title: Correlation of molecular genetics with molecular and morphological imaging in gliomas with an oligodendroglial component.
abstract: OBJECTIVE
  Since the recognition that oligodendrogliomas may be chemosensitive, their diagnosis and clinical management has become highly controversial. Histopathology diagnosis remains challenging and new tools such as molecular genetics or molecular imaging require evaluation.
  
  
  METHODS
  In a single-center, population-based prospective study, allelic imbalance in chromosomes 1p36, 19q13, 17p13, 10p12-15, and 10q22-26 has been investigated in 19 oligodendroglioma WHO grade 2 (OII), 20 oligoastrocytoma WHO grade 2 (OAII), 8 oligodendroglioma WHO grade 3 (OIII), and 12 oligoastrocytoma WHO grade 3 (OAIII), and compared with pretherapy histopathology, computed tomography and/or magnetic resonance (CT and/or MR), [fluorine-18]fluoro-2-deoxyglucose (18F-FDG), and thallium-201 single-photon emission computed tomography (201Tl SPECT).
  
  
  RESULTS
  In 50 cases, 18F-FDG uptake correlated with 201Tl uptake; however, 8 cases had increased 201Tl uptake but were hypometabolic for 18F-FDG, and 1 case was hypermetabolic with normal 201Tl uptake. Sixteen cases enhanced on CT/MR but failed to show 201Tl uptake; and 2 low-grade non-enhancing oligodendrogliomas had increased 201Tl uptake. Increased metabolism was more likely in high-grade cases, with 201Tl uptake more strongly correlated with grade than was 18F-FDG uptake. Tumors with 1p/19q loss were more likely to show increased 201Tl uptake and, to a lesser degree, increased 18F-FDG uptake than those without these losses. Elevated metabolism in 28% of low-grade tumors was significantly more common in tumors with 1p/19q loss, and increased uptake of both 18F-FDG and 201Tl in low-grade cases was found only in those with 1p/19q loss.
  
  
  CONCLUSIONS
  In this study, dissociation of uptake of contrast agents and radiotracers suggests independent deregulation of the blood-brain barrier breakdown and metabolism during disease progression of oligodendroglial neoplasms, and the association of elevated metabolism with 1p/19q loss, particularly in low-grade tumors, may have implications for clinical management.
authors.affiliation: JK Douglas Laboratories and Clatterbridge Centre for Oncology, Clatterbridge Hospital, Bebington, Wirral, United Kingdom. carol.walker@ccrt.nhs.uk
authors.forename: Carol
authors.initials: C
authors.lastname: Walker
authors.forename: Daniel G
authors.initials: DG
authors.lastname: du Plessis
authors.forename: Diane
authors.initials: D
authors.lastname: Fildes
authors.forename: Brian
authors.initials: B
authors.lastname: Haylock
authors.forename: David
authors.initials: D
authors.lastname: Husband
authors.forename: Michael D
authors.initials: MD
authors.lastname: Jenkinson
authors.forename: Kathy A
authors.initials: KA
authors.lastname: Joyce
authors.forename: John
authors.initials: J
authors.lastname: Broome
authors.forename: Klaus
authors.initials: K
authors.lastname: Kopitski
authors.forename: Joanne
authors.initials: J
authors.lastname: Prosser
authors.forename: Trevor
authors.initials: T
authors.lastname: Smith
authors.forename: Sobhan
authors.initials: S
authors.lastname: Vinjamuri
authors.forename: Peter C
authors.initials: PC
authors.lastname: Warnke
mesh_terms: D000328:Adult; D000368:Aged; D000483:Alleles; D001812:Blood-Brain Barrier; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000235:genetics* / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D005910:Glioma / Q000235:genetics* / Q000473:pathology*; D006801:Humans; D007834:Lasers; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000473:pathology*; D011446:Prospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18