[en] Over the last two decades the large volume of research involving various brain tracers has shed invaluable light on the pathophysiology of cerebral neoplasms. Yet the question remains as to how best to incorporate this newly acquired insight into the clinical context. Thallium is the most studied radiotracer with the longest track record. Many, but not all studies, show a relationship between Tl-201 uptake and tumor grade. Due to the overlap between tumor uptake and histologic grades, Tl-201 cannot be used as the sole noninvasive diagnostic or prognostic tool in brain tumor patients. However, it may help differentiating a high-grade tumor recurrence from radiation necrosis. MIBI is theoretically a better imaging agent than Tl-201 but it has not convincingly been shown to differentiate tumors according to grade. MDR-1 gene expression as demonstrated by MIBI does not correlate with chemoresistance in high grade gliomas. Currently, MIBI's clinical role in brain tumor imaging has yet to be defined. IMT, a radio-labeled amino acid analog, may be useful for identifying postoperative tumor recurrence and, in this application, appears to be a cheaper, more widely available tool than positron emission tomography (PET). However, its ability to accurately identify tumor grade is limited. 18 F-2-Fluoro-2-deoxy-D-glucose (FDG) PET predicts tumor grade, and the metabolic activity of brain tumors has a prognostic significance. Whether FDG uptake has an independent prognostic value above that of histology remains debated. FDG-PET is effective in differentiating recurrent tumor from radiation necrosis for high-grade tumors, but has limited value in defining the extent of tumor involvement and recurrence of low-grade lesions. Amino-acid tracers, such as MET, perform better for this purpose and thus play a complementary role to FDG. Given the poor prognosis of patients with gliomas, particularly with high-grade lesions, the overall clinical utility of single photon emission computed tomography (SPECT) and PET in characterizing recurrent lesions remains dependent on the availability of effective treatments. These tools are thus mostly suited to the evaluation of treatment response in experimental protocols designed to improve the patients' outcome. (C) 2003 Elsevier Inc. All rights reserved.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
Bénard, François
Romsa, Jonathan
Hustinx, Roland ; Université de Liège - ULiège > Département des sciences cliniques > Médecine nucléaire
Language :
English
Title :
Imaging gliomas with positron emission tomography and single-photon emission computed tomography
Publication date :
April 2003
Journal title :
Seminars in Nuclear Medicine
ISSN :
0001-2998
eISSN :
1558-4623
Publisher :
W B Saunders Co, Philadelphia, United States - Pennsylvania
American Cancer Society: Cancer Facts & Figures 2002. New York, American Cancer Society, 2002, p 5
Smimiotopoulos JG: The new WHO classification of brain tumors. Neuroimag Clin N Am 9:595-613, 1999
Levin VA, Leibel SA, Gutin PH: Neoplasms of the Central Nervous System. in Principles and Practice of Oncology De Vita VT, Hellman S, Gutin PH (eds): Cancer. Philadelphia, Lippincott Williams & Wilkins, 2001
Vandenberg S, Sampaio Lopes MB: Classification, in Berger MS, Wilson CB (eds): The Gliomas Philadelphia, WB Saunders, 1999, pp 172-191
Keles GE, Lambom KR, Berger MS: Low-grade hemispheric gliomas in adults: A critical review of extent of resection as a factor influencing outcome. J Neurosurg 95:735-745, 2001
