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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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PET imaging for low-grade glioma

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  • Stefanie Huettinger - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Jens Gempt - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Niels Buchmann - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Juergen Schlegel - Institut für Neuropathologie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Stefan Foerster - Nuklearmedizinische Klinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Claire Delbridge - Institut für Neuropathologie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Yu-Mi Ryang - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Thomas Pyka - Nuklearmedizinische Klinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Annette Foerschler - Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Claus Zimmer - Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Bernhard Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Florian Ringel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocDI.05.08

doi: 10.3205/13dgnc201, urn:nbn:de:0183-13dgnc2019

Published: May 21, 2013

© 2013 Huettinger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: FET-PET imaging is applied for tumor grading, prognostic stratification and diagnosis of tumor recurrence, especially in high-grade gliomas. Till now, not much is known about FET-PET imaging in low-grade gliomas. IDH1 and IDH2 mutations occur often in low-grade gliomas and play a role in gliomagenesis. Our objective was to assess the FET-PET tracer uptake in low-grade gliomas, compared to contrast enhancement in MRI imaging and histopathology (IDH1 mutation, Ki 67).

Method: 54 patients, who underwent glioma resection for newly diagnosed or recurrent low-grade glioma and received preoperative MRI and PET imaging were included during the time between November 2006 and July 2012. Tumor entity and location as well as histopathology (Ki67, IDH1) were assessed for evaluation. PET images were acquired and fused to MRI images (T1 contrast/T2 Flair). In PET imaging, 3 areas were classified: SUV 1.3, SUV 1.6 and SUV 2.0 and SUVmax were evaluated in contrast to region of interest. Tumor volume was assessed in these areas and in MR imaging (T2 Flair, T1 contrast). Tracer uptake above SUV 1.3 was declared as significant tracer uptake.

Results: 54 patients (25 female, 29 male, median age, at initial diagnosis 40y) were assessed: 31 diffuse astrocytomas, 4 fibrillary astrocytomas, 3 pilocytic astrocytomas, 5 oligoastrocytomas, 2 oligodendrogliomas, 2 DNET, 5 gangliogliomas and 1 PXA. 35 out of 54 patients (64.8 %) with low grade gliomas had elevated tracer uptake in PET imaging. 20 of these had a strong uptake (SUV 2.0 positive), six of them showed only weak uptake (SUV 1.3 positive). 19 of 54 patients (35.2 %) had contrast enhancement in MRI imaging, a significant correlation between tracer uptake (SUV > 1.3) and MRI contrast enhancement was disclosed (0,410, p < 0,003). 25 patients had IDH1 mutation (46.3 %). Our patients had a significant correlation between tracer uptake (SUV > 1.3) and IDH1 mutation (0.357, p < 0.013), contrast enhancement and IDH1 had no significant correlation. Ki67 was assessed in 39 of 54 patients and we see a significant correlation between Ki67 values and IDH1-mutation status (0.357, p = 0.009).

Conclusions: PET imaging may play an important role in the diagnosis of low grade gliomas. Tumors with contrast enhancement in MR imaging also have elevated tracer uptake. Our data show that there is correlation between IDH1 mutation, tracer uptake (SUV > 1.3) and Ki67, but not between IDH1 mutation and contrast enhancement in MR imaging.