FDG-PET in immunocompetent patients with primary central nervous system lymphoma: correlation with MRI and clinical follow-up

Palmedo, Holger; Urbach, Horst; Bender, Hans; Schlegel, Uwe; Schmidt‐Wolf, Ingo G.H.; Matthies, Alexander; Linnebank, Michael; Joe, Alexius; Bucerius, Jan; Biersack, H.-J.; Pels, Hendrik

doi:10.1007/s00259-005-1917-6

Cited by 111 publications

(78 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…FDG-PET commonly identifies hypermetabolic lesions through increased uptake of FDG in PCNSL (2,3). Furthermore, FDG-PET was found to be suitable for evaluating therapeutic response (17). Our results suggested that FDG uptake was dependent upon GLUT3 rather than GLUT1 in PCNSL.…”

Section: Discussionmentioning

confidence: 73%

Correlation between positron emission tomography findings and glucose transporter 1, 3 and L-type amino acid transporter 1 mRNA expression in primary central nervous system lymphomas

Takahashi

Akahane

Yamamoto

et al. 2014

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Primary central nervous system lymphoma (PCNSL)is an aggressive form of non-Hodgkin lymphoma with a poor prognosis. [18 F] 2-fluoro-2-deoxy-D-glucose (FDG) and L-(methyl-11 C)-methionine (MET) are the most widely used tracers in oncological positron emission tomography studies for PCNSL and commonly identify hypermetabolic lesions through increased uptake of FDG and MET. However, the mechanisms underlying the uptake of FDG and MET in PCNSL have not been clearly determined. The present study aimed to investigate the mRNA expression levels of glucose transporter (GLUT)1, GLUT3 and L-type amino acid transporter 1 (LAT1) in resected PCNSL specimens, in order to identify whether these transporters are associated with the increased uptake of FDG and MET. A total of 7 patients diagnosed with PCNSL were investigated. The uptake of FDG and MET by the tumors was evaluated based on the maximum standardized uptake value (SUVmax). The quantity of GLUT1, GLUT3 and LAT1 mRNA in the PCNSL specimens was measured to determine whether GLUT1, GLUT3 and̸or LAT1 are involved in the increased uptake of FDG and MET in PCNSL. Furthermore, microvessel density (MVD) and cell density (CD) were measured in all the cases. Our results indicated that the expression of GLUT3, but not GLUT1, was significantly correlated with FDG SUVmax and the expression of LAT1 was significantly correlated with MET SUVmax. However, neither MVD nor CD were found to be significantly associated with the uptake of FDG and MET. GLUT3 was identified as a key determinant of FDG accumulation, whereas LAT1 was a key determinant of MET accumulation in PCNSL. Therefore, GLUT3 and LAT1 may represent potential targets for the future development of novel therapeutic agents for PCNSL.

show abstract

Section: Discussionmentioning

confidence: 73%

Correlation between positron emission tomography findings and glucose transporter 1, 3 and L-type amino acid transporter 1 mRNA expression in primary central nervous system lymphomas

Takahashi

Akahane

Yamamoto

et al. 2014

Molecular and Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…Karantanis et al reported that the mean T/N ratio was 2.45 in 13 PCNSLs at primary diagnosis [20]. Palmedo et al reported that the mean T/N ratio was 2.36 in 6 PCNSLs before initiation of chemotherapy [21]. Both reports did not mention steroid treatment; thus, there is a concern about the possible influence of corticosteroid application before the FDG PET study.…”

