Update on the Use of PET/MRI Contrast Agents and Tracers in Brain Oncology: A Systematic Review

Smeraldo, Alessio; Ponsiglione, Alfonso Maria; Soricelli, Andrea; Netti, Paolo Antonio; Torino, Enza

doi:10.2147/ijn.s362192

Cited by 6 publications

(4 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We proved in a previous hotspot study of head and neck cancers in FDG PET that the use of this step by step deformable registration method limited the impact of post-RT-CT remodeling and improved the similarity indices of studied volumes [46]. In a future perspective, combined PET/MRI systems, which provide an interesting way in dedicated brain imaging, may optimize this co-registration and thus improve spatial similarity indices [41,42,52,53]. Finally, FET may be expensive and is not available in all countries.…”

Section: Discussionmentioning

confidence: 85%

Hotspot on 18F-FET PET/CT to Predict Aggressive Tumor Areas for Radiotherapy Dose Escalation Guiding in High-Grade Glioma

Allard

Dissaux

Bourhis

et al. 2022

Cancers

View full text Add to dashboard Cite

The standard therapy strategy for high-grade glioma (HGG) is based on the maximal surgery followed by radio-chemotherapy (RT-CT) with insufficient control of the disease. Recurrences are mainly localized in the radiation field, suggesting an interest in radiotherapy dose escalation to better control the disease locally. We aimed to identify a similarity between the areas of high uptake on O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) positron emission tomography/computed tomography (PET) before RT-CT, the residual tumor on post-therapy NADIR magnetic resonance imaging (MRI) and the area of recurrence on MRI. This is an ancillary study from the IMAGG prospective trial assessing the interest of FET PET imaging in RT target volume definition of HGG. We included patients with diagnoses of HGG obtained by biopsy or tumor resection. These patients underwent FET PET and brain MRIs, both after diagnosis and before RT-CT. The follow-up consisted of sequential brain MRIs performed every 3 months until recurrence. Tumor delineation on the initial MRI 1 (GTV 1), post-RT-CT NADIR MRI 2 (GTV 2), and progression MRI 3 (GTV 3) were performed semi-automatically and manually adjusted by a neuroradiologist specialist in neuro-oncology. GTV 2 and GTV 3 were then co-registered on FET PET data. Tumor volumes on FET PET (MTV) were delineated using a tumor to background ratio (TBR) ≥ 1.6 and different %SUVmax PET thresholds. Spatial similarity between different volumes was performed using the dice (DICE), Jaccard (JSC), and overlap fraction (OV) indices and compared together in the biopsy or partial surgery group (G1) and the total or subtotal surgery group (G2). Another overlap index (OV’) was calculated to determine the threshold with the highest probability of being included in the residual volume after RT-CT on MRI 2 and in MRI 3 (called “hotspot”). A total of 23 patients were included, of whom 22% (n = 5) did not have a NADIR MRI 2 due to a disease progression diagnosed on the first post-RT-CT MRI evaluation. Among the 18 patients who underwent a NADIR MRI 2, the average residual tumor was approximately 71.6% of the GTV 1. A total of 22% of patients (5/23) showed an increase in GTV 2 without diagnosis of true progression by the multidisciplinary team (MDT). Spatial similarity between MTV and GTV 2 and between MTV and GTV 3 were higher using a TBR ≥ 1.6 threshold. These indices were significantly better in the G1 group than the G2 group. In the FET hotspot analysis, the best similarity (good agreement) with GTV 2 was found in the G1 group using a 90%SUVmax delineation method and showed a trend of statistical difference with those (poor agreement) in the G2 group (OV’ = 0.67 vs. 0.38, respectively, p = 0.068); whereas the best similarity (good agreement) with GTV 3 was found in the G1 group using a 80% SUVmax delineation method and was significantly higher than those (poor agreement) in the G2 group (OV’= 0.72 vs. 0.35, respectively, p = 0.014). These results showed modest spatial similarity indices between MTV, GTV 2, and GTV 3 of HGG. Nevertheless, the results were significantly improved in patients who underwent only biopsy or partial surgery. TBR ≥ 1.6 and 80–90% SUVmax FET delineation methods showing a good agreement in the hotspot concept for targeting standard dose and radiation boost. These findings need to be tested in a larger randomized prospective study.

show abstract

Section: Discussionmentioning

confidence: 85%

Hotspot on 18F-FET PET/CT to Predict Aggressive Tumor Areas for Radiotherapy Dose Escalation Guiding in High-Grade Glioma

