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European Journal of Nuclear Medicine and Molecular Imaging

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01-09-2019 | Astrocytoma | Original Article

⁶⁸Ga-NOTA-Aca-BBN(7-14) PET imaging of GRPR in children with optic pathway glioma

Authors: Jingjing Zhang, Yongji Tian, Deling Li, Gang Niu, Lixin Lang, Fang Li, Yuhan Liu, Zhaohui Zhu, Xiaoyuan Chen

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2019

Abstract

Purpose

Optic pathway glioma (OPG) is a rare neoplasm that arises predominantly during childhood. Its location in a sensitive region involving the optic pathways, onset in young patients and controversial therapy choice make the management of OPG a challenge in paediatric neuro-oncology. In this study we assessed gastrin-releasing peptide receptor (GRPR)-targeted positron emission tomography (PET) imaging in children with OPG, and the application of a PET/MRI imaging-guided surgery navigation platform.

Methods

Eight children (five boys, mean age 8.81 years, range 5–14 years) with suspicion of optic pathway glioma on MRI were recruited. Written informed consent was obtained from all patients and legal guardians. Brain PET/CT or PET/MRI acquisitions were performed 30 min after intravenous injection of 1.85 MBq/kg body weight of ⁶⁸Ga-NOTA-Aca-BBN(7-14). Four patients also underwent ¹⁸F-FDG brain PET/CT for comparison. All patients underwent surgical resection within 1 week.

Results

All 11 lesions (100%) in the eight patients showed prominent ⁶⁸Ga-NOTA-Aca-BBN(7-14) uptake with excellent contrast in relation to surrounding normal brain tissue. Tumour-to-background ratios (SUVmax and SUVmean) were significantly higher for ⁶⁸Ga-NOTA-Aca-BBN(7-14) than for ¹⁸F-FDG (28.4 ± 5.59 vs. 0.47 ± 0.11 and 18.3 ± 4.99 vs. 0.35 ± 0.07, respectively). Fusion images for tumour delineation were obtained in all patients using the PET/MRI navigation platform. All lesions were pathologically confirmed as OPGs with positive GRPR expression, and 75% were pilocytic astrocytoma WHO grade I and 25% were diffuse astrocytoma WHO grade II. There was a positive correlation between the SUV of ⁶⁸Ga-NOTA-Aca-BBN(7-14) and the expression level of GRPR (r² = 0.56, P < 0.01, for SUVmax; r² = 0.47, P < 0.05, for SUVmean).

Conclusion

This prospective study showed the feasibility of ⁶⁸Ga-NOTA-Aca-BBN(7-14) PET in children with OPG for tumour detection and localization. ⁶⁸Ga-NOTA-Aca-BBN(7-14) PET/MRI may be helpful for assisting surgery planning in OPG patients with severe symptoms, GRPR-targeted PET has the potential to provide imaging guidance for further GRPR-targeted therapy in patients with OPG.

Ertiaei A, Hanaei S, Habibi Z, Moradi E, Nejat F. Optic pathway gliomas: clinical manifestation, treatment, and follow-up. Pediatr Neurosurg. 2016;51:223–8. https://doi.org/10.1159/000445064.CrossRefPubMed

Park ES, Park JB, Ra YS. Pediatric glioma at the optic pathway and thalamus. J Korean Neurosurg Soc. 2018;61:352–62. https://doi.org/10.3340/jkns.2018.0040.CrossRefPubMedPubMedCentral

Aihara Y, Chiba K, Eguchi S, Amano K, Kawamata T. Pediatric optic pathway/hypothalamic glioma. Neurol Med Chir (Tokyo). 2018;58:1–9. https://doi.org/10.2176/nmc.ra.2017-0081.CrossRef

D'Arco F, Culleton S, De Cocker LJL, Mankad K, Davila J, Tamrazi B. Current concepts in radiologic assessment of pediatric brain tumors during treatment, part 1. Pediatr Radiol. 2018;48:1833–43. https://doi.org/10.1007/s00247-018-4194-9.CrossRefPubMed

Listernick R, Ferner RE, Liu GT, Gutmann DH. Optic pathway gliomas in neurofibromatosis-1: controversies and recommendations. Ann Neurol. 2007;61:189–98. https://doi.org/10.1002/ana.21107.CrossRefPubMed

Campen CJ, Gutmann DH. Optic pathway gliomas in neurofibromatosis type 1. J Child Neurol. 2018;33:73–81. https://doi.org/10.1177/0883073817739509.CrossRefPubMedPubMedCentral

