Dynamic 18F-FET PET in suspected WHO grade II gliomas defines distinct biological subgroups with different clinical courses
Dynamic 18F-FET PET in suspected WHO grade II gliomas defines distinct biological subgroups with different clinical courses
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DOI：
10.1002/ijc.29259
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发表时间：
2015-05-01
影响因子：
6.4
通讯作者：
Kreth, Friedrich-Wilhelm
中科院分区：
文献类型：
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作者：
Thon, Niklas;Kunz, Mathias;Kreth, Friedrich-Wilhelm
在疑似II级神经胶质瘤中，O-（2-[F-18]氟乙基）-1-酪氨酸（F-18-FET）正电子发射断层扫描（PET）的时间-活性曲线（TAC）有三种不同的模式：（i）在整个肿瘤中均匀增加TAC，和降低TAC，（ii）在整个肿瘤中均匀增加或（iii）仅在其他增加的TAC模式内局部增加。TAC增加与低级别组织学相关，TAC减少与高级别组织学相关。这项前瞻性研究分析了这些模式是否与不同的生物学肿瘤亚型和不同的结果相关。使用F-18-FET PET引导活检进行逐步组织病理学评价。分子遗传学评价包括O-6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）启动子甲基化、异柠檬酸脱氢酶（IDH 1/2）突变和1 p/19 q共缺失状态。使用Kaplan-Meier方法估计无进展生存期（PFS）。预后因素从多元回归模型中获得。纳入98例成人患者。TAC均匀性增高者51例，局灶性降低者19例，均匀性降低者28例。相应的1年（2年）PFS分别为92%（85%）、89%（51%）和50%（28%; p=0.002）。IDH 1/2突变在TAC均匀增加（90%）和局灶性减少（79%）的肿瘤中更常见，但在TAC均匀减少的肿瘤中罕见（25%; p
In suspected grade II gliomas, three distinct patterns of time-activity curves (TAC) on O-(2-[F-18]fluoroethyl)-1-tyrosine (F-18-FET) positron emission tomography (PET) have been delineated (i) increasing TAC homogeneously throughout the tumor, and decreasing TAC, (ii) either homogeneously throughout the tumor or (iii) only focally within otherwise increasing TAC patterns. Increasing TAC was associated with low-grade histology and decreasing TAC with high-grade histology. This prospective study analyzed whether these patterns correlate with distinct biological tumor subtypes and differential outcome. F-18-FET PET-guided biopsies were used for stepwise histopathological evaluation. Molecular-genetic evaluation included O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, isocitrate dehydrogenase (IDH1/2) mutational and 1p/19q codeletion status. Progression-free survival (PFS) was estimated with the Kaplan-Meier method. Prognostic factors were obtained from multivariate regression models. 98 adult patients were included. Homogeneous increasing, focal decreasing and homogeneous decreasing TAC were seen in 51, 19 and 28 patients. The corresponding 1-year (2-years) PFS were 92% (85%), 89% (51%) and 50% (28%; p=0.002). IDH1/2 mutations were more frequent in tumors with homogeneous increasing (90%) and focal decreasing (79%) TAC, but were rare in those exhibiting homogeneous decreasing TAC (25%; p