Bette Stefanie, Gempt Jens, Delbridge Claire, Kirschke Jan S, Schlegel Juergen, Foerster Stefan, Huber Thomas, Pyka Thomas, Zimmer Claus, Meyer Bernhard, Ringel Florian
Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
World Neurosurg. 2016 May;89:230-9. doi: 10.1016/j.wneu.2016.01.085. Epub 2016 Mar 9.
O-(2-[18F]-fluoroethyl)-L-tyrosine positron emission tomography ((18)F-FET-PET) imaging is applied for tumor grading, prognostic stratification, and diagnosis of tumor recurrence, especially in high-grade gliomas. Experience with (18)F-FET-PET imaging in low-grade gliomas is limited. Therefore, the objective of the present study was to assess (18)F-FET-PET tracer uptake in low-grade gliomas and to investigate possible correlations with contrast enhancement in magnetic resonance imaging (MRI) and histopathology.
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 (18)F-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. (18)F-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.
PET tracer uptake was observed in 78.5% of all World Health Organization Grade I and II tumors. (18)F-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.
We found that 78.5% of low-grade gliomas do show elevated tracer uptake in (18)F-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 (18)F-FET-PET. No correlation of progression-free survival to tracer uptake and IDH1/2-mutation status was observed.
O-(2-[18F]-氟乙基)-L-酪氨酸正电子发射断层扫描（(18)F-FET-PET）成像用于肿瘤分级、预后分层及肿瘤复发诊断，尤其适用于高级别胶质瘤。(18)F-FET-PET成像在低级别胶质瘤中的应用经验有限。因此，本研究的目的是评估低级别胶质瘤中(18)F-FET-PET示踪剂摄取情况，并研究其与磁共振成像（MRI）对比增强及组织病理学之间的可能相关性。
纳入65例新诊断或复发的低级别胶质瘤患者（29例女性，36例男性，中位年龄38岁），这些患者术前行MRI和(18)F-FET-PET成像。评估肿瘤类型、肿瘤位置、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共缺失）及无进展生存期。采集(18)F-FET-PET图像并与MRI（T2加权液体衰减反转恢复序列）融合，在肿瘤与背景比值>1.3、>1.6和>2.0的区域以及MRI上测量肿瘤体积。
在所有世界卫生组织一级和二级肿瘤中，78.5%观察到PET示踪剂摄取。(18)F-FET摄取对少突胶质细胞成分和1p19q共缺失具有较高的阴性预测价值。未观察到组织学特征、无进展生存期或IDH1/2突变状态与示踪剂摄取之间存在进一步的显著相关性。
我们发现78.5%的低级别胶质瘤在(18)F-FET-PET成像中显示示踪剂摄取升高。无示踪剂摄取的低级别胶质瘤排除少突胶质细胞分化和1p19q共缺失。静态(18)F-FET-PET无法对分子亚型进行进一步区分。未观察到无进展生存期与示踪剂摄取及IDH1/2突变状态之间存在相关性。