Sturgess B, Brown M, Fraser F, Bailey S. “They've got a lot of needs and I don't think they're being met fully”: a qualitative study of the multi-professional team approach to the management of children with optic pathway gliomas. Pediatr Blood Cancer. 2018;65:e27377. https://doi.org/10.1002/pbc.27377.CrossRefPubMed

Karaconji T, Whist E, Jamieson RV, Flaherty MP, Grigg JRB. Neurofibromatosis type 1: review and update on emerging therapies. Asia Pac J Ophthalmol (Phila). 2019;8(1):62–72. https://doi.org/10.22608/APO.2018182.CrossRef

Rasool N, Odel JG, Kazim M. Optic pathway glioma of childhood. Curr Opin Ophthalmol. 2017;28:289–95. https://doi.org/10.1097/ICU.0000000000000370.CrossRefPubMed

10.

Bilgic S, Erbengi A, Tinaztepe B, Onol B. Optic glioma of childhood: clinical, histopathological, and histochemical observations. Br J Ophthalmol. 1989;73:832–7. https://doi.org/10.1136/bjo.73.10.832.CrossRefPubMedPubMedCentral

11.

Avery RA, Fisher MJ, Liu GT. Optic pathway gliomas. J Neuroophthalmol. 2011;31:269–78. https://doi.org/10.1097/WNO.0b013e31822aef82.CrossRefPubMed

12.

Jahraus CD, Tarbell NJ. Optic pathway gliomas. Pediatr Blood Cancer. 2006;46:586–96. https://doi.org/10.1002/pbc.20655.CrossRefPubMed

13.

Wisoff JH, Abbott R, Epstein F. Surgical management of exophytic chiasmatic-hypothalamic tumors of childhood. J Neurosurg. 1990;73:661–7. https://doi.org/10.3171/jns.1990.73.5.0661.CrossRefPubMed

14.

Goodden J, Pizer B, Pettorini B, Williams D, Blair J, Didi M, et al. The role of surgery in optic pathway/hypothalamic gliomas in children. J Neurosurg Pediatr. 2014;13:1–12. https://doi.org/10.3171/2013.8.PEDS12546.CrossRefPubMed

15.

Liu Y, Hao X, Liu W, Li C, Gong J, Ma Z, et al. Analysis of survival prognosis for children with symptomatic optic pathway gliomas who received surgery. World Neurosurg. 2018;109:e1–e15. https://doi.org/10.1016/j.wneu.2017.09.144.CrossRefPubMed

16.

Ananias HJ, Yu Z, Dierckx RA, van der Wiele C, Helfrich W, Wang F, et al. (99m)Technetium-HYNIC(tricine/TPPTS)-Aca-bombesin(7-14) as a targeted imaging agent with microSPECT in a PC-3 prostate cancer xenograft model. Mol Pharm. 2011;8:1165–73. https://doi.org/10.1021/mp200014h.CrossRefPubMed

17.

Reubi JC, Korner M, Waser B, Mazzucchelli L, Guillou L. High expression of peptide receptors as a novel target in gastrointestinal stromal tumours. Eur J Nucl Med Mol Imaging. 2004;31:803–10. https://doi.org/10.1007/s00259-004-1476-2.CrossRefPubMed

18.

Heuser M, Schlott T, Schally AV, Kahler E, Schliephake R, Laabs SO, et al. Expression of gastrin releasing peptide receptor in renal cell carcinomas: a potential function for the regulation of neoangiogenesis and microvascular perfusion. J Urol. 2005;173:2154–9. https://doi.org/10.1097/01.ju.0000158135.26893.bc.CrossRefPubMed

19.

Van de Wiele C, Dumont F, Dierckx RA, Peers SH, Thornback JR, Slegers G, et al. Biodistribution and dosimetry of (99m)Tc-RP527, a gastrin-releasing peptide (GRP) agonist for the visualization of GRP receptor-expressing malignancies. J Nucl Med. 2001;42:1722–7.PubMed

20.

Van de Wiele C, Phonteyne P, Paillasse P, Goethals I, Van den Broecke R, Cocquyt V, et al. Gastrin-releasing peptide receptor imaging in human breast carcinoma versus immunohistochemistry. J Nucl Med. 2008;49:260–4. https://doi.org/10.2967/jnumed.107.047167.CrossRefPubMed

21.

Stoykow C, Erbes T, Maecke HR, Bulla S, Bartholoma M, Mayer S, et al. Gastrin-releasing peