Description: Prognostic Value of O-(2-[18F]-Fluoroethyl)-L-Tyrosine PET and MRI in Low-Grade Glioma

This title appears in the Scientific Report : 2007

Prognostic Value of O-(2-[18F]-Fluoroethyl)-L-Tyrosine PET and MRI in Low-Grade Glioma

In glioma of World Health Organization (WHO) grade II (low-grade glioma), the natural course of a particular patient is not predictable and the treatment strategy is controversial. We determined prognostic factors in adult patients with untreated, nonenhancing, supratentorial low-grade glioma with s...

Personal Name(s):	Floeth, F. W.
	Pauleit, D. / Sabel, M. / Stoffels, G. / Reifenberger, G. / Riemenschneider, M. J. / Jansen, P. / Coenen, H. H. / Steiger, H.-J. / Langen, K.-J.
Contributing Institute:	Institut für Neurowissenschaften und Biophysik - Medizin; INB-3 Zentralinstitut für Angewandte Mathematik; ZAM Nuklearchemie; INB-4
Published in:	Journal of Nuclear Medicine Journal of nuclear medicine, 48 48 (2007 2007) 4 4, S. 519-527 519-527
Imprint:	New York, NY Society of Nuclear Medicine 2007 2007-04-01 2007-04-01
Physical Description:	519 - 527
DOI:	10.2967/jnumed.106.037895
PubMed ID:	17401087
Document Type:	Journal Article
Research Program:	Scientific Computing Funktion und Dysfunktion des Nervensystems
Series Title:	Journal of Nuclear Medicine 48
Subject (ZB):	J low-grade glioma prognosis amino acid PET O-(2-F-18-fluoroethyl)-L-tyrosine (F-18-FET) circumscribed lesion diffuse lesion
	Publikationsportal JuSER

Please use the identifier: http://dx.doi.org/10.2967/jnumed.106.037895 in citations.

In glioma of World Health Organization (WHO) grade II (low-grade glioma), the natural course of a particular patient is not predictable and the treatment strategy is controversial. We determined prognostic factors in adult patients with untreated, nonenhancing, supratentorial low-grade glioma with special regard to PET using the amino acid O-(2-F-18-fluoroethyl)-L-tyrosine (F-18-FET) and MRI. Methods: In a prospective study, baseline F-18-FET PET and MRI analyses were performed on 33 consecutive patients with histologically confirmed low-grade glioma. None of the patients had radiation or chemotherapy. Clinical, histologic, therapeutic (initial cytoreduction vs. biopsy), F-18-FET uptake, and MRI morphologic parameters were analysed for their prognostic significance. Statistical endpoints were clinical or radiologic tumor progression, malignant transformation to glioma of WHO grade III or IV (high-grade glioma), and death. Results: Baseline F-18-FET uptake and a diffuse versus circumscribed tumor pattern on MRI were highly significant predicators of prognosis (P < 0.01). By combination of these prognostically significant variables, 3 major prognostic subgroups of low-grade glioma patients could be identified. The first of these subgroups was patients with circumscribed low-grade glioma on MRI without F-18-FET uptake (n = 11 patients, progression in 18%, no malignant transformation and no death). The second subgroup was patients with circumscribed low-grade glioma with F-18-FET uptake (n = 13 patients, progression in 46%, malignant malignant transformation to a high-grade glioma in 15%, and death in 8%). The third subgroup was patients with diffuse low-grade glioma with F-18-FET uptake (n = 9 patients, progression in 100%, malignant transformation to a high-grade glioma in 78%, and death in 56%). Conclusion: We conclude that baseline amino acid uptake on F-18-FET PET and a diffuse versus circumscribed tumor pattern on MRI are strong predictors for the outcome of patients with low-grade glioma.