11C-Acetate PET/CT Detects Reactive Astrogliosis Helping Glioma Classification. (26th October 2022)

• Record Type: Journal Article
• Authors: Kim, Dongwoo; Chun, Joong Hyun; Yi, Ju Hyeon; Ko, Hae Young; Chung, Jee-In; Lee, Misu; Park, Yongmin Mason; Nam, Min-Ho; Kim, Jisu; Kim, Seon Yoo; Park, Youngjoo; Moon, Ju Hyung; Kang, Seok-Gu; Chang, Jong Hee; Lee, C. Justin; Kim, Se Hoon; Yun, Mijin
• Is Part Of: Clinical nuclear medicine. Volume 47:Number 10(2022)
• Page Start: 863
• Page End: 868
• Publication Date: 2022-10-26
• Subjects: 11C-acetate PET/CT -- glioma -- grading -- IDH1 mutation -- reactive astrogliosis; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000004341
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: 11 C-acetate ( 11 C-ACE) uptake on PET/CT was recently discovered to represent reactive astrocytes in the tumor microenvironment. This study aimed at evaluating the role of 11 C-ACE PET/CT as an imaging biomarker of reactive astrogliosis in characterizing different types of gliomas. Methods: In this prospective study, a total of 182 patients underwent 11 C-ACE PET/CT before surgery. The ratio of SUVmax of a glioma to the SUVmean of the contralateral choroid plexus ( 11 C-ACE TCR) on PET/CT was calculated. 11 C-ACE TCRs were compared with the World Health Organization grades and isocitrate dehydrogenase 1 ( IDH1 ) mutation status. Grade 2 was considered low-grade tumor, and grades 3 and 4 were considered high-grade tumors. Results: The median 11 C-ACE TCR was significantly higher in IDH1 wild-type (wt) tumors (n = 91) than in IDH1 -mutant (mt) tumors (n = 91) (2.38 vs 1.30, P < 0.001). Of the 91 IDH1 -mt tumors, there were no differences in the median 11 C-ACE TCRs between oligodendrogliomas (ODs) and astrocytic tumors (1.40 vs 1.20, P > 0.05). In grading low- versus high-grade gliomas, the receiver operating characteristic curve analyses showed a higher area under the curve (0.951) in IDH1 -wt tumors than in IDH1 -mt tumors (0.783, P = 0.002). Grade 2 ODs were well differentiated from high-grade gliomas. The 11 C-ACE TCR of grade 3 ODs was significantly lower than that of IDH1 -wt glioblastomas. Conclusions: High 11 C-ACE uptake is associated with high-grade IDH1 -wt tumors, thus facilitating differentiation from high-grade IDH1-mt and low-grade gliomas. In particular, low 11 C-ACE uptake in ODs is advantageous in overcoming the limitation of radiolabeled amino acid tracers.