Digital FDG-PET detects mutation-driven glycolysis in primary central nervous system lymphoma.
作者信息
Sasaki Mayu, Teraoka Yuri, Kato Ayumi, Nakajima Tadaaki, Ishiwata Yoshinobu, Miyake Yohei, Honma Hirokuni, Nakamura Taishi, Ikegaya Naoki, Takayama Yutaro, Yazawa Osamu, Sawamura Shungo, Oshima Akito, Hayashi Hiroaki, Ye Wei Kai, Sasaoka Kanoko, Yoshii Yukie, Fujii Satoshi, Tateishi Ukihide, Yamamoto Tetsuya, Utsunomiya Daisuke, Kato Shingo, Tateishi Kensuke
机构信息
From the Department of Diagnostic Radiology (MS, YT, AK, YI, SS, DU,SK.), Department of Science (TN.), Department of Neurosurgery (YM, HH, TN, NI, YT, OY, AO, TY, KT), Department of Pediatrics (HH.), Laboratory of Biopharmaceutical and Regenerative Science (WKY, KS.) and Department of Molecular Pathology (SF.), Yokohama City University, Yokohama, Kanagawa, Japan; LinqMed Inc (YY.), Tokyo, Japan; Department of Diagnostic Radiology (UT.), Institution of Science Tokyo, Tokyo, Japan.
出版信息
AJNR Am J Neuroradiol. 2025 Jul 21. doi: 10.3174/ajnr.A8935.
BACKGROUND AND PURPOSE
The relationship between digital F-fluorodeoxyglucose positron emission tomography (dFDG-PET) findings and glucose metabolism-related genetic alterations remains unclear in primary central nervous system lymphoma (PCNSL). This study aimed to evaluate whether dFDG-PET can serve as a noninvasive tool to detect mutation-driven glycolytic activity in PCNSL.
MATERIALS AND METHODS
We retrospectively analyzed the imaging and molecular data of 54 patients with PCNSL (55 lesions). MRI and FDG-PET parameters, including the maximum standardized uptake value (SUVmax) and tumor-to-background ratio (TBR), were assessed. Tumor specimens were subjected to histopathological and genomic evaluations, including the mutation status.
RESULTS
Among 55 tumors, 34 (61.8%) were examined with dFDG-PET and 21 (38.2%) with analog F-FDG-PET (aFDG-PET). In the dFDG-PET group, -mutant tumors showed significantly higher SUVmax (30.2 ± 9.9) and TBR (6.1 ± 1.5) compared to wild-type tumors (SUVmax: 19.3 ± 7.2, = 0.006; TBR: 3.5 ± 1.3, < 0.001). In the aFDG-PET group, the SUVmax was significantly higher in -mutant tumors ( = 0.01), whereas the TBR differences were not statistically significant ( = 0.38). Receiver operating characteristic analysis of TBR in dFDG-PET yielded an area under the curve of 0.913 (95% CI: 0.954-1.000) with a cutoff value of 4.49, achieving 88% sensitivity and 88% specificity for mutation detection. Multivariate logistic regression identified SUVmax and TBR from dFDG-PET as independent predictors of mutation status. The transcriptomic analysis confirmed the significant upregulation of glycolysis-related genes, including , in -mutant tumors, supporting increased glycolytic activity.
CONCLUSIONS
dFDG-PET may serve as a valuable noninvasive imaging modality to detect mutation-driven enhanced glycolysis in patients with PCNSL.
ABBREVIATIONS
dPET＝ Digital positron emission tomography; PCNSL＝ Primary central nervous system lymphoma; SUVmax＝maximum standardized uptake value; TBR＝ tumor-to background ratio.
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