Prognostic Value of O-(2-[18F]-Fluoroethyl)-L-Tyrosine-Positron Emission Tomography Imaging for Histopathologic Characteristics and Progression-Free Survival in Patients with Low-Grade Glioma
Prognostic Value of O-(2-[18F]-Fluoroethyl)-L-Tyrosine-Positron Emission Tomography Imaging for Histopathologic Characteristics and Progression-Free Survival in Patients with Low-Grade Glioma
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DOI：
10.1016/j.wneu.2016.01.085
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发表时间：
2016-05-01
影响因子：
2
通讯作者：
Ringel, Florian
中科院分区：
文献类型：
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作者：
Bette, Stefanie;Gempt, Jens;Ringel, Florian
目的：O-(2-[18F]-氟乙基)-L-酪氨酸正电子发射断层扫描(F-18-FET-PET)成像应用于肿瘤分级、预后分层和肿瘤复发的诊断，特别是在高级别胶质瘤中。 F-18-FET-PET 成像在低级别神经胶质瘤中的经验有限。因此，本研究的目的是评估低级别胶质瘤中 F-18-FET-PET 示踪剂的摄取，并研究其与磁共振成像 (MRI) 和组织病理学中对比增强的可能相关性。 方法：共纳入 65 名新诊断或复发低级别胶质瘤患者（29 名女性，36 名男性，中位年龄 38 岁），术前可进行 MRI 和 F-18-FET-PET 成像。评估肿瘤实体、肿瘤位置以及组织病理学（异柠檬酸脱氢酶 [IDH] 1/2 突变、Ki67、p53、少突胶质细胞分化、1p19q 联合缺失）和无进展生存期。采集 F-18-FET-PET 图像并与 MRI（T2 加权流体衰减反转恢复）融合，并在肿瘤与背景比 >1.3、>1.6 和 >2.0 的区域以及 MRI 中测量肿瘤体积。 结果：在所有世界卫生组织 I 级和 II 级肿瘤中，78.5% 观察到 PET 示踪剂摄取。 F-18-FET 摄取对少突胶质细胞成分和 1p19q 联合缺失显示出较高的阴性预测值。没有观察到组织学特征、无进展生存期或 IDH1/2 突变状态与示踪剂摄取之间的进一步显着相关性。结论：我们发现 78.5% 的低级别胶质瘤在 F-18-FET-PET 成像中确实显示出示踪剂摄取升高。没有示踪剂摄取的低级别胶质瘤排除少突胶质细胞分化和 1p19q 联合缺失。使用静态 F-18-FET-PET 无法进一步区分分子亚型。没有观察到无进展生存期与示踪剂摄取和 IDH1/2 突变状态的相关性。
OBJECTIVE: O-(2-[18F]-fluoroethyl)-L-tyrosine positron emission tomography (F-18-FET-PET) imaging is applied for tumor grading, prognostic stratification, and diagnosis of tumor recurrence, especially in high-grade gliomas. Experience with F-18-FET-PET imaging in low-grade gliomas is limited. Therefore, the objective of the present study was to assess F-18-FET-PET tracer uptake in low-grade gliomas and to investigate possible correlations with contrast enhancement in magnetic resonance imaging (MRI) and histopathology.METHODS: A total of 65 patients (29 female, 36 male, median age 38 years) with newly diagnosed or recurrent low-grade gliomas for whom preoperative MRI and F-18-FET-PET imaging were available were included. Tumor entity, tumor location, as well as histopathology (isocitrate dehydrogenase [IDH] 1/2 mutation, Ki67, p53, oligodendroglial differentiation, 1p19q codeletion), and progression-free survival were assessed. F-18-FET-PET images were acquired and fused to MRI (T2-weighted fluid-attenuated inversion recovery) and tumor volume was measured in areas with a tumor-to-background ratio >1.3, >1.6, and >2.0 and in MRI.RESULTS: PET tracer uptake was observed in 78.5% of all World Health Organization Grade I and II tumors. F-18-FET uptake showed a high negative predictive value for oligodendroglial components and for 1p19q codeletion. No further significant correlation between histologic features, progression-free survival, or IDH1/2 mutation status and tracer uptake was observed.CONCLUSIONS: We found that 78.5% of low-grade gliomas do show elevated tracer uptake in F-18-FET-PET imaging. Low-grade glioma without tracer uptake exclude oligodendroglial differentiation and 1p19q codeletion. Further differentiation between molecular subtypes is not possible with static F-18-FET-PET. No correlation of progression-free survival to tracer uptake and IDH1/2-mutation status was observed.