Imaging gliomas with positron emission tomography and single-photon emission computed tomography

Bénard, François; Romsa, Jonathan; Hustinx, Roland

doi:10.1053/snuc.2003.127304

Cited by 151 publications

(108 citation statements)

References 69 publications

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“…However, histopathological grading relies on subjective judgment of morphological features and is frequently associated with interobserver variability (Giannini et al, 2001), while contrast enhancement is also present in many low-grade oligodendroglial neoplasms White et al, 2005). Elevated metabolism may also be considered an early indication of tumour progression (Higa et al, 2001;Benard et al, 2003;Padma et al, 2003;Vos et al, 2003;Datta et al, 2004), and in this study was seen in both low-and high-grade tumours. However, too few grade II cases with elevated metabolism or grade III cases with normal metabolism were available to permit assessment of the prognostic significance of SPECT data separately in low or high-grade cases.…”

Section: Discussionsupporting

confidence: 54%

“…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%

“…Metabolic imaging using radiolabeled tracers such as 201 Thallium or 18 F-fluorodeoxyglucose has been used in a number of glioma studies, to yield diagnostic or prognostic information (Benard et al, 2003;Padma et al, 2003;Datta et al, 2004), to guide biopsy (Levivier et al, 2002), to distinguish recurrent tumour from radiation necrosis (Stokkel et al, 1999) or monitor response to therapy (Vos et al, 2003) but the relationship between metabolism and chemosensitivity in oligodendroglial neoplasms has still to be determined. In a multidisciplinary study of oligodendroglial neoplasms undergoing therapy at a single UK treatment centre between 2000 and 2003, the À1p/À19q genotype was associated with a more indolent clinical history with longer time to first oncology therapy and prolonged survival from first referral, than cases with intact 1p/19q .…”

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confidence: 99%

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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: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 76%

mentioning

confidence: 99%

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Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

et al. 2006

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“…Thus, increased AMT uptake does not appear to be the consequence of tumor-induced seizures or interictal epileptiform activity during the tracer uptake. a-[ 11 C]methyl-L-tryptophan uptake in lowgrade tumors is of particular clinical interest because accurate delineation of recurrent or residual low-grade tumors is difficult on MRI and such tumors typically show low uptake on glucose and other amino-acid PET scans (DiChiro, 1987;Kaschten et al, 1998;Derlon et al, 2000;Benard et al, 2003). a-[ 11 C]methyl-L-tryptophan appears to be a unique PET tracer by showing increased uptake in DNETs, which do not accumulate several other PET tracers (Lee et al, 2000;Richardson et al, 2001;Maehara et al, 2004;Weckesser et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

In Vivo Uptake and Metabolism of α-[¹¹C]Methyl-l-Tryptophan in Human Brain Tumors

Juhász

Chugani

Muzik

et al. 2006

J Cereb Blood Flow Metab

126

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Abnormal metabolism of tryptophan has been implicated in modulation of tumor cell proliferation and immunoresistance. a-[ 11 C]Methyl-L-tryptophan (AMT) is a PET tracer to measure cerebral tryptophan metabolism in vivo. In the present study, we have measured tumor tryptophan uptake in 40 patients with primary brain tumors using AMT PET and standard uptake values (SUV). Tryptophan metabolism was further quantified in 23 patients using blood input data. Estimates of the volume of distribution (VD 0 ) and the metabolic rate constant (k 3 0 ) were calculated and related to magnetic resonance imaging (MRI) and histology findings. All grade II to IV gliomas and glioneuronal tumors showed increased AMT SUV, including all recurrent/residual tumors. Gadolinium enhancement on MRI was associated with high VD 0 values, suggesting impaired blood-brain barrier, while k 3 0 values were not related to contrast enhancement. Low-grade astrocytic gliomas showed increased tryptophan metabolism, as measured by k 3 0 . In contrast, oligodendrogliomas showed high VD 0 values but lower k 3 0 as compared with normal cortex. In astrocytic tumors, low grade was associated with high k 3 0 and lower VD 0 , while high-grade tumors showed the reverse pattern. The findings show high AMT uptake in primary and residual/recurrent gliomas and glioneuronal tumors. Increased AMT uptake can be due to increased metabolism of tryptophan and/ or high volume of distribution, depending on tumor type and grade. High tryptophan metabolic rates in low-grade tumors may indicate activation of the kynurenine pathway, a mechanism regulating tumor cell growth. AMT PET might be a useful molecular imaging method to guide therapeutic approaches aimed at controlling tumor cell proliferation by acting on tryptophan metabolism.

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“…As a result, many techniques are under development, including positron emission tomography, MR spectroscopy, and perfusion imaging. Reviews are provided by Benard [5] and Law [6]. None of these techniques have yet proven clinically reliable.…”

Section: Introductionmentioning

confidence: 99%

Tumor Therapeutic Response and Vessel Tortuosity: Preliminary Report in Metastatic Breast Cancer

Bullitt

Lin

Ewend

et al. 2006

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2006

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Abstract.No current non-invasive method is capable of assessing the efficacy of brain tumor therapy early during treatment. We outline an approach that evaluates tumor activity via statistical analysis of vessel shape using vessels segmented from MRA. This report is the first to describe the changes in vessel shape that occur during treatment of metastatic brain tumors as assessed by sequential MRA. In this preliminary study of 16 patients undergoing treatment for metastatic breast cancer we conclude that vessel shape may predict tumor response several months in advance of traditional methods.

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Imaging gliomas with positron emission tomography and single-photon emission computed tomography

Cited by 151 publications

References 69 publications

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

In Vivo Uptake and Metabolism of α-[¹¹C]Methyl-l-Tryptophan in Human Brain Tumors

Tumor Therapeutic Response and Vessel Tortuosity: Preliminary Report in Metastatic Breast Cancer

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Imaging gliomas with positron emission tomography and single-photon emission computed tomography

Cited by 151 publications

References 69 publications

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

In Vivo Uptake and Metabolism of α-[11C]Methyl-l-Tryptophan in Human Brain Tumors

Tumor Therapeutic Response and Vessel Tortuosity: Preliminary Report in Metastatic Breast Cancer

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In Vivo Uptake and Metabolism of α-[¹¹C]Methyl-l-Tryptophan in Human Brain Tumors