TSPO PET for glioma imaging using the novel ligand 18F-GE-180: first results in patients with glioblastoma
TSPO PET for glioma imaging using the novel ligand 18F-GE-180: first results in patients with glioblastoma
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DOI：
10.1007/s00259-017-3799-9
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发表时间：
2017-12-01
影响因子：
9.1
通讯作者：
Niyazi, M.
中科院分区：
文献类型：
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作者：
Albert, Nathalie L.;Unterrainer, M.;Niyazi, M.
目的研究脑胶质瘤中18kda线粒体转位蛋白（TSPO）的表达上调。F-18-GE-180是一种新型的第三代TSPO受体配体，与以前的示踪剂相比，具有更好的目标-背景对比度。在这项初步研究中，我们比较了未治疗和复发性胶质母细胞瘤患者的PET成像、F-18-GE-180和MRI。方法11例经组织学证实的IDH野生型胶质瘤（胶质母细胞瘤10例，间变性星形细胞瘤1例）初诊或复发时行F-18-GE-180 PET检查。在60-80 min p.i.求和图像中评估PET参数平均背景摄取（SUVBG），最大肿瘤与背景比（TBRmax）和不同阈值（SUVBG × 1.6, 1.8和2.0）的PET体积。将不同PET体积与MRI增强肿瘤体积进行比较。结果所有胶质瘤在F-18-GE-180 PET上均呈阳性，具有非常高的肿瘤-背景对比度(中位SUVBG 0.47 （0.37-0.93), TBRmax 6.61(3.88-9.07)）。即使在MRI上没有增强的区域也可以发现F-18-GE-180摄取，导致PET体积明显大于MRI体积（中位数为90.5,74.5和63.8 mL vs. 31.0 mL; p = 0.003, 0.004, 0.013）。在百分比差异上，PET体积比各自的MRI体积平均大179%，135%和90%。放疗前PET体积和MRI体积的中位空间体积相关系数（Sorensen-Dice系数）分别为0.48、0.54和0.58。结论F-18-GE-180 PET在未治疗和预处理的胶质母细胞瘤中提供了非常高的肿瘤-背景对比度，并且在MRI上显示示踪剂的摄取甚至超过了对比增强。F-18-GE-180的摄取在多大程度上反映了人类胶质瘤和炎症细胞的肿瘤程度，还有待于未来的前瞻性研究，通过引导立体定向活检和组织病理学结果的相关性来评估。
Objective The 18-kDa mitochondrial translocator protein (TSPO) was reported to be upregulated in gliomas. F-18-GE-180 is a novel 3rd generation TSPO receptor ligand with improved target-to-background contrast compared to previous tracers. In this pilot study, we compared PET imaging with F-18-GE-180 and MRI of patients with untreated and recurrent pretreated glioblastoma.Methods Eleven patients with histologically confirmed IDH wildtype gliomas (10 glioblastomas, 1 anaplastic astrocytoma) underwent F-18-GE-180 PET at initial diagnosis or recurrence. The PET parameters mean background uptake (SUVBG), maximal tumour-to-background ratio (TBRmax) and PET volume using different thresholds (SUVBG x 1.6, 1.8 and 2.0) were evaluated in the 60-80 min p.i. summation images. The different PET volumes were compared to the contrast-enhancing tumour volume on MRI.Results All gliomas were positive on F-18-GE-180 PET and were depicted with extraordinarily high tumour-to-background contrast (median SUVBG 0.47 (0.37-0.93), TBRmax 6.61 (3.88-9.07)). F-18-GE-180 uptake could be found even in areas without contrast enhancement on MRI, leading to significantly larger PET volumes than MRI-based volumes (median 90.5, 74.5, and 63.8 mL vs. 31.0 mL; p = 0.003, 0.004, 0.013). In percentage difference, the PET volumes were on average 179%, 135%, and 90% larger than the respective MRI volumes. The median spatial volumetric correlation (Sorensen-Dice coefficient) of PET volumes and MRI volumes prior to radiotherapy was 0.48, 0.54, and 0.58.Conclusion F-18-GE-180 PET provides a remarkably high tumour-to-background contrast in untreated and pretreated glioblastoma and shows tracer uptake even beyond contrast enhancement on MRI. To what extent F-18-GE-180 uptake reflects the tumour extent of human gliomas and inflammatory cells remains to be evaluated in future prospective studies with guided stereotactic biopsies and correlation of histopathological results.