Ga-68-NOTA-Aca-BBN(7-14) PET imaging of GRPR in children with optic pathway glioma
Ga-68-NOTA-Aca-BBN(7-14) PET imaging of GRPR in children with optic pathway glioma
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Ga-68-NOTA-Aca-BBN(7-14)儿童视神经胶质瘤GRPR PET成像
DOI：
10.1007/s00259-019-04392-7
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发表时间：
2019
影响因子：
9.1
通讯作者：
Chen Xiaoyuan
中科院分区：
文献类型：
--
作者：
Zhang Jingjing;Tian Yongji;Li Deling;Niu Gang;Lang Lixin;Li Fang;Liu Yuhan;Zhu Zhaohui;Chen Xiaoyuan
目的视神经胶质瘤（opticpathoglioma，OPG）是一种少见的肿瘤，好发于儿童期.它位于涉及视神经通路的敏感区域，年轻患者的发病和有争议的治疗选择使OPG的管理成为儿科神经肿瘤学的挑战。在这项研究中，我们评估了胃泌素释放肽受体（GRPR）为靶点的正电子发射断层扫描（PET）成像在儿童OPG，和应用PET/MRI成像引导手术导航platform.MethodsEight儿童（5名男孩，平均年龄8.81岁，范围5-14岁）与怀疑视神经胶质瘤的MRI被招募。从所有患者和法律的监护人处获得书面知情同意书。在静脉注射1.85 MBq/kg体重的68 Ga-NOTA-BBN（7-14）后30分钟进行脑PET/CT或PET/MRI采集。4例患者还接受了18F-FDG脑PET/CT检查以进行比较。结果8例患者的11个病灶（100%）均显示68 Ga-NOTA-γ-BBN（7-14）摄取，与周围正常脑组织对比良好。68 Ga-NOTA-BBN（7-14）的肿瘤与背景比值（SUVmax和SUVmean）显著高于18F-FDG（分别为28.4 ± 5.59 vs. 0.47 ± 0.11和18.3 ± 4.99 vs. 0.35 ± 0.07）。使用PET/MRI导航平台在所有患者中获得用于肿瘤描绘的融合图像。所有病变均经病理证实为GRPR阳性表达的OPG，75%为毛细胞性星形细胞瘤WHO I级，25%为弥漫性星形细胞瘤WHO II级。68 Ga-NOTA-BBN（7-14）的SUV与GRPR表达水平呈正相关（r ~ 2 = 0.56，P < 0.01）; r2= 0.47，P < 0.05，结论68 Ga-NOTA-BBN（7 - 14）PET用于儿童OPG肿瘤检测和定位是可行的。PET/MRI可能有助于辅助症状严重的OPG患者制定手术计划，GRPR靶向PET有可能为OPG患者的进一步GRPR靶向治疗提供影像学指导。
PurposeOptic pathway glioma (OPG) is a rare neoplasm that arises predominantly during childhood. Its location in a sensitive region involving the optic pathways, onset in young patients and controversial therapy choice make the management of OPG a challenge in paediatric neuro-oncology. In this study we assessed gastrin-releasing peptide receptor (GRPR)-targeted positron emission tomography (PET) imaging in children with OPG, and the application of a PET/MRI imaging-guided surgery navigation platform.MethodsEight children (five boys, mean age 8.81 years, range 5–14 years) with suspicion of optic pathway glioma on MRI were recruited. Written informed consent was obtained from all patients and legal guardians. Brain PET/CT or PET/MRI acquisitions were performed 30 min after intravenous injection of 1.85 MBq/kg body weight of68Ga-NOTA-Aca-BBN(7-14). Four patients also underwent18F-FDG brain PET/CT for comparison. All patients underwent surgical resection within 1 week.ResultsAll 11 lesions (100%) in the eight patients showed prominent68Ga-NOTA-Aca-BBN(7-14) uptake with excellent contrast in relation to surrounding normal brain tissue. Tumour-to-background ratios (SUVmax and SUVmean) were significantly higher for68Ga-NOTA-Aca-BBN(7-14) than for18F-FDG (28.4 ± 5.59 vs. 0.47 ± 0.11 and 18.3 ± 4.99 vs. 0.35 ± 0.07, respectively). Fusion images for tumour delineation were obtained in all patients using the PET/MRI navigation platform. All lesions were pathologically confirmed as OPGs with positive GRPR expression, and 75% were pilocytic astrocytoma WHO grade I and 25% were diffuse astrocytoma WHO grade II. There was a positive correlation between the SUV of68Ga-NOTA-Aca-BBN(7-14) and the expression level of GRPR (r2= 0.56,P< 0.01, for SUVmax;r2= 0.47,P< 0.05, for SUVmean).ConclusionThis prospective study showed the feasibility of68Ga-NOTA-Aca-BBN(7-14) PET in children with OPG for tumour detection and localization.68Ga-NOTA-Aca-BBN(7-14) PET/MRI may be helpful for assisting surgery planning in OPG patients with severe symptoms, GRPR-targeted PET has the potential to provide imaging guidance for further GRPR-targeted therapy in patients with OPG.