title: Prediction of oligodendroglial histology and LOH 1p/19q using dynamic [(18)F]FET-PET imaging in intracranial WHO grade II and III gliomas.
abstract: Oligodendroglial components (OC) and loss of heterozygosity on chromosomes 1p and 19q (LOH 1p/19q) are associated with better outcome in patients with glioma. We aimed to assess the fitness of [(18)F]fluoroethyltyrosine positron-emission-tomography (FET-PET) for noninvasively identifying these important prognostic/predictive factors. One hundred forty-four patients with MRI-suspected WHO grade II and III glioma underwent FET-PET scans prior to histological diagnosis. FET-PET analyses included maximal tumoral uptake (SUV(max)/BG), biological tumor volume (BTV), mean tumoral uptake (SUV(mean)/BG), total tumoral uptake (SUV(total)/BG), and kinetic analysis. Suspicion of OC was based on static and dynamic FET-uptake parameters. PET results were correlated with histology and 1p/19q status. OC tumors exhibited significantly higher uptake values, compared with astrocytomas (AC) (SUV(max)/BG 3.1 vs 2.3, BTV 15.5 mL vs 7.2 mL, SUV(total)/BG 38.5 vs 17.4, P < .01 each; SUV(mean)/BG 2.2 vs 2.1, P < .05). These differences were more pronounced in WHO grade II gliomas. Comparable results were found with respect to 1p/19q status. Kinetic analysis misclassified 18 of 34 low-grade OC tumors as high-grade glioma but misclassified only 5 of 45 of the low-grade ACs. FET-based suspicion of OC resulted in concordance rates of both 76% for the prediction of OC and LOH 1p/19q. FET-uptake was significantly higher in gliomas with OC, compared with AC, and likewise in 1p/19q codeleted, compared with noncodeleted tumors. However, FET-PET analysis did not reliably predict the presence of OC/LOH 1p/19q in the individual patient, mostly because of an overlap in PET characteristics of OC tumors and high-grade AC. Histological examination is still required for an accurate diagnosis.
authors.affiliation: Department of Nuclear Medicine, University of Munich, Munich, Germany.
authors.forename: Nathalie L
authors.initials: NL
authors.lastname: Jansen
authors.forename: Christoph
authors.initials: C
authors.lastname: Schwartz
authors.forename: Vera
authors.initials: V
authors.lastname: Graute
authors.forename: Sabina
authors.initials: S
authors.lastname: Eigenbrod
authors.forename: Jürgen
authors.initials: J
authors.lastname: Lutz
authors.forename: Rupert
authors.initials: R
authors.lastname: Egensperger
authors.forename: Gabriele
authors.initials: G
authors.lastname: Pöpperl
authors.forename: Hans A
authors.initials: HA
authors.lastname: Kretzschmar
authors.forename: Paul
authors.initials: P
authors.lastname: Cumming
authors.forename: Peter
authors.initials: P
authors.lastname: Bartenstein
authors.forename: Jörg-Christian
authors.initials: JC
authors.lastname: Tonn
authors.forename: Friedrich-Wilhelm
authors.initials: FW
authors.lastname: Kreth
authors.forename: Christian
authors.initials: C
authors.lastname: la Fougère
authors.forename: Niklas
authors.initials: N
authors.lastname: Thon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000473:pathology; D002878:Chromosomes, Human, Pair 1 / Q000235:genetics; D002888:Chromosomes, Human, Pair 19 / Q000235:genetics; D005260:Female; D019788:Fluorodeoxyglucose F18; D005910:Glioma / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000473:pathology; D006801:Humans; D019656:Loss of Heterozygosity; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009836:Oligodendroglia / Q000473:pathology*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18