What Does Reduced FDG Uptake Mean in High-Grade Gliomas?. (December 2019)

• Record Type: Journal Article
• Authors: Bund, Caroline; Lhermitte, Benoît; Cicek, A. Ercument; Ruhland, Elisa; Proust, François; Namer, Izzie Jacques
• Is Part Of: Clinical nuclear medicine. Volume 44:Number 12(2019)
• Publication Date: 2019-12
• Subjects: FDG PET -- glioma -- metabolomics -- HRMAS-NMR spectroscopy; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000002765
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: As well as in many others cancers, FDG uptake is correlated with the degree of malignancy in gliomas, that is, commonly high FDG uptake in high-grade gliomas. However, in clinical practice, it is not uncommon to observe high-grade gliomas with low FDG uptake. Our aim was to explore the tumor metabolism in 2 populations of high-grade gliomas presenting high or low FDG uptake. Methods: High-resolution magic-angle spinning nuclear magnetic resonance spectroscopy was realized on tissue samples from 7 high-grade glioma patients with high FDG uptake and 5 high-grade glioma patients with low FDG uptake. Tumor metabolomics was evaluated from 42 quantified metabolites and compared by network analysis. Results: Whether originating from astrocytes or oligodendrocytes, the high-grade gliomas with low FDG avidity represent a subgroup of high-grade gliomas presenting common characteristics: low aspartate, glutamate, and creatine levels, which are probably related to the impaired electron transport chain in mitochondria; high serine/glycine metabolism and so one-carbon metabolism; low glycerophosphocholine-phosphocholine ratio in membrane metabolism, which is associated with tumor aggressiveness; and finally negative MGMT methylation status. Conclusions: It seems imperative to identify this subgroup of high-grade gliomas with low FDG avidity, which is especially aggressive. Their identification could be important for early detection for a possible personalized treatment, such as antifolate treatment.