Correlation of preoperative thallium SPECT with histological grading and overall survival in adult gliomas

Comte, Frédéric; Bauchet, Luc; Rigau, Valérie; Hauet, Jean Robert; Fabbro, Michel; Coubes, Philippe; Chevalier, Jeanine; Mariano‐Goulart, Denis; Rossi, Michel; Zanca, Michel

doi:10.1097/01.mnm.0000191855.19327.af

Cited by 12 publications

(9 citation statements)

References 24 publications

(27 reference statements)

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“…Although the association between 201 Tl and 18 F-FDG uptake and adverse prognosis has been reported previously in gliomas (Higa et al, 2001;Benard et al, 2003;Padma et al, 2003;Comte et al, 2006), this study represents the largest series of oligodendroglial neoplasms with response and outcome data following treatment by a uniform chemotherapeutic protocol, and is the only study to investigate metabolism and outcome in oligodendroglial neoplasms classified by molecular genetics. The cohort was drawn from a larger study of oligodendroglial neoplasms from a single treatment centre over a 3-year period (Walker et al, , 2006 and reflects the range of patients with histopathological diagnosis of oligodendroglial tumour given PCV chemotherapy in the routine clinic.…”

Section: Discussionmentioning

confidence: 76%

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

et al. 2006

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The À1p/À19q genotype predicts chemosensitivity in oligodendroglial neoplasms, but some with intact 1p/19q also respond and not all with 1p/19q loss derive durable benefit from chemotherapy. We have evaluated the predictive and prognostic significance of pretherapy 201 Tl and 18 F-FDG SPECT and genotype in 38 primary and 10 recurrent oligodendroglial neoplasms following PCV chemotherapy. 1p/19q loss was seen in 8/15 OII, 6/15 OAII, 7/7 OIII, 3/11 OAIII and was associated with response (FisherExact: P ¼ 0.000) and prolonged progression-free (log-rank: P ¼ 0.002) and overall survival (OS) (log-rank: P ¼ 0.0048). Response was unrelated to metabolism, with tumours with high or low metabolism showing response. Increased 18 F-FDG or 201 Tl uptake predicted shorter progression-free survival (PFS) in the series (log-rank: 201 Tl P ¼ 0.0097, 18 F-FDG P ¼ 0.0170) and in cases with or without the À1p/À19q genotype. Elevated metabolism was associated with shorter OS in cases with intact 1p/19q (log-rank: 18 F-FDG P ¼ 0.0077; 201 Tl P ¼ 0.0004) and shorter PFS in responders (log-rank: 18 F-FDG P ¼ 0.005; 201 Tl P ¼ 0.0132). 201 Tl uptake and 1p/19q loss were independent predictors of survival in multivariate analysis. In this initial study, 201 Tl and 18 F-FDG uptake did not predict response to PCV, but may be associated with poor survival following therapy irrespective of genotype. This may be clinically useful warranting further study.

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Section: Discussionmentioning

confidence: 76%

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

et al. 2006

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“…Similarly, Comte et al . [ 36 ] found significant correlation between pre-operative 201 Tl SPECT with histologic grading and overall survival of patients with glioma. The recent publication by Iida [ 31 ] suggested that early uptake is the best predictor of progression-free survival.…”

Section: Introductionmentioning

confidence: 99%

“…Other studies have reported no correlation between uptake and tumour type or survival for certain types of brain tumour, in particular, pilocytic astrocytoma and oligodendroglioma [ 36 , 44 ] . Furthermore, some groups have disagreed with such a correlation altogether, and argued for the superiority of CT or MRI [ 45 , 46 ] .…”

Section: Introductionmentioning

confidence: 99%

CT-based quantitative SPECT for the radionuclide 201Tl: experimental validation and a standardized uptake value for brain tumour patients

