PDF(Pubmed)
Abstract：
MRI and PET are used in neuro-oncology for the detection and characterisation of lesions for malignancy to target surgical biopsy and to plan surgical resections or stereotactic radiosurgery. The critical role of short-chain fatty acids (SCFAs) in brain tumour biology has come to the forefront. The non-metabolised SCFA radiotracer, [18F]fluoropivalate (FPIA), shows low background signal in most tissues except eliminating organs and has appropriate human dosimetry. Tumour uptake of the radiotracer is, however, unknown. We investigated the uptake characteristics of FPIA in this pilot PET/MRI study.
Ten adult glioma subjects were identified based on radiological features using standard-of-care MRI prior to any surgical intervention, with subsequent histopathological confirmation of glioma subtype and grade (lower-grade - LGG - and higher-grade - HGG - patients). FPIA was injected as an intravenous bolus injection (range 342-368 MBq), and dynamic PET and MRI data were acquired simultaneously over 66 min.
All patients tolerated the PET/MRI protocol. Three patients were reclassified following resection and histology. Tumour maximum standardised uptake value (SUVmax,60) increased in the order LGG (WHO grade 2) < HGG (WHO grade 3) < HGG (WHO grade 4). The net irreversible solute transfer, Ki, and influx rate constant, K1, were significantly higher in HGG (p < 0.05). Of the MRI variables studied, DCE-MRI-derived extravascular-and-extracellular volume fraction (ve) was high in tumours of WHO grade 4 compared with other grades (p < 0.05). SLC25A20 protein expression was higher in HGG compared with LGG.
Tumoural FPIA PET uptake is higher in HGG compared to LGG. This study supports further investigation of FPIA PET/MRI for brain tumour imaging in a larger patient population.
Clinicaltrials.gov, NCT04097535.
Ten adult glioma subjects were identified based on radiological features using standard-of-care MRI prior to any surgical intervention, with subsequent histopathological confirmation of glioma subtype and grade (lower-grade - LGG - and higher-grade - HGG - patients). FPIA was injected as an intravenous bolus injection (range 342-368 MBq), and dynamic PET and MRI data were acquired simultaneously over 66 min.
All patients tolerated the PET/MRI protocol. Three patients were reclassified following resection and histology. Tumour maximum standardised uptake value (SUVmax,60) increased in the order LGG (WHO grade 2) < HGG (WHO grade 3) < HGG (WHO grade 4). The net irreversible solute transfer, Ki, and influx rate constant, K1, were significantly higher in HGG (p < 0.05). Of the MRI variables studied, DCE-MRI-derived extravascular-and-extracellular volume fraction (ve) was high in tumours of WHO grade 4 compared with other grades (p < 0.05). SLC25A20 protein expression was higher in HGG compared with LGG.
Tumoural FPIA PET uptake is higher in HGG compared to LGG. This study supports further investigation of FPIA PET/MRI for brain tumour imaging in a larger patient population.
Clinicaltrials.gov, NCT04097535.
摘要：
目的：MRI和PET在神经肿瘤学中用于检测和表征恶性肿瘤的病变，以靶向手术活检并计划手术切除或立体定向放射外科手术。短链脂肪酸（SCFA）在脑肿瘤生物学中的关键作用已成为最前沿。非代谢SCFA放射性示踪剂，[18F]氟戊酸（FPIA），除消除器官外，在大多数组织中显示出低背景信号，并具有适当的人体剂量测定。放射性示踪剂的肿瘤摄取是，然而,未知。在这项初步的PET/MRI研究中，我们调查了FPIA的摄取特征。
方法：在任何手术干预之前，根据放射学特征使用标准护理MRI确定了10名成人神经胶质瘤受试者。随后的神经胶质瘤亚型和分级的组织病理学确认（低级-LGG-和高级-HGG-患者）。FPIA作为静脉推注注射(范围342-368MBq)，动态PET和MRI数据在66分钟内同时采集。
结果：所有患者均耐受PET/MRI方案。切除和组织学检查后，对三名患者进行了重新分类。肿瘤最大标准化摄取值（SUVmax，60）按LGG（WHO2级）结论：HGG的肿瘤FPIAPET摄取高于LGG。这项研究支持在更大的患者人群中对FPIAPET/MRI进行脑肿瘤成像的进一步研究。
背景：Clinicaltrials.gov，NCT04097535。
方法：在任何手术干预之前，根据放射学特征使用标准护理MRI确定了10名成人神经胶质瘤受试者。随后的神经胶质瘤亚型和分级的组织病理学确认（低级-LGG-和高级-HGG-患者）。FPIA作为静脉推注注射(范围342-368MBq)，动态PET和MRI数据在66分钟内同时采集。
结果：所有患者均耐受PET/MRI方案。切除和组织学检查后，对三名患者进行了重新分类。肿瘤最大标准化摄取值（SUVmax，60）按LGG（WHO2级）
背景：Clinicaltrials.gov，NCT04097535。