DeAngelis LM: Brain tumors. N Engl J Med 344:114-123, 2001
Ricci PE: Imaging of adult brain tumors. Neuroimag Clin N Am 9:651-669, 1999
Nelson SJ: Imaging of brain tumors after therapy. Neuroimag Clin N Am 9:801-819, 1999
Ancri D, Basset JY, Lonchampt MF, et al: Diagnosis of cerebral lesions by Thallium 201. Radiology 128:417-422, 1978
Kaplan WD, Takvorian T, Morris JH, et al: Thallium-201 brain tumor imaging: A comparative study with pathologic correlation. J Nucl Med 28:47-52, 1987
Kim KT, Black KL, Marciano D, et al: Thallium-201 SPECT imaging of brain tumors: Methods and results. J Nucl Med 31:965-969, 1990
Oriuchi N, Tamura M, Shibazaki T, et al: Clinical evaluation of thallium-201 SPECT in supratentorial gliomas: relationship to histologic grade, prognosis and proliferative activities. J Nucl Med 34:2085-2089, 1993
Jinnouchi S, Hoshi H, Ohnishi T, et al: Thallium-201 SPECT for predicting histological types of meningiomas. J Nucl Med 34:2091-2094, 1993
Ishibashi M, Taguchi A, Sugita Y, et al: Thallium-201 in brain tumors: relationship between tumor cell activity in astrocytic tumor and proliferating cell nuclear antigen. J Nucl Med 36:2201-2206, 1995
Dierckx RA, Martin JJ, Dobbeleir A, et al: Sensitivity and specificity of thallium-201 single-photon emission tomography in the functional detection and differential diagnosis of brain tumors. Eur J Nucl Med 21:621-633, 1994
Ricci M, Pantano P, Pierallini A, et al: Relationship between thallium-201 uptake by supratentorial glioblastomas and their morphological characteristics on magnetic resonance imaging. Eur J Nucl Med 23:524-529, 1996
Sun D, Liu Q, Liu W, et al: Clinical application of 201T1 SPECT imaging of brain tumors. J Nucl Med 41:5-10, 2000
Staffen W, Hondl N, Trinka E, et al: Clinical relevance of 201T1-chloride SPET in the differential diagnosis of brain tumors. Nucl Med Commun 19:335-340, 1998
O'Tuama LA, Treves ST, Larar JN, et al: Thallium-201 versus technetium-99m-MIBI SPECT in evaluation of childhood brain tumors: A within-subject comparison. J Nucl Med 34:1045-1051, 1993
Bagni B, Pinna L, Tamarozzi R, et al: SPET imaging of intracranial tumors with 99Tcm-sestamibi. Nucl Med Commun 16:258-264, 1995
Soler C, Beauchesne P, Maatougui K, et al: Technetium-99m sestamibi brain single-photon emission tomography for detection of recurrent gliomas after radiation therapy. Eur J Nucl Med 25:1649-1657, 1998
Yokogami K, Kawano H, Moriyama T, et al: Application of SPET using technetium-99m sestamibi in brain tumors and comparison with expression of the MDR-1 gene: Is it possible to predict the response to chemotherapy in patients with gliomas by means of 99mTc-sestamibi SPET? Eur J Nucl Med 25:401-409, 1998
Nishiyama Y, Yamamoto Y, Fukunaga K, et al: Comparison of 99Tcm-MIBI with 201T1 chloride SPET in patients with malignant brain tumours. Nucl Med Commun 22:631-639, 2001
Soricelli A, Cuocolo A, Varrone A, et al: Technetium99m-tetrofosmin uptake in brain tumors by SPECT: Comparison with thallium-201 imaging. J Nucl Med 39:802-806, 1998
Biersack HJ, Coenen HH, Stocklin G, et al: Imaging of brain tumors with [I-123]iodo-alpha-methyl tyrosine and SPECT. J Nucl Med 30:110-112, 1989
Langen KJ, Muhlensiepen H, Holschbach M, et al: Transport mechanisms of [I-123]iodo-alpha-methyl-L-tyrosine in a human glioma cell line: comparison with [3H]methyl-L-methionine. J Nucl Med 41:1250-1255, 2000
