18F-FSPG PET/CT Imaging of System xC- Transporter Activity in Patients with Primary and Metastatic Brain Tumors.
18F-FSPG PET/CT Imaging of System xC- Transporter Activity in Patients with Primary and Metastatic Brain Tumors.
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原发性和转移性脑肿瘤患者中系统 xC-转运蛋白活性的 18F-FSPG PET/CT 成像。
作者：
Wardak,Mirwais;Sonni,Ida;Fan,AudreyP;Minamimoto,Ryogo;Jamali,Mehran;Hatami,Negin;Zaharchuk,Greg;Fischbein,Nancy;Nagpal,Seema;Li,Gordon;Koglin,Norman;Berndt,Mathias;Bullich,Santiago;Stephens,AndrewW;Dinkelborg,LudgerM;Abel,
背景PET示踪剂 （4S）-4-（3-[18F]氟丙基）-L-谷氨酸 （18F-FSPG）瞄准系统 xC协同转运蛋白， 目的探讨18F-FSPG PET/CT在颅内肿瘤诊断中的作用。 材料与方法26例患者（平均年龄54岁± 12岁，男性17例，共48例 原发性脑肿瘤（n= 17）或脑 转移瘤（n= 9）被纳入该前瞻性研究， 单中心研究（ClinicalTrials.gov标识符：NCT 02370563） 2014年11月和2016年3月。30分钟动态脑18F-FSPG PET/CT扫描和60-75分钟静态全身（WB）18F-FSPG PET/CT扫描， 后天的此外，所有参与者都接受了MRI检查，其中4人 参与者接受氟18（18F）氟脱氧葡萄糖 (FDG)PET成像。PET参数及其相对变化 获得所有病变。动力学模型用于估计18F-FSPG肿瘤速率常数， 动态加上WB PET数据。影像学参数与病变相关 结果，通过随访MRI和/或病理检查确定 考试采用Mann-WhitneyU检验或Studentt检验进行组平均值比较。 受试者工作特征曲线分析用于 结果18F-FSPG PET/CT有助于识别所有48个脑病变。平均 WB全脑PET图像上的肿瘤与背景比（TBR） 时间点为26.6 ± 24.9（范围：2.6-150.3）。当进行18F-FDG PET时，18F-FSPG允许 非18F-FDG亲合性病变的可视化或允许 更好地区分周围组织的病变。参与人数 对于原发性脑肿瘤， 内流速率常数Ki和最大标准化 区分不良和良好病变结局的摄取值为 89%和81%。良、恶性病变的18F-FSPG摄取曲线有显著性差异 原发性脑肿瘤组的预后（P< .05），但在脑转移瘤组中没有。 （4S）-4-（3-[18F]氟丙基）-L-谷氨酸 （18F-FSPG）有助于检测原发性脑肿瘤和脑 具有高肿瘤与背景比率的转移。多时间点PET的18F-FSPG摄取的相对变化似乎是 有助于预测病变结局。临床试验注册号NCT 02370563 © RSNA，2022
BackgroundThe PET tracer (4S)-4-(3-[18F]fluoropropyl)-l-glutamate (18F-FSPG) targets the system xC–cotransporter, which is overexpressed in various tumors.PurposeTo assess the role of18F-FSPG PET/CT in intracranial malignancies.Materials and MethodsTwenty-six patients (mean age, 54 years ± 12; 17 men; 48 total lesions) with primary brain tumors (n= 17) or brain metastases (n= 9) were enrolled in this prospective, single-center study (ClinicalTrials.gov identifier: NCT02370563) between November 2014 and March 2016. A 30-minute dynamic brain18F-FSPG PET/CT scan and a static whole-body (WB)18F-FSPG PET/CT scan at 60–75 minutes were acquired. Moreover, all participants underwent MRI, and four participants underwent fluorine 18 (18F) fluorodeoxyglucose (FDG) PET imaging. PET parameters and their relative changes were obtained for all lesions. Kinetic modeling was used to estimate the18F-FSPG tumor rate constants using the dynamic and dynamic plus WB PET data. Imaging parameters were correlated to lesion outcomes, as determined with follow-up MRI and/or pathologic examination. The Mann-WhitneyUtest or Studentttest was used for group mean comparisons. Receiver operating characteristic curve analysis was used for performance comparison of different decision measures.Results18F-FSPG PET/CT helped identify all 48 brain lesions. The mean tumor-to-background ratio (TBR) on the whole-brain PET images at the WB time point was 26.6 ± 24.9 (range: 2.6–150.3). When18F-FDG PET was performed,18F-FSPG permitted visualization of non-18F-FDG–avid lesions or allowed better lesion differentiation from surrounding tissues. In participants with primary brain tumors, the predictive accuracy of the relative changes in influx rate constant Kiand maximum standardized uptake value to discriminate between poor and good lesion outcomes were 89% and 81%, respectively. There were significant differences in the18F-FSPG uptake curves of lesions with good versus poor outcomes in the primary brain tumor group (P< .05) but not in the brain metastases group.ConclusionPET/CT imaging with (4S)-4-(3-[18F]fluoropropyl)-l-glutamate (18F-FSPG) helped detect primary brain tumors and brain metastases with a high tumor-to-background ratio. Relative changes in18F-FSPG uptake with multi-time-point PET appear to be helpful in predicting lesion outcomes.Clinical trial registration no. NCT02370563© RSNA, 2022