Allard

Dissaux

Bourhis

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…Since an increased amount of tumor-infiltrating immunosuppressive cells (i.e., GAMs) were found to correlate with a more intense TSPO signal, this imaging modality might be applied to select patients suitable for GAMs-targeted immunotherapies, currently under investigation [38]. On the other hand, TSPO might be exploited for theranostic approaches, employing a couple of radiopharmaceuticals with similar or identical chemical properties and both directed towards a tumor-associated biomarker, the first labeled with radionu- Second, although PET/MRI has been emerging as the most promising hybrid imaging modality in brain tumors [43], only one among the selected studies [25] employed a PET/MRI tomograph. Thus, the potential impact of PET/MRI with respect to PET/CT in this specific field is worthy of further study.…”

Section: Discussionmentioning

confidence: 99%

Clinical Applications of TSPO PET for Glioma Imaging: Current Evidence and Future Perspective—A Systematic Review

et al. 2023

View full text Add to dashboard Cite

Our aim was to provide a comprehensive overview of the existing literature concerning the clinical applications of positron emission computed tomography (PET) with radiopharmaceuticals targeting the translocator protein (TSPO) in gliomas. A literature search for studies about TSPO PET in the last 10 years (from 2013 to February 2023) was carried out on PubMed, Scopus, and Web of Science using the following keywords: “PET” AND “Gliomas” AND “TSPO”. The Critical Appraisal Skills Program checklist for diagnostic test studies was used for testing the quality of selected papers. Ten articles were selected, encompassing 314 glioma patients submitted to PET/CT (9/10) or PET/MRI (1/10) with TSPO ligands. Among the various available TSPO tracers, the most frequently used was the third-generation ligand, [18F]-GE-180. TSPO PET results were useful to identify anaplastic transformation in gliomas and for the prognostic stratification of patients bearing homogeneous genetic alterations. When compared to amino-acid PET, TSPO PET with [18F]-GE-180 presented superior image quality and provided larger and only partially overlapping PET-based volumes. Although biased by some issues (i.e., small sample size, most of the studies coming from the same country), preliminary applications of TSPO PET were encouraging. Further studies are needed to define implications in clinical practice and shape the role of TSPO PET for patients’ selection for potential TSPO-targeted molecular therapies.

show abstract

“…The current diagnosis for imaging is to combine the abovementioned PET and CT to improve accuracy and degree [26]. In brain regions in particular, if magnetic resonance can be combined with specific metabolically relevant radiotracers, not only can high positive correlations be observed, but this will also inform the grading and characterization of brain tumors and the prediction and assessment of treatment response [27].…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

Application of Metabolic Reprogramming to Cancer Imaging and Diagnosis

Yang

Cai

et al. 2022

IJMS

View full text Add to dashboard Cite

Cellular metabolism governs the signaling that supports physiological mechanisms and homeostasis in an individual, including neuronal transmission, wound healing, and circadian clock manipulation. Various factors have been linked to abnormal metabolic reprogramming, including gene mutations, epigenetic modifications, altered protein epitopes, and their involvement in the development of disease, including cancer. The presence of multiple distinct hallmarks and the resulting cellular reprogramming process have gradually revealed that these metabolism-related molecules may be able to be used to track or prevent the progression of cancer. Consequently, translational medicines have been developed using metabolic substrates, precursors, and other products depending on their biochemical mechanism of action. It is important to note that these metabolic analogs can also be used for imaging and therapeutic purposes in addition to competing for metabolic functions. In particular, due to their isotopic labeling, these compounds may also be used to localize and visualize tumor cells after uptake. In this review, the current development status, applicability, and limitations of compounds targeting metabolic reprogramming are described, as well as the imaging platforms that are most suitable for each compound and the types of cancer to which they are most appropriate.

show abstract

Update on the Use of PET/MRI Contrast Agents and Tracers in Brain Oncology: A Systematic Review

Cited by 6 publications

References 98 publications

Hotspot on 18F-FET PET/CT to Predict Aggressive Tumor Areas for Radiotherapy Dose Escalation Guiding in High-Grade Glioma

Hotspot on 18F-FET PET/CT to Predict Aggressive Tumor Areas for Radiotherapy Dose Escalation Guiding in High-Grade Glioma

Clinical Applications of TSPO PET for Glioma Imaging: Current Evidence and Future Perspective—A Systematic Review

Application of Metabolic Reprogramming to Cancer Imaging and Diagnosis

Contact Info

Product

Resources

About