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Positron emission tomography of high-grade gliomas

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Abstract

High-grade gliomas [HGG (WHO grades III–IV)] are almost invariably fatal. Imaging of HGG is important for orientating diagnosis, prognosis and treatment planning and is crucial for development of novel, more effective therapies. Given the potentially unlimited number of usable tracing molecules and the elevated number of available radionuclides, PET allows gathering multiple informations on HGG including data on tissue metabolism and drug pharmacokinetics. PET studies on the diagnosis, prognosis and treatment of HGG carried out by most frequently used tracers and radionuclides (11C and 18F) and published in 2014 have been reviewed. These studies demonstrate that a thorough choice of tracers may confer elevated diagnostic and prognostic power to PET imaging of HGG. They also suggest that a combination of PET and MRI may give the most complete and reliable imaging information on HGG and that research on hybrid PET/MRI may be paying back in terms of improved diagnosis, prognosis and treatment planning of these deadly tumours.

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Abbreviations

10B:

Boron-10

11B:

Boron-11

11C:

Carbon-11

18F:

Fluorine-18

7Li:

Lithium-7

ACFET:

N-acetyl O-(2-fluoroethyl)-l-tyrosine

ADC:

Apparent diffusion coefficient

AMT:

α-Methyl-l-tryptophan

AUC:

Area under the curve

BNCT:

Boron neutron capture therapy

BPA-FR:

4-Borono-phenylalanine conjugated with fructose

BTV:

Biological tumour volume

CBV:

Cerebral blood volume

CHO:

Choline

CPT-11:

Irinotecan hydrochloride

CR:

Creatine

CT:

Computed tomography

CTV:

Clinical target volume

DIPG:

Diffuse intrinsic pontine glioma

DWI:

Diffusion-weighted MR imaging

FAZA:

Fluoroazomycin-arabinoside

FBPA:

4-Borono-2-18 F-fluoro-phenylalanine

FDA:

U.S. Food and drug administration

FDG:

2-Fluoro-2-deoxy-d-glucose

FDOPA:

3,4-Dihydroxy-6-fluoro-l-phenylalanine

FET:

O-(2-fluoroethyl)-l-tyrosine

FET-ALA:

O-(2-fluoroethyl)-l-tyrosyl-l-alanine

FET-GLY:

O-(2-fluoroethyl)-l-tyrosyl-l-glycine

LAIR:

Fluid-attenuated-inversion-recovery

FLT:

3′-Deoxy-3′-fluorothymidine

FMISO:

Fluoromisonidazole

FUS:

Focus ultrasound

GB:

Glioblastoma

GIC:

Glioma initiating cell(s)

GTV:

Gross tumour volume

HGG:

High grade gliomas

HV:

Hypoxic volume

IMRT:

Intensity-modulated radiation therapy

K:

Uptake rate constant (mL/g/min)

LGG:

Low-grade glioma

MET:

Methionine

MIB-1:

Mind bomb 1

MRI:

Magnetic resonance imaging

MRS:

Magnetic resonance spectroscopy

MTV:

Metabolic tumour volume

NADC:

Normalized ADC

NADCMIN:

Minimum NADC

OS:

Overall survival

PC:

Phosphatidylcholine

PD:

Pharmacodynamics

PET:

Positron emission tomography

PFS:

Progression-free survival

PK:

Pharmacokinetics

PPV:

Positive predictive values

PV:

Proliferation volume

PWI:

Perfusion-weighted MRI

RANO:

Response assessment in neuro-oncology

RCBF:

Regional cerebral blood flow

RCBV:

Regional CBV

RN:

Radiation necrosis

ROC:

Receiver operating characteristic

ROI:

Region(s) of interest

ROIB :

ROI in the normal brain

ROIT :

ROI in the tumour

RPI:

Radiological prognostic index

RT:

Radiation therapy

SUV:

Standardized uptake value

SUVMAX:

Maximum standardized uptake value

TAC:

Time-activity curve(s)

T/C:

Tumour to normal cerebellum ratio

T/N:

Tumour to normal brain tissue ratio

T/S:

Tumour to normal striatum ratio

T/W:

Tumour to normal white matter ratio

WHO:

World health organization

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Acknowledgments

Work partially supported by Compagnia San Paolo, Turin, Italy (Grant No. 2010.1944 and Project” Terapie innovative per il glioblastoma”—PI: Prof. P. Malatesta). No potential conflict of interest regarding this article has been reported.

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  1. Mutagenesis Unit, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi 10, 16132, Genoa, Italy

    Guido Frosina

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Frosina, G. Positron emission tomography of high-grade gliomas. J Neurooncol 127, 415–425 (2016). https://doi.org/10.1007/s11060-016-2077-1

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