Static and dynamic 18F–FET PET for the characterization of gliomas defined by IDH and 1p/19q status

Verger, Antoine; Stoffels, Gabriele; Bauer, Elena; Lohmann, Philipp; Blau, Tobias; Fink, Gereon R.; Neumaier, Bernd; Shah, N. Jon; Langen, Karl‐Josef; Galldiks, Norbert

doi:10.1007/s00259-017-3846-6

Cited by 98 publications

(63 citation statements)

References 37 publications

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“…In general, MET uptakes in IDH1-wildtype gliomas were significantly higher compared with those in IDH1-mutant gliomas [6,7,8]. However, several amino acid PET studies showed paradoxically higher tracer uptakes in IDH-mutant gliomas, especially with oligodendroglial components, compared with counterpart IDH1-wildtype tumours [8,9,10]. These results suggest that amino acid PET studies are not fully consistent or accurate for differentiating glioma at diagnosis based on the 2016 WHO classification.…”

Section: Introductionmentioning

confidence: 83%

“…In fact, AOs (median 5.07, IQR 4.72-7.21) showed increased MET uptake as high as those in GBMs (median 6.19, IQR 4.63-7.41), in which most of them were IDH1-wild type tumours in the present study. Several amino acid PET studies showed paradoxically higher tracer uptakes in IDH-mutant gliomas and the inability to predict the IDH1 mutation status among grade Ⅱ and Ⅲ gliomas [9,10]. These results suggest that the use of amino acid PET for differentiating glioma at diagnosis may be useful but is subject to controversy.…”

Section: Based On the 2016 Who Classification Met-pet Studies In Patmentioning

confidence: 99%

“…These results suggest that the use of amino acid PET for differentiating glioma at diagnosis may be useful but is subject to controversy. Recently, several studies have shown the usefulness of amino-acid PET with dynamic analysis for glioma differentiation based on the 2016 WHO classification [10,24]. trapping is a representation of thymidine incorporation into DNA [11,12].…”

Section: Based On the 2016 Who Classification Met-pet Studies In Patmentioning

confidence: 99%

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Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

Ogawa

Kawai

Miyake

et al. 2020

Preprint

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Background :The molecular features of isocitrate dehydrogenase (IDH) mutation and chromosome 1p and 19q (1p/19q) codeletion status have pivotal role for differentiating gliomas and have been integrated in the World Health Organization (WHO) classification in 2016. Positron emission tomography (PET) with 3’-Deoxy-3’-[18F]fluorothymidine (FLT) has been used to evaluate tumour grade and proliferative activity and compared with L-[methyl-11C]-methionine (MET) in glioma patients. Herein, we evaluated tracer uptakes of MET-PET/CT and FLT-PET/CT for differentiating glioma based on the 2016 WHO classification especially in relation to IDH1 mutation status.Methods : In total, 81 patients with newly diagnosed supratentorial glioma were enrolled in this study. They underwent PET/CT studies with MET and FLT before surgery. The molecular features and histopathological diagnosis based on the 2016 WHO classification were determined using surgical specimens. The ratios of the maximum standardized uptake value (SUV) of the tumours to the mean SUV of the contralateral cortex (T/N ratios) were calculated on MET-PET/CT and FLT-PET/CT images. Results : The mean T/N ratios of MET-PET/CT and FLT-PET/CT in IDH1-wildtype tumours were significantly higher than those in IDH1-mutant tumours (P<0.001 and P<0.001, respectively). Receiver operating characteristic analysis for differentiating IDH1 mutation status showed that the area under the curve of the FLT T/N ratio was significantly larger than that of the MET T/N ratio (P<0.01). The mean T/N ratio of FLT-PET/CT in IDH1-wildtype tumours was significantly higher than that in IDH1-mutant tumours among grade Ⅱ and Ⅲ gliomas (P=0.005), but this was not the case for MET-PET/CT. Both MET-PET/CT and FLT-PET/CT were able to distinguish between grade Ⅱ and Ⅲ gliomas in IDH1-mutant tumours (P=0.002 and P<0.001, respectively), but only FLT-PET/CT was able to distinguish between grade Ⅲ and Ⅳ gliomas in IDH1-wildtype tumours (P=0.029).Conclusion :This study showed that FLT-PET/CT can be used to determine the IDH1 mutation status and evaluate glioma grade more accurately than MET-PET/CT. FLT-PET/CT can improve glioma differentiation based on the 2016 WHO classification, but caution must be paid for tumours without contrast enhancement and further studies should be conducted with more cases.

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Section: Introductionmentioning

confidence: 83%

Section: Based On the 2016 Who Classification Met-pet Studies In Patmentioning

confidence: 99%

Section: Based On the 2016 Who Classification Met-pet Studies In Patmentioning

confidence: 99%

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Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

Ogawa

Kawai

Miyake

et al. 2020

Preprint

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“…To date, few studies investigated in LGGs the correlations of metabolic and structural MRI findings with molecular features and histological grade 37,38 . Among these studies, few only examined imaging findings in the context of the new WHO brain tumor classification 12,15,39 .…”

Section: Discussionmentioning

confidence: 99%

Lower Grade Gliomas: Relationships Between Metabolic and Structural Imaging with Grading and Molecular Factors

et al. 2019

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“…Nevertheless, based on these preliminary data, we are currently not able to identify molecular classes using current amino acid PET techniques. A recently published study by Verger et al [46] concluded that static and dynamic 18-F-FET PET has a statistically significant role in discriminating between IDH mutated astrocytomas and IDH wild-type glioblastomas, although the method lacks value when discriminating between these two groups of gliomas and IDH mutated/1p19q codeleted oligodendrogliomas. Since most of the relevant literature is from the era before molecular markers, further research should be encouraged.…”

Section: Discussionmentioning

confidence: 99%

Amino acid tracers in PET imaging of diffuse low-grade gliomas: a systematic review of preoperative applications

Näslund¹,

Smits

Förander

et al. 2018

Acta Neurochir

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Positron emission tomography (PET) imaging using amino acid tracers has in recent years become widely used in the diagnosis and prediction of disease course in diffuse low-grade gliomas (LGG). However, implications of preoperative PET for treatment and prognosis in this patient group have not been systematically studied. The aim of this systematic review was to evaluate the preoperative diagnostic and prognostic value of amino acid PET in suspected diffuse LGG. Medline, Cochrane Library, and Embase databases were systematically searched using keywords “PET,” “low-grade glioma,” and “amino acids tracers” with their respective synonyms. Out of 2137 eligible studies, 28 met the inclusion criteria. Increased amino acid uptake (lesion/brain) was consistently reported among included studies; in 25–92% of subsequently histopathology-verified LGG, in 83–100% of histopathology-verified HGG, and also in some non-neoplastic lesions. No consistent results were found in studies reporting hot spot areas on PET in MRI-suspected LGG. Thus, the diagnostic value of amino acid PET imaging in suspected LGG has proven difficult to interpret, showing clear overlap and inconsistencies among reported results. Similarly, the results regarding the prognostic value of PET in suspected LGG and the correlation between uptake ratios and the molecular tumor status of LGG were conflicting. This systematic review illustrates the difficulties with prognostic studies presenting data on group-level without adjustment for established clinical prognostic factors, leading to a loss of additional prognostic information. We conclude that the prognostic value of PET is limited to analysis of histological subgroups of LGG and is probably strongest when using kinetic analysis of dynamic FET uptake parameters.Electronic supplementary materialThe online version of this article (10.1007/s00701-018-3563-3) contains supplementary material, which is available to authorized users.

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Static and dynamic 18F–FET PET for the characterization of gliomas defined by IDH and 1p/19q status

Abstract: Data suggest that static and dynamic F-FET PET parameters may allow determining non-invasively the IDH mutation status. However, IDH mutated and 1p/19q co-deleted oligodendrogliomas cannot be differentiated from glioblastomas and astrocytomas byF-FET PET.

Cited by 98 publications

References 37 publications

Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

Lower Grade Gliomas: Relationships Between Metabolic and Structural Imaging with Grading and Molecular Factors

Amino acid tracers in PET imaging of diffuse low-grade gliomas: a systematic review of preoperative applications

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