Kuwert T, Morgenroth C, Woesler B, et al: Uptake of iodine-123-alpha-methyl tyrosine by gliomas and non-neoplastic brain lesions. Eur J Nucl Med 23:1345-1353, 1996
Kuwert T, Woesler B, Morgenroth C, et al: Diagnosis of recurrent glioma with SPECT and iodine-123-alpha-methyl tyrosine. [erratum appears in J Nucl Med 1998 Mar;39(3):574.]. J Nucl Med 39:23-27, 1998
Schmidt D, Gottwald U, Langen KJ, et al: [I-123]Iodo-alpha-methyl-L-tyrosine uptake in cerebral gliomas: relationship to histological grading and prognosis. Eur J Nucl Med 28:855-861, 2001
Weber WA, Dick S, Reidl G, et al: Correlation between postoperative 3-[(123)I]iodo-L-alpha-methyltyrosine uptake and survival in patients with gliomas. J Nucl Med 42:1144-1150, 2001
Langen KJ, Ziemons K, Kiwit JC, et al: [123I]iodo-alpha-methyltyrosine and [methyl-11C]-L-methionine uptake in cerebral gliomas: a comparative study using SPECT and PET. J Nucl Med 38:517-522, 1997
Weber W, Bartenstein P, Gross MW, et al: Fluorine-18-FDG PET and iodine-123-IMT SPECT in the evaluation of brain tumors. J Nucl Med 38:802-880, 1997
Woesler B, Kuwert T, Morgenroth C, et al: Non-invasive grading of primary brain tumours: results of a comparative study between SPET with 123I-alpha-methyl tyrosine and PET with 18F-deoxyglucose. Eur J Nucl Med 24:428-434, 1997
Bader JB, Samnick S, Moringlane JR, et al: Evaluation of 1-3-[123I]iodo-alpha-methyltyrosine SPET and [18F]fluorodeoxyglucose PET in the detection and grading of recurrences in patients pretreated for gliomas at follow-up: a comparative study with stereotactic biopsy. Eur J Nucl Med 26:144-151, 1999
Sasaki M, Kuwabara Y, Yoshida T, et al: A comparative study of thallium-201 SPET, carbon-11 methionine PET and fluorine-18 fluorodeoxyglucose PET for the differentiation of astrocytic tumours. Eur J Nucl Med 25:1261-1269, 1998
Samnick S, Hellwig D, Bader JB, et al: Initial evaluation of the feasibility of single photon emission tomography with p[I-123]iodo-L-phenylalanine for routine brain tumour imaging. Nucl Med Commun 23:121-130, 2002
Wrenn Jr F, Good M, Handler P: The use of positron emitting radioisotopes for localization of brain tumors. Science 113:525-527, 1951
Brownell G, Sweet W: Localization of brain tumors with positron emitters. Nucleonics 11:40-45, 1953
Schelstraete K, Simons M, Deman J, et al: Uptake of 13N-ammonia by human tumors as studied by positron emission tomography. Br J Radiol 55:797-804, 1982
Ito M, Lammertsma A, Wise R, et al: Measurement of regional cerebral blood flow and oxygen utilization in patients with cerebral tumors using 150 and positron emission tomography: analytical techniques and preliminary results. Neuroradiology 23:63-67, 1982
Leenders K: PET: Blood flow and oxygen consumption in brain tumors. J Neuro-Oncol 22:269-273, 1994
Shields AF, Lim K, Grierson J, et al: Utilization of labeled thymidine in DNA synthesis: Studies for PET. J Nucl Med 31:337-342, 1990
Vander Borght T, Pauwels S, Lambotte L, et al: Brain tumor imaging with PET and 2-[carbon-11]Thymidine. J Nucl Med 25:974-982, 1994
De Reuck J, Santens P, Goethals P, et al: [Methyl-11C]thymidine positron emission tomography in tumoral and non-tumoral cerebral lesions. Acta Neurol Belg 99:118-125, 1999
Eary JF, Mankoff DA, Spence AM, et al: 2-[C-11]thymidine imaging of malignant brain tumors. Cancer Res 59:615-621, 1999
Blasberg RG, Roelcke U, Weinreich R, et al: Imaging brain tumor proliferative activity with [I-124]iododeoxyuridine. Cancer Res 60:624-635, 2000
Shields AF, Grierson JR, Dohmen BM, et al: Imaging proliferation in vivo with [F-18]FLT and positron emission tomography. Nat Med 4:1334-1336, 1998
Warnick RE, Pietronigro DD, McBride DQ, et al: In vivo metabolism of radiolabeled putrescine in gliomas: implications for positron emission tomography of brain tumors. Neurosurgery 23:464-469, 1988
Mitsuki S, Diksic M, Conway T, et al: Pharmacokinetics of 11C-labelled BCNU and SarCNU in gliomas studied by PET. J Neurooncol 10:47-55, 1991
Valk P, Mathis C, Prados M, et al: Hypoxia in human gliomas: Demonstration by PET with fluorine-18-fluoromisonidazole. J Nucl Med 33:2133-2137, 1992
Fulham MJ, Bizzi A, Dietz MJ, et al: Mapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance. Radiology 185:675-686, 1992
Shinoura N, Nishijima M, Hara T, et al: Brain tumors: detection with C-11 choline PET. Radiology 202:497-503, 1997
Ohtani T, Kurihara H, Ishiuchi S, et al: Brain tumour imaging with carbon-11 choline: Comparison with FDG PET and gadolinium-enhanced MR imaging. Eur J Nucl Med 28: 1664-1670, 2001
DeGrado TR, Baldwin SW, Wang S, et al: Synthesis and evaluation of (18)F-labeled choline analogs as oncologic PET tracers. J Nucl Med 42:1805-1814, 2001
Kubota K, Yamada K, Fukada H, et al: Tumor detection with carbon-11-labelled amino acids. Eur J Nucl Med 9:136-140, 1984
Ishiwata K, Kubota K, Murakami M, et al: Re-evaluation of amino acid PET studies: Can the protein synthesis rates in brain and tumor tissues be measured in vivo? J Nucl Med 34:1936-1943, 1993
Lilja A, Bergstrom K, Hartvig P, et al: Dynamic study of supratentorial gliomas with L-methyl-11C-methionine and positron emission tomography. AJNR Am J Neuroradiol 6:505-514, 1985
Bustany P, Chatel M, Derlon JM, et al: Brain tumor protein synthesis and histological grades: A study by positron emission tomography (PET) with C11-L-Methionine. J Neurooncol 3:397-404, 1986
Derlon JM, Bourdet C, Bustany P, et al: [11C]L-methionine uptake in gliomas. Neurosurgery 25:720-728, 1989
Kameyama M, Shirane R, Itoh J, et al: The accumulation of 11C-methionine in cerebral glioma patients studied with PET. Acta Neurochir (Wien) 104:8-12, 1990
Vaalburg W, Coenen HH, Crouzel C, et al: Amino acids for the measurement of protein synthesis in vivo by PET. Int J Rad Appl Instrum B 19:227-237, 1992
Ishiwata K, Kubota K, Murakami M, et al: A comparative study on protein incorporation of L-[methyl-3H]methionine, L-[1-14C]leucine and L-2-[18F]fluorotyrosine in tumor bearing mice. Nucl Med Biol 20:895-899, 1993
Kubota K, Kubota R, Yamada S, et al: Effects of radiotherapy on the cellular uptake of carbon-14 labeled L-methionine in tumor tissue. Nucl Med Biol 22:193-198, 1995
Kubota K, Ishiwata K, Kubota R, et al: Tracer feasibility for monitoring tumor radiotherapy: a quadruple tracer study with fluorine-18-fluorodeoxyglucose or fluorine-18-fluorode-oxyuridine, L-[methyl-14C]methionine, [6-3H]thymidine and gallium-67, J Nucl Med 32:2118-2123, 1991
Derlon JM, Petit-Taboue MC, Chapon F, et al: The in vivo metabolic pattern of low-grade brain gliomas: a positron emission tomographic study using 18F-fluorodeoxyglucose and 11C-L-methylmethionine. Neurosurgery 40:276-287; discussion 287-288, 1997
Kaschten B, Stevenaert A, Sadzot B, et al: Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med 39:778-785, 1998
Bergstrom M, Collins VP, Ehrin E, et al: Discrepancies in brain tumor extent as shown by computed tomography and positron emission tomography using [68Ga]EDTA, [11C]glucose, and [11C]methionine. J Comput Assist Tomogr 7:1062-1066, 1983
Ogawa T, Kanno I, Shishido F, et al: Clinical value of PET with 18F-fluorodeoxyglucose and L-methyl-11C-methionine for diagnosis of recurrent brain tumor and radiation injury. Acta Radiol 32:197-202, 1991
Pirotte B, Goldman S, Bidaut LM, et al: Use of positron emission tomography (PET) in stereotactic conditions for brain biopsy. Acta Neurochir (Wien) 134:79-82, 1995
Roelcke U, Radu EW, von Ammon K, et al: Alteration of blood-brain barrier in human brain tumors: comparison of [18F]fluorodeoxyglucose, [11C]methionine and rubidium-82 using PET. J Neurol Sci 132:20-27, 1995
Ogawa T, Shishido F, Kanno I, et al: Cerebral glioma: evaluation with methionine PET. Radiology 186:45-53, 1993
Voges J, Herholz K, Holzer T, et al: 11C-methionine and 18F-2-fluorodeoxyglucose positron emission tomography: a tool for diagnosis of cerebral glioma and monitoring after brachytherapy with 1251 seeds. Stereotactic Functional Neurosurg 69:129-135, 1997
De Witte O, Goldberg I, Wikler D, et al: Positron emission tomography with injection of methionine as a prognostic factor in glioma. J Neurosurg 95:746-750, 2001
Herholz K, Holzer T, Bauer B, et al: 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 50:1316-1322, 1998
Lemaire C, Damhaut P, Lauricella B, et al: Fast [18F]FDG synthesis by alkaline hydrolysis on a low polarity solid phase support. J Labelled Cpd Radiopharm 45:435-447, 2002
Wienhard K, Herholz K, Coenen HH, et al: Increased amino acid transport into brain tumors measured by PET of L-(2-18F)fluorotyrosine. J Nucl Med 32:1338-1346, 1991
Warburg O: The Metabolism of Tumors. London, Constable and Company Limited, 1930
Weber G: Enzymology of cancer cells. N Engl J Med 296:486-493; 541-551, 1977
Hatanaka M, Augl C, Gilden RV: Evidence for a functional change in the plasma membrane of murine sarcoma virus-infected mouse embryo cells. Transport and transport-associated phosphorylation of 14C-2-deoxy-D-glucose. J Biol Chem 245:714-717, 1970
Gallagher B, Fowler J, Gutterson N, et al: Metabolic trapping as a principle of radiopharmaceutical design: Some factors responsible for the biodistribution of [18F]deoxyglucose. J Nucl Med 19:1154-1161, 1989
Merrall N, Plevin R, Gould G: Growth factors, mitogens, oncogenes and the regulation of glucose transport. Cell Signal 5:667-675, 1993
Nishioka T, Oda Y, Seino Y, et al: Distribution of the glucose transporters in human brain tumors. Cancer Res 52: 3972-3979, 1992
Herholz K, Pietrzyk U, Voges J, et al: Correlation of glucose consumption and tumor cell density in astrocytomas. A stereotactic PET study. J Neurosurg 79:853-858, 1993
Patronas NJ, Di Chiro G, Brooks RA, et al: Work in progress: [18F] Fluorodeoxyglucose and positron emission tomography in the evaluation of radiation necrosis of the brain. Radiology 144:885-889, 1982
Di Chiro G, DeLaPaz RL, Brooks RA, et al: Glucose utilization of cerebral gliomas measured by [18F] fluorodeoxyglucose and positron emission tomography. Neurology 32: 1323-1329, 1982
Kim CK, Alavi JB, Alavi A, et al: New grading system of cerebral gliomas using positron emission tomography with F-18 fluorodeoxyglucose. J Neurooncol 10:85-91, 1991
Meyer PT, Schreckenberger M, Spetzger U, et al: Comparison of visual and ROI-based brain tumor grading using 18F-FDG PET: ROC analyses. Eur J Nucl Med 28:165-174, 2001
Hustinx R, Smith RJ, Benard F, et al: Can the standardized uptake value characterize primary brain tumors on FDG-PET? Eur J Nucl Med 26:1501-1509, 1999