Willowson

Bailey²,

Schembri³

et al. 2012

Cancer Imaging

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We have previously reported on a method for reconstructing quantitative data from 99mTc single photon emission computed tomography (SPECT) images based on corrections derived from X-ray computed tomography, producing accurate results in both experimental and clinical studies. This has been extended for use with the radionuclide 201Tl. Accuracy was evaluated with experimental phantom studies, including corrections for partial volume effects where necessary. The quantitative technique was used to derive standardized uptake values (SUVs) for 201Tl evaluation of brain tumours. A preliminary study was performed on 26 patients using 201Tl SPECT scans to assess residual tumour after surgery and then to monitor response to treatment, with a follow-up time of 18 months. Measures of SUVmax were made following quantitative processing of the data and using a threshold grown volume of interest around the tumour. Phantom studies resulted in the calculation of concentration values consistently within 4% of true values. No continuous relation was found between SUVmax (post-resection) and patient survival. Choosing an SUVmax cut-off of 1.5 demonstrated a difference in survival between the 2 groups of patients after surgery. Patients with an SUVmax <1.5 had a 70% survival rate over the first 10 months, compared with a 47% survival rate for those with SUVmax >1.5. This difference did not achieve significance, most likely due to the small study numbers. By 18 months follow-up this difference had reduced, with corresponding survival rates of 40% and 27%, respectively. Although this study involves only a small cohort, it has succeeded in demonstrating the possibility of an SUV measure for SPECT to help monitor response to treatment of brain tumours and predict survival.

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“…In the present case study, resection of the ventral portion of the precentral gyrus was inevitable due to the following clinical findings: (1) other than the pathological Gadolinium-enhancement on preoperative MRI, which is associated with more aggressive lesions (Upadhyay and Waldman, 2011), thallium uptake was high on the preoperative single photon emission computed tomography (SPECT), which is known to be a good indicator of the histological grade (Comte et al, 2006). (2) Histological diagnosis of glioblastoma multiforme was made on the intraoperative as well as post-operative histological examinations.…”

Section: Methodsmentioning

confidence: 94%

Functional significance of the electrocorticographic auditory responses in the premotor cortex

et al. 2015

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Other than well-known motor activities in the precentral gyrus, functional magnetic resonance imaging (fMRI) studies have found that the ventral part of the precentral gyrus is activated in response to linguistic auditory stimuli. It has been proposed that the premotor cortex in the precentral gyrus is responsible for the comprehension of speech, but the precise function of this area is still debated because patients with frontal lesions that include the precentral gyrus do not exhibit disturbances in speech comprehension. We report on a patient who underwent resection of the tumor in the precentral gyrus with electrocorticographic recordings while she performed the verb generation task during awake brain craniotomy. Consistent with previous fMRI studies, high-gamma band auditory activity was observed in the precentral gyrus. Due to the location of the tumor, the patient underwent resection of the auditory responsive precentral area which resulted in the post-operative expression of a characteristic articulatory disturbance known as apraxia of speech (AOS). The language function of the patient was otherwise preserved and she exhibited intact comprehension of both spoken and written language. The present findings demonstrated that a lesion restricted to the ventral precentral gyrus is sufficient for the expression of AOS and suggest that the auditory-responsive area plays an important role in the execution of fluent speech rather than the comprehension of speech. These findings also confirm that the function of the premotor area is predominantly motor in nature and its sensory responses is more consistent with the “sensory theory of speech production,” in which it was proposed that sensory representations are used to guide motor-articulatory processes.

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Correlation of preoperative thallium SPECT with histological grading and overall survival in adult gliomas

Abstract: Thallium SPECT provides useful information about the histological grade of the tumour and overall patient survival. Additionally, in spite of its relatively weak resolution, it appears to be a powerful routine clinical tool for the management of gliomas.

Cited by 12 publications

References 24 publications

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

CT-based quantitative SPECT for the radionuclide 201Tl: experimental validation and a standardized uptake value for brain tumour patients

Functional significance of the electrocorticographic auditory responses in the premotor cortex

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