Dataset Information

Value of [¹⁸F]-FDG positron emission tomography in patients with recurrent glioblastoma receiving bevacizumab.

ABSTRACT:

Background

Treatment of recurrent glioblastoma (GBM) with bevacizumab can induce MRI changes that confound the determination of progression. We sought to determine the value of [¹⁸F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) in GBM patients receiving bevacizumab at the time of suspected progression and, thereby, its utility as a potential prognostic adjunct in progressive disease.

Methods

This retrospective study included patients who underwent brain FDG PET within 4 weeks of receiving bevacizumab for recurrent GBM with suspected progression. Volumes-of-interest were placed over the reference lesion with measurement of maximum standardized uptake value (SUV_max), peak standardized uptake value (SUV_peak), metabolic tumor volume, total lesion glycolysis (TLG), and tumor-to-normal contralateral white matter ratios (TNR-WM). Tumors were additionally categorized as non-avid or avid based on qualitative FDG uptake. Associations between baseline variables and overall survival (OS) were examined using univariable and multivariable Cox proportional hazards regression, with P < .05 considered significant.

Results

Thirty-one patients were analyzed. Qualitative FDG uptake was significantly associated with OS (P = .03), with a median OS of 9.0 months in non-avid patients versus 4.5 months in avid patients. SUV_max, SUV_peak, TNR-WM, and TLG were significantly associated with OS (P < .001, TLG: P = .009). FDG avidity and SUV_max remained significantly associated with OS (P = .046 and .048, respectively) in the multivariable analysis including age, KPS, and MGMT status. Dichotomizing patients using an SUV_max cutoff of 15.3 was associated with OS (adjusted P = .048).

Conclusion

FDG PET is a promising imaging tool to further stratify prognosis in recurrent GBM patients on antiangiogenic therapy.

SUBMITTER: Graham MS

PROVIDER: S-EPMC7236386 | biostudies-literature | 2020 Jan-Dec

REPOSITORIES: biostudies-literature

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Publications

Value of [<sup>18</sup>F]-FDG positron emission tomography in patients with recurrent glioblastoma receiving bevacizumab.

Graham Maya S MS Krebs Simone S Bale Tejus T Domfe Kwaku K Lobaugh Stephanie M SM Zhang Zhigang Z Dunphy Mark P MP Kaley Thomas T Young Robert J RJ

Neuro-oncology advances 20200101 1

<h4>Background</h4>Treatment of recurrent glioblastoma (GBM) with bevacizumab can induce MRI changes that confound the determination of progression. We sought to determine the value of [<sup>18</sup>F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) in GBM patients receiving bevacizumab at the time of suspected progression and, thereby, its utility as a potential prognostic adjunct in progressive disease.<h4>Methods</h4>This retrospective study included patients who underwent brain F ...[more]

PMID: 32642703

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Project description:IntroductionConventional methods of imaging brain tumors fail to assess metabolically active tumor regions, which limits their capabilities for tumor detection, localization, and response assessment. Positron emission tomography (PET) with 18F-fluciclovine (fluciclovine) provides regional assessment of amino acid uptake in tumors that could overcome some of the limitations of conventional imaging. However, the biological basis of enhanced fluciclovine uptake is insufficiently characterized in brain tumors, which confounds clinical interpretation and application. This study sought to address this gap by correlating multiple biologic quantities with fluciclovine PET uptake across a range of human glioblastoma xenograft models.MethodsThirty-one rats underwent orthotopic implantations with one of five different human glioblastoma cell lines. After tumors were established, fluciclovine PET and magnetic resonance imaging (MRI) scans were performed. The fluciclovine tumor-to-normal-brain (TN) uptake ratio was used to quantify fluciclovine uptake. MRI scans were used to assess tumor volume and gadolinium enhancement status. Histologic assessments quantified tumor cell proliferation, tumor cell density, and tumor cell amino acid transporters (LAT1 and ASCT2). Multivariate linear regression models related fluciclovine uptake with the other measured quantities.ResultsWithin the multivariate regression, the fluciclovine TN uptake ratio (measured 15 to 35 minutes after fluciclovine injection) was most strongly associated with tumor ASCT2 levels (β=0.64; P=0.001). The fluciclovine TN uptake ratio was also significantly associated with tumor volume (β=0.45; P=0.001) and tumor enhancement status (β=0.40; P=0.01). Tumor cell proliferation, tumor cell density, and LAT1 levels were not significantly associated with fluciclovine uptake in any of the multivariate models. In general, both enhancing and non-enhancing tumors could be visualized on fluciclovine PET images, with the median TN uptake ratio across the five tumor lines being 2.4 (range 1.1 to 8.9).ConclusionsIncreased fluciclovine PET uptake was associated with increased levels of the amino acid transporter ASCT2, suggesting fluciclovine PET may be useful for assessing brain tumor amino acid metabolism. Fluciclovine PET uptake was elevated in both enhancing and non-enhancing tumors but the degree of uptake was greater in larger tumors and tumors with enhancement, indicating these variables could confound fluciclovine metabolic measurements if not accounted for.

Project description:BackgroundTo investigate the current knowledge and attitudes towards [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) among non-radiologist medical staff in China.MethodsThis cross-sectional study was conducted between November 18, 2022, and December 6, 2022, at the First Affiliated Hospital (Southwest Hospital) of the Army Medical University (Third Military Medical University) among non-radiologist staff (medical, nursing, and others). The questionnaire survey (Cronbach's α = 0.887) included 28 items: 10 on demographics, 11 on knowledge (maximum score of 22), and seven on attitudes (maximum score of 35). The factors influencing knowledge and attitudes were identified using multivariable logistic regression analysis.ResultsThis study analyzed 631 valid questionnaires. The mean knowledge score was 7.16 ± 6.48 (32.55%), indicating poor knowledge. The mean attitude score was 22.859 ± 2.36 (65.29%), indicating positive attitudes. Nursing (OR = 0.301, 95%CI: 0.159-0.571), other occupations (OR = 0.426, 95%CI: 0.200-0.905), departments with high volumes of PET/CT prescriptions (OR = 0.419, 95%CI: 0.269-0.652), radioprotection training (OR = 2.520, 95%CI: 1.576-4.030), underwent (or a relative) a PET/CT (OR = 1.713, 95%CI: 1.063-2.761), and contact with 1-10 (OR = 2.429, 95%CI: 1.627-3.627) or > 10 (OR = 3.575, 95%CI: 1.762-7.252) patients per month were independently associated with higher knowledge scores. Only the knowledge scores (OR = 1.063, 95%CI: 1.032-1.094) were independently associated with higher attitude scores.ConclusionNon-radiologist medical staff members in China have poor knowledge but positive attitudes toward PET/CT. This study identified knowledge areas worth improving in future training interventions. Radioprotection training appears particularly useful in improving the knowledge of PET/CT, which should translate into more favorable attitudes.Trial registrationNot applicable.

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Project description:BackgroundCardiac arrest (CA) patients who survived by cardiopulmonary resuscitation (CPR) can present different levels of neurological deficits ranging from minor cognitive impairments to persistent vegetative state and brain death. The pathophysiology of the resulting brain injury is poorly understood, and whether changes in post-CA brain metabolism contribute to the injury are unknown. Here we utilized [18F]fluorodeoxyglucose (FDG)-Positron emission tomography (PET) to study in vivo cerebral glucose metabolism 72 h following CA in a murine CA model.MethodsAnesthetized and ventilated adult C57BL/6 mice underwent 12-min KCl-induced CA followed by CPR. Seventy-two hours following CA, surviving mice were intraperitoneally injected with [18F]FDG (~ 186 µCi/200 µL) and imaged on Molecubes preclinical micro-PET/computed tomography (CT) imaging systems after a 30-min awake uptake period. Brain [18F]FDG uptake was determined by the VivoQuant software on fused PET/CT images with the 3D brain atlas. Upon completion of Positron emission tomography (PET) imaging, remaining [18F]FDG radioactivity in the brain, heart, and liver was determined using a gamma counter.ResultsGlobal increases in brain [18F]FDG uptake in post-CA mice were observed compared to shams and controls. The median standardized uptake value of [18F]FDG for CA animals was 1.79 versus sham 1.25 (p < 0.05) and control animals 0.78 (p < 0.01). This increased uptake was consistent throughout the 60-min imaging period and across all brain regions reaching statistical significance in the midbrain, pons, and medulla. Biodistribution analyses of various key organs yielded similar observations that the median [18F]FDG uptake for brain was 7.04%ID/g tissue for CA mice versus 5.537%ID/g tissue for sham animals, p < 0.05).ConclusionsThis study has successfully applied [18F]FDG-PET/CT to measure changes in brain metabolism in a murine model of asystolic CA. Our results demonstrate increased [18F]FDG uptake in the brain 72 h following CA, suggesting increased metabolic demand in the case of severe neurological injury. Further study is warranted to determine the etiology of these changes.

Dataset Information

Value of [¹⁸F]-FDG positron emission tomography in patients with recurrent glioblastoma receiving bevacizumab.

Background

Methods

Results

Conclusion

Publications

Value of [<sup>18</sup>F]-FDG positron emission tomography in patients with recurrent glioblastoma receiving bevacizumab.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Value of [18F]-FDG positron emission tomography in patients with recurrent glioblastoma receiving bevacizumab.

Background

Methods

Results

Conclusion

Publications

Value of [<sup>18</sup>F]-FDG positron emission tomography in patients with recurrent glioblastoma receiving bevacizumab.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Value of [¹⁸F]-FDG positron emission tomography in patients with recurrent glioblastoma receiving bevacizumab.