Holthoff VA, Herholz K, Berthold F, et al: In vivo metabolism of childhood posterior fossa tumors and primitive neuroectodermal tumors before and after treatment. Cancer 72:1394-1403, 1993
Patronas NJ, Brooks RA, DeLaPaz RL, et al: Glycolytic rate (PET) and contrast enhancement (CT) in human cerebral gliomas. AJNR Am J Neuroradiol 4:533-535, 1983
Alavi JB, Alavi A, Chawluk J, et al: Positron emission tomography in patients with glioma. A predictor of prognosis. Cancer 62:1074-1078, 1988
Holzer T, Herholz K, Jeske J, et al: FDG-PET as a prognostic indicator in radiochemotherapy of glioblastoma. J Comput Assist Tomogr 17:681-687, 1993
De Witte f, Lefranc F, Levivier M, et al: FDG-PET as a prognostic factor in high-grade astrocytoma. J Neuro-Oncol 49:157-163, 2000
Di Chiro G, Oldfield E, Wright DC, et al: Cerebral necrosis after radiotherapy and/or intraarterial chemotherapy for brain tumors: PET and neuropathologic studies. AJR Am J Roentgenol 150:189-197, 1988
Glantz MJ, Hoffman JM, Coleman RE, et al: Identification of early recurrence of primary central nervous system tumors by [18F]fluorodeoxyglucose positron emission tomography. Ann Neurol 29:347-355, 1991
Buchpiguel CA, Alavi JB, Alavi A, et al: PET versus SPECT in distinguishing radiation necrosis from tumor recurrence in the brain. J Nucl Med 36:159-164, 1995
Kim EE, Chung SK, Haynie TP, et al: Differentiation of residual or recurrent tumors from post-treatment changes with F-18 FDG PET. Radiographics 12:269-279, 1992
Brock CS, Young H, O'Reilly SM, et al: Early evaluation of tumour metabolic response using [18F]fluorodeoxyglucose and positron emission tomography: A pilot study following the phase II chemotherapy schedule for temozolomide in recurrent high-grade gliomas. Br J Cancer 82:608-615, 2000
Rozental JM, Levine RL, Nickles RJ, et al: Glucose uptake by gliomas after treatment. A positron emission tomographic study. Arch Neurol 46:1302-1307, 1989
Rozental JM, Levine RL, Mehta MP, et al: Early changes in tumor metabolism after treatment: the effects of stereotactic radiotherapy. Int J Radiat Oncol Biol Phys 20:1053-1060, 1991
Francavilla T, Miletich R, Di Chiro G, et al: Positron emission tomography in the detection of malignant degeneration of low-grade gliomas. Neurosurgery 24:1-5, 1989
De Witte O, Levivier M, Violon P, et al: Prognostic value positron emission tomography with [18F]fluoro-2-deoxy-D-glucose in the low-grade glioma. Neurosurgery 39:470-476; discussion 476-477, 1996
Hanson MW, Glantz MJ, Hoffman JM, et al: FDG-PET in the selection of brain lesions for biopsy. J Comput Assist Tomogr 15:796-801, 1991
Di Chiro G, Brooks RA, Patronas NJ, et al: Issues in the in vivo measurement of glucose metabolism of human central nervous system tumors. Ann Neurol 15:S138-46, 1984 (supp)
Jacobs A, Dubrovin M, Hewett J, et al: Functional coexpression of HSV-1 thymidine kinase and green fluorescent protein: Implications for noninvasive imaging of transgene expression. Neoplasia 1:154-161, 1999
Jacobs A, Tjuvajev JG, Dubrovin M, et al: Positron emission tomography-based imaging of transgene expression mediated by replication-conditional, oncolytic herpes simplex virus type 1 mutant vectors in vivo. Cancer Res 61:2983-2995, 2001
Tjuvajev JG, Doubrovin M, Akhurst T, et al: Comparison of radiolabeled nucleoside probes (FIAU, FHBG, and FHPG) for PET imaging of HSV1-tk gene expression. J Nucl Med 43:1072-1083, 2002
