18F-FSPG PET/CT Imaging of System xC– Transporter Activity in Patients with Primary and Metastatic Brain Tumors
| Autor: | Mirwais Wardak, Ida Sonni, Audrey P. Fan, Ryogo Minamimoto, Mehran Jamali, Negin Hatami, Greg Zaharchuk, Nancy Fischbein, Seema Nagpal, Gordon Li, Norman Koglin, Mathias Berndt, Santiago Bullich, Andrew W. Stephens, Ludger M. Dinkelborg, Ty Abel, H. Charles Manning, Jarrett Rosenberg, Frederick T. Chin, Sanjiv Sam Gambhir, Erik S. Mittra |
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| Rok vydání: | 2022 |
| Předmět: |
Male
screening and diagnosis Brain Neoplasms Clinical Trials and Supportive Activities Neurosciences Glutamic Acid Middle Aged Medical and Health Sciences Brain Disorders Brain Cancer Detection Nuclear Medicine & Medical Imaging Rare Diseases Fluorodeoxyglucose F18 Clinical Research Positron-Emission Tomography Positron Emission Tomography Computed Tomography Humans Biomedical Imaging Radiology Nuclear Medicine and imaging Prospective Studies Radiopharmaceuticals Original Research Cancer 4.2 Evaluation of markers and technologies |
| Zdroj: | Radiology, vol 303, iss 3 Radiology |
| ISSN: | 1527-1315 0033-8419 |
| Popis: | BACKGROUND: The PET tracer (4S)-4-(3-[(18)F]fluoropropyl)-l-glutamate ((18)F-FSPG) targets the system x(C)(–) cotransporter, which is overexpressed in various tumors. PURPOSE: To assess the role of (18)F-FSPG PET/CT in intracranial malignancies. MATERIALS AND METHODS: Twenty-six patients (mean age, 54 years ± 12; 17 men; 48 total lesions) with primary brain tumors (n = 17) or brain metastases (n = 9) were enrolled in this prospective, single-center study (ClinicalTrials.gov identifier: NCT02370563) between November 2014 and March 2016. A 30-minute dynamic brain (18)F-FSPG PET/CT scan and a static whole-body (WB) (18)F-FSPG PET/CT scan at 60–75 minutes were acquired. Moreover, all participants underwent MRI, and four participants underwent fluorine 18 ((18)F) fluorodeoxyglucose (FDG) PET imaging. PET parameters and their relative changes were obtained for all lesions. Kinetic modeling was used to estimate the (18)F-FSPG tumor rate constants using the dynamic and dynamic plus WB PET data. Imaging parameters were correlated to lesion outcomes, as determined with follow-up MRI and/or pathologic examination. The Mann-Whitney U test or Student t test was used for group mean comparisons. Receiver operating characteristic curve analysis was used for performance comparison of different decision measures. RESULTS: (18)F-FSPG PET/CT helped identify all 48 brain lesions. The mean tumor-to-background ratio (TBR) on the whole-brain PET images at the WB time point was 26.6 ± 24.9 (range: 2.6–150.3). When (18)F-FDG PET was performed, (18)F-FSPG permitted visualization of non-(18)F-FDG–avid lesions or allowed better lesion differentiation from surrounding tissues. In participants with primary brain tumors, the predictive accuracy of the relative changes in influx rate constant K(i) and maximum standardized uptake value to discriminate between poor and good lesion outcomes were 89% and 81%, respectively. There were significant differences in the (18)F-FSPG uptake curves of lesions with good versus poor outcomes in the primary brain tumor group (P < .05) but not in the brain metastases group. CONCLUSION: PET/CT imaging with (4S)-4-(3-[(18)F]fluoropropyl)-l-glutamate ((18)F-FSPG) helped detect primary brain tumors and brain metastases with a high tumor-to-background ratio. Relative changes in (18)F-FSPG uptake with multi-time-point PET appear to be helpful in predicting lesion outcomes. Clinical trial registration no. NCT02370563 © RSNA, 2022 Online supplemental material is available for this article. |
| Databáze: | OpenAIRE |
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