Section: Discussionmentioning

confidence: 93%

The diagnostic role of 18F-FDG PET for primary central nervous system lymphoma

et al. 2014

View full text Add to dashboard Cite

Objective 18F-FDG PET has become one of the most important methods for studying malignant lymphoma, but its diagnostic role for primary central nervous system lymphoma (PCNSL) has not been established. The aim of this study is to determine the appropriate cut-off values of FDG uptake and to investigate how corticosteroid administration influences PCNSL. MethodsWe retrospectively reviewed 82 patients with contrast-enhanced brain tumors who underwent an FDG PET scan at onset, including 19 PCNSLs. FDG uptake of the lesion was assessed by the maximum standardized uptake value (SUVmax) and the ratio of tumor to normal contralateral cortex activity (T/N ratio). Receiver operating characteristic (ROC) curves were generated from the SUVmax and T/N ratios. To investigate the influence of corticosteroid application before a FDG PET scan, we evaluated the association between the FDG uptake of the lesion and the cumulative dose of corticosteroid administration on 13 PCNSL patients who had received steroid treatment before an FDG PET examination. ResultsThe mean FDG SUVmax and T/N ratio of PCNSLs were 22.6 and 2.79, respectively, and these values were significantly higher than that of the other malignant brain tumors.ROC analysis indicated that the evaluation of FDG uptake using the T/N ratio was more reliable than the SUVmax with respect to the differential diagnosis. When PCNSL patients went without steroid application before FDG PET, the accuracy of the T/N ratio with a cut-off point of 2.0 was 91.1%, the sensitivity was 94.7%, and the specificity was 87.3%. Although there are no significant differences in the FDG T/N ratio for PCNSL patients with or without steroid treatment, a negative correlation was found between the T/N ratio and cumulative dose of corticosteroid before PET study (r = 0.71, p = 0.032). ConclusionsWe concluded that the T/N ratio was superior to SUVmax for FDG uptake assessment as for distinguishing PCNSLs from other malignant brain tumors; the appropriate T/N ratio cut-off point was 2.0. In addition, FDG uptake could be influenced by cumulative doses of corticosteroid before a PET scan, and thus this fact should be taken into consideration when evaluating FDG PET for PCNSL diagnosis.

show abstract

“…22 Distinguishing non-enhancing lymphomatous infiltration from vascular leukoencephalopathy and MTX-related leukoencephalopathy is challenging, particularly in elderly patients. In this setting, MRI spectroscopy 23 and PET scan 24 should be investigated as complementary tools.…”

Section: Discussionmentioning

confidence: 99%

Patterns of response and relapse in primary CNS lymphomas after first-line chemotherapy: imaging analysis of the ANOCEF-GOELAMS prospective randomized trial

Tabouret

Houillier

Martin-Duverneuil

et al. 2016

NEUONC

View full text Add to dashboard Cite

Background. Our aim was to review MRI characteristics of patients with primary CNS lymphoma (PCNSL) enrolled in a randomized phase II trial and to evaluate their potential prognostic value and patterns of relapse, including T2 fluid attenuated inversion recovery (FLAIR) MRI abnormalities. Methods. Neuroimaging findings in 85 patients with PCNSL enrolled in a prospective trial were reviewed blinded to outcomes. MRI characteristics and responses according to International PCNSL Collaborative Group (IPCG) criteria were correlated with progression-free survival (PFS) and overall survival (OS). Results. Multivariate analysis showed that objective response at 2 months (P < .001) and at end of treatment (P = .015) were predictors of prolonged OS. Infratentorial location (P = .008) and large (>11.4 cm 3 ) enhancing tumor volume (P = .006) were associated with poor OS and PFS, respectively. Ratio of change in product of largest diameters at early MRI evaluation but not timing of complete response achievement (early vs delayed) was prognostic for OS. Sixty-nine patients relapsed. Relapse in the brain (n = 52) involved an initial enhancing site, a different site, or both in 46%, 40%, and 14% of patients, respectively. At baseline, non-enhancing T2-FLAIR hypersignal lesions distant from the enhancing tumor site were detected in 18 patients. These lesions markedly decreased (>50%) in 16 patients after chemotherapy, supporting their neoplastic nature. Of these patients, 10/18 relapsed, half (n = 5) in the initially non-enhancing T2-FLAIR lesions. Conclusions. Baseline tumor size and infratentorial localization are of prognostic value in PCNSL. Our findings provide evidence that non-enhancing FLAIR abnormalities may add to overall tumor burden, suggesting that response criteria should be refined to incorporate evaluation of T2-weighted/FLAIR sequences.

show abstract

FDG-PET in immunocompetent patients with primary central nervous system lymphoma: correlation with MRI and clinical follow-up

Abstract: PCNSLs demonstrate high FDG uptake and can be diagnosed by FDG-PET with high sensitivity. It seems that FDG-PET is suitable for early therapeutic monitoring after chemotherapy.

Cited by 111 publications

References 14 publications

Correlation between positron emission tomography findings and glucose transporter 1, 3 and L-type amino acid transporter 1 mRNA expression in primary central nervous system lymphomas

Correlation between positron emission tomography findings and glucose transporter 1, 3 and L-type amino acid transporter 1 mRNA expression in primary central nervous system lymphomas

The diagnostic role of 18F-FDG PET for primary central nervous system lymphoma

Patterns of response and relapse in primary CNS lymphomas after first-line chemotherapy: imaging analysis of the ANOCEF-GOELAMS prospective randomized trial

Contact Info

Product

Resources

About