title: [(18)F]-fluoro-L-thymidine PET and advanced MRI for preoperative grading of gliomas.
abstract: OBJECTIVE
  Conventional MRI based on contrast enhancement is often not sufficient in differentiating grade II from grade III and grade III from grade IV diffuse gliomas. We assessed advanced MRI, MR spectroscopy and [(18)F]-fluoro-l-thymidine ([(18)F]-FLT) PET as tools to overcome these limitations.
  
  
  METHODS
  In this prospective study, thirty-nine patients with diffuse gliomas of grades II, III or IV underwent conventional MRI, perfusion, diffusion, proton MR spectroscopy ((1)H-MRS) and [(18)F]-FLT-PET imaging before surgery. Relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC), Cho/Cr, NAA/Cr, Cho/NAA and FLT-SUV were compared between grades.
  
  
  RESULTS
  Cho/Cr showed significant differences between grade II and grade III gliomas (p = 0.03). To discriminate grade II from grade IV and grade III from grade IV gliomas, the most relevant parameter was the maximum value of [(18)F]-FLT uptake FLTmax (respectively, p < 0.001 and p < 0.0001). The parameter showing the best correlation with the grade was the mean value of [(18)F]-FLT uptake FLTmean (R(2) = 0.36, p < 0.0001) and FLTmax (R(2) = 0.5, p < 0.0001).
  
  
  CONCLUSIONS
  Whereas advanced MRI parameters give indications for the grading of gliomas, the addition of [(18)F]-FLT-PET could be of interest for the accurate preoperative classification of diffuse gliomas, particularly for identification of doubtful grade III and IV gliomas.
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France.
authors.forename: S
authors.initials: S
authors.lastname: Collet
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France.
authors.forename: S
authors.initials: S
authors.lastname: Valable
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France ; CHU de Caen, Service de Neuroradiologie, Caen F-14000, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Constans
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France ; CHU de Caen, Service d'Anatomie Pathologie, Caen F-14000, France.
authors.forename: E
authors.initials: E
authors.lastname: Lechapt-Zalcman
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France.
authors.forename: S
authors.initials: S
authors.lastname: Roussel
authors.affiliation: CNRS, UMS 3408, GIP CYCERON, Caen F-14074, France ; Université de Caen Basse-Normandie, UMS 3408, Caen F-14074, France.
authors.forename: N
authors.initials: N
authors.lastname: Delcroix
authors.affiliation: Inserm, Caen U1077, France ; Université de Caen Basse-Normandie UMR, Caen-S1077, France ; École Pratique des Hautes Etudes, UMR, Caen-S1077, France ; CHU de Caen, Caen U1077, France.
authors.forename: A
authors.initials: A
authors.lastname: Abbas
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France.
authors.forename: M
authors.initials: M
authors.lastname: Ibazizene
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France.
authors.forename: M
authors.initials: M
authors.lastname: Bernaudin
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France.
authors.forename: L
authors.initials: L
authors.lastname: Barré
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France ; CHU de Caen, Service de neurochirurgie, Caen F-14000, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Derlon
authors.affiliation: CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France ; CHU de Caen, Service de Neurologie, Caen F-14000, France.
authors.forename: J S
authors.initials: JS
authors.lastname: Guillamo
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000145:classification / Q000175:diagnosis*; D015224:Dideoxynucleosides; D005260:Female; D005462:Fluorine Radioisotopes; D005910:Glioma / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D049268:Positron-Emission Tomography / Q000379:methods*; D057234:Preoperative Period
chemical_list: D015224:Dideoxynucleosides; D005462:Fluorine Radioisotopes; C002854:alovudine
keywords: Glioblastoma; Glioma; Grading; MR spectroscopy; MRI; [18F]-FLT-PET