title: Aerobic Glycolysis as a Marker of Tumor Aggressiveness: Preliminary Data in High Grade Human Brain Tumors.
abstract: OBJECTIVE
  Glucose metabolism outside of oxidative phosphorylation, or aerobic glycolysis (AG), is a hallmark of active cancer cells that is not directly measured with standard (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET). In this study, we characterized tumor regions with elevated AG defined based on PET measurements of glucose and oxygen metabolism.
  
  
  METHODS
  Fourteen individuals with high-grade brain tumors underwent structural MR scans and PET measurements of cerebral blood flow (CBF), oxygen (CMRO2) and glucose (CMRGlu) metabolism, and AG, using (15)O-labeled CO, O2 and H2O, and FDG, and were compared to a normative cohort of 20 age-matched individuals.
  
  
  RESULTS
  Elevated AG was observed in most high-grade brain tumors and it was associated with decreased CMRO2 and CBF, but not with significant changes in CMRGlu. Elevated AG was a dramatic and early sign of tumor growth associated with decreased survival. AG changes associated with tumor growth were differentiated from the effects of nonneoplastic processes such as epileptic seizures.
  
  
  CONCLUSIONS
  Our findings demonstrate that high-grade brain tumors exhibit elevated AG as a marker of tumor growth and aggressiveness. AG may detect areas of active tumor growth that are not evident on conventional FDG PET.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Andrei G
authors.initials: AG
authors.lastname: Vlassenko
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: McConathy
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Lars E
authors.initials: LE
authors.lastname: Couture
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Yi
authors.initials: Y
authors.lastname: Su
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Parinaz
authors.initials: P
authors.lastname: Massoumzadeh
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Hayden S
authors.initials: HS
authors.lastname: Leeds
authors.affiliation: Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Chicoine
authors.affiliation: Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: Tran
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Jiayi
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Pathology & Immunology, Division of Neuropathology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Sonika
authors.initials: S
authors.lastname: Dahiya
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Marcus
authors.affiliation: Department of Neurosurgery, Swedish Neuroscience Specialists Ivy Brain Tumor Center, Seattle, WA 98104, USA.
authors.forename: Sarah Jost
authors.initials: SJ
authors.lastname: Fouke
authors.affiliation: Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Rich
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Marcus E
authors.initials: ME
authors.lastname: Raichle
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA ; Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Tammie L S
authors.initials: TL
authors.lastname: Benzinger
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006019:Glycolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
chemical_list: D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose