Determining the extent of tumor resection at surgical planning with 18F-fluciclovine PET/CT in patients with suspected glioma: multicenter phase III trials

Wakabayashi, Toshihiko; Hirose, Yuichi; Miyake, Keisuke; Arakawa, Yoshiki; Kagawa, Naoki; Nariai, Tadashi; Narita, Yoshitaka; Nishikawa, Ryo; Tsuyuguchi, Naohiro; Fukami, Tadateru; Sasaki, Hidenao; Sasayama, Takashi; Kondo, Akihide; Iuchi, Toshihiko; Kubota, Keiichi; Minamimoto, Ryogo; Terauchi, Takashi; Nakazato, Yoichi; Kubomura, Kan; Wada, Masatoshi

doi:10.1007/s12149-021-01670-z

Cited by 17 publications

(30 citation statements)

References 19 publications

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“…It is urgent to develop advanced imaging modalities to detect and better understand KWNP. PET/CT is a radiographic technique primarily used for diagnosis and staging of glioma [8,9]. In our case no brain tumor was found.…”

Section: Discussionmentioning

confidence: 56%

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A case of Kernohan-Woltman notch phenomenon caused by an epidural hematoma: the diagnostic and prognostic value of PET/CT imaging

et al. 2022

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Background Kernohan-Woltman notch phenomenon (KWNP) classically occurs when a lesion causes compression of the contralateral cerebral peduncle against the tentorium, resulting in ipsilateral hemiparesis. It has been studied clinically, radiologically and electrophysiologically which all confirmed to cause false localizing motor signs. Here, we demonstrate the potential use of fluorine-18 fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) to identify KWNP caused by an epidural hematoma. Case presentation A 29-year-old male patient post right-sided traumatic brain injury presenting with persistent ipsilateral hemiparesis. Patient underwent decompressive craniotomy and intracranial hematoma evacuation. Brain magnetic resonance imaging in the postoperative period showed a subtle lesion in the left cerebral peduncle. PET/CT was performed to exclude early brain tumor and explain his ipsilateral hemiparesis. PET/CT imaging demonstrated a focal region of intense 18 F-FDG uptake in the left cerebral peduncle. Throughout the treatment in outpatient neurorehabilitation unit, the patient exhibited a gradual recovery of his right hemiparesis. Conclusion In our case report, for the first time, PET/CT offered microstructural and functional confirmation of KWNP. Moreover, our case suggests that 18 F-FDG PET/CT may serve as an important reference for the probability of functional recovery.

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Section: Discussionmentioning

confidence: 56%

“…PET/CT is a radiographic technique primarily used for diagnosis and staging of glioma [ 8 , 9 ]. In our case no brain tumor was found.…”

Section: Discussionmentioning

confidence: 99%

A case of Kernohan-Woltman notch phenomenon caused by an epidural hematoma: the diagnostic and prognostic value of PET/CT imaging

et al. 2022

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“…Some newly designed tracers such as 68 Ga-Alb-FAPtp-01 [ 108 ] and 89 Zr/ 177 Lu-labeled Lumi804-aCD11b can be used both in imaging and treatment [ 109 ] . Tracers for glioma imaging are summarized in Table 2 [ 62 – 63 , 65 – 90 , 92 , 94 – 96 , 99 – 106 ] .…”

Section: Discussionmentioning

confidence: 99%

“…These transporters work as an exchange system that brings in a preferential amino acid at the expense of a less essential one, but do not increase the overall cellular levels of amino acids [ 93 ] . Many studies have showed that 18 F-fluciclovine can delineate glioma in areas not visualized using MRI and be used in glioma grading [ 92 , 94 – 96 ] .…”

Section: Positron Emission Tomography Tracers For Gliomamentioning

confidence: 99%

Tracers progress for positron emission tomography imaging of glial-related disease

Jia¹,

Xie²

2022

J Biomed Res

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Glial cells play an essential part in the neuron system. They can not only serve as structural blocks in the human brain but also participate in many biological processes. Extensive studies have shown that astrocytes and microglia play an important role in neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, Huntington's disease, as well as glioma, epilepsy, ischemic stroke, and infections. Positron emission tomography is a functional imaging technique providing molecular-level information before anatomic changes are visible and has been widely used in many above-mentioned diseases. In this review, we focus on the positron emission tomography tracers used in pathologies related to glial cells, such as glioma, Alzheimer's disease, and neuroinflammation.

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“…Studies have demonstrated 18 F-fluciclovine uptake within glioma tissue that is not Gd-T1 hyperintense and suggests that its uptake may not be an epiphenomenon of a breakdown in the BBB [ 4 , 8 , 9 ]. The results from multicentre phase 3 trials in glioma patients undergoing both pre-operative MRI and 18 F-fluciclovine PET-computed tomography (PET-CT) have demonstrated the clinical utility of 18 F-fluciclovine, leading to changes in surgical resection extent in over 40% of patients [ 10 ]. Animal models of diffuse glioma have also reported that 18 F-fluciclovine uptake is not dependent upon areas of BBB breakdown and may be correlated with glioma cell density [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Exploratory Analysis of Serial 18F-fluciclovine PET-CT and Multiparametric MRI during Chemoradiation for Glioblastoma

Fatania

Frood

Tyyger

et al. 2022

Cancers

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Anti-1-amino-3-18fluorine-fluorocyclobutane-1-carboxylic acid (18F-fluciclovine) positron emission tomography (PET) shows preferential glioma uptake but there is little data on how uptake correlates with post-contrast T1-weighted (Gd-T1) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) activity during adjuvant treatment. This pilot study aimed to compare 18F-fluciclovine PET, DCE-MRI and Gd-T1 in patients undergoing chemoradiotherapy for glioblastoma (GBM), and in a parallel pre-clinical GBM model, to investigate correlation between 18F-fluciclovine uptake, MRI findings, and tumour biology. 18F-fluciclovine-PET-computed tomography (PET-CT) and MRI including DCE-MRI were acquired before, during and after adjuvant chemoradiotherapy (60 Gy in 30 fractions with temozolomide) in GBM patients. MRI volumes were manually contoured; PET volumes were defined using semi-automatic thresholding. The similarity of the PET and DCE-MRI volumes outside the Gd-T1 volume boundary was measured using the Dice similarity coefficient (DSC). CT-2A tumour-bearing mice underwent MRI and 18F-fluciclovine PET-CT. Post-mortem mice brains underwent immunohistochemistry staining for ASCT2 (amino acid transporter), nestin (stemness) and Ki-67 (proliferation) to assess for biologically active tumour. 6 patients were recruited (GBM 1–6) and grouped according to overall survival (OS)—short survival (GBM-SS, median OS 249 days) and long survival (GBM-LS, median 903 days). For GBM-SS, PET tumour volumes were greater than DCE-MRI, in turn greater than Gd-T1. For GBM-LS, Gd-T1 and DCE-MRI were greater than PET. Tumour-specific 18F-fluciclovine uptake on pre-clinical PET-CT corresponded to immunostaining for Ki-67, nestin and ASCT2. Results suggest volumes of 18F-fluciclovine-PET activity beyond that depicted by DCE-MRI and Gd-T1 are associated with poorer prognosis in patients undergoing chemoradiotherapy for GBM. The pre-clinical model confirmed 18F-fluciclovine uptake reflected biologically active tumour.

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Determining the extent of tumor resection at surgical planning with 18F-fluciclovine PET/CT in patients with suspected glioma: multicenter phase III trials

Cited by 17 publications

References 19 publications

A case of Kernohan-Woltman notch phenomenon caused by an epidural hematoma: the diagnostic and prognostic value of PET/CT imaging

A case of Kernohan-Woltman notch phenomenon caused by an epidural hematoma: the diagnostic and prognostic value of PET/CT imaging

Tracers progress for positron emission tomography imaging of glial-related disease

Exploratory Analysis of Serial 18F-fluciclovine PET-CT and Multiparametric MRI during Chemoradiation for Glioblastoma

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