its diagnostic value.…”

Section: Introductionmentioning

confidence: 99%

The diagnostic value of lower glucose consumption for IDH1 mutated gliomas on FDG-PET

et al. 2021

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Background Non-invasive diagnosis of IDH1 mutation for gliomas has great clinical significance, and PET has natural advantage to detect metabolism, as IDH mutated gliomas share lower glucose consumption. Methods Clinical data of patients with gliomas and 18F-FDG PET were retrospectively reviewed. Receiver operating characteristic curve (ROC) analysis was conducted, and standard uptake value (SUV) was estimated in combination with grades or IDH1 mutation. The glucose consumption was investigated with U251 cells expressing wild-type or mutated IDH1 by glucose assay. Quantification of glucose was determined by HPLC in clinical tissues. Meanwhile, bioinformatics and western blot were applied to analyze the expression level of metabolic enzymes (e.g. HK1, PKM2, PC) in gliomas. Results Seventy-one glioma cases were enrolled, including 30 carrying IDH1 mutation. The sensitivity and specificity dependent on SUVmax (3.85) predicting IDH1 mutation reached 73.2 and 86.7%, respectively. The sensitivity and specificity of differentiating grades by SUVmax (3.1) were 92.3 and 64.4%, respectively. Glucose consumption of U251 IDH1 mutant cells (0.209 ± 0.0472 mg/ml) was obviously lower than IDH1wild-type cells (0.978 ± 0.0773 mg/ml, P = 0.0001) and astrocyte controls (0.335 ± 0.0592 mg/ml, P = 0.0451). Meanwhile, the glucose quantity in IDH1mutant glioma samples were significantly lower than those in IDH1 wild-type tissues (1.033 ± 1.19608 vs 6.361 ± 4.3909 mg/g, P = 0.0051). Silico analysis and western blot confirmed that HK1 and PKM2 in IDH1 wild-type gliomas were significantly higher than in IDH1 mutant group, while PC was significantly higher in IDH1 mutant gliomas. Conclusion SUVmax on PET can predict IDH1 mutation with adequate sensitivity and specificity, as is supported by reduced glucose consumption in IDH1 mutant gliomas.

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“…Early static FET-PET scans have a higher accuracy for glioma grading than the standard 20-40 min scans ( 15 ). Whereas, PET 20–40 min post-injection seems appropriate for delineation of low-grade gliomas as well as IDH-mutant gliomas, high-grade gliomas, and some IDH wildtype gliomas seem to have larger volumes in early images ( 16 ). Dual time-point FET-PET is a promising compromise that might improve glioma grading and definition of tumor borders using two static images early (5–15 min post-injection) and late (50–80 min post-injection) after radiotracer injection ( 17 , 18 ).…”

Section: Introductionmentioning

confidence: 99%

Glioma Biopsy Based on Hybrid Dual Time-Point FET-PET/MRI—A Proof of Concept Study

et al. 2021

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Neuroimaging based on O-[2-(18F)fluoroethyl]-l-tyrosine (FET)-PET provides additional information on tumor grade and extent compared with MRI. Dynamic PET for biopsy target selection further improves results but is often clinically impractical. Static FET-PET performed at two time-points may be a good compromise, but data on this approach are limited. The aim of this study was to compare the histology of lesions obtained from two challenging glioma patients with targets selected based on hybrid dual time-point FET-PET/MRI. Five neuronavigated tumor biopsies were performed in two difficult cases of suspected glioma. Lesions with (T1-CE) and without contrast enhancement (T1 and T2-FLAIR) on MRI were selected. Dual time-point FET-PET imaging was performed 5–15 min (PET10) and 45–60 min (PET60) after radionuclide injection. The most informative FET-PET/MRI images were coregistered with MRI in time of biopsy planning. Five biopsy targets (three from high uptake and two from moderate uptake FET areas) thought to represent the most malignant sites and tumor extent were selected. Histopathological findings were compared with FET-PET and MRI images. Increased FET uptake in the area of non-CE locations on MRI correlated well with high-grade gliomas localized as far as 3 cm from T1-CE foci. Selecting a target in the motor cortex based on FET kinetics defined by dual time-point PET resulted in a grade IV diagnosis after previous negative biopsies based on MRI. An additional grade III diagnosis was obtained from an area of glioma infiltration with moderate FET uptake (between 1 and 1.25 SUV). These findings seem to show that dual time-point FET-PET-based biopsies can provide additional and clinically useful information for glioma diagnosis. Selection of targets based on dual time-point images may be useful for determining the most malignant tumor areas and may therefore be useful for resection and radiotherapy planning.

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Biological tumour volumes of gliomas in early and standard 20–40 min 18F-FET PET images differ according to IDH mutation status

Cited by 31 publications

References 31 publications

Prediction of IDH Status Through MRI Features and Enlightened Reflection on the Delineation of Target Volume in Low-Grade Gliomas

Prediction of IDH Status Through MRI Features and Enlightened Reflection on the Delineation of Target Volume in Low-Grade Gliomas

The diagnostic value of lower glucose consumption for IDH1 mutated gliomas on FDG-PET

Glioma Biopsy Based on Hybrid Dual Time-Point FET-PET/MRI—A Proof of Concept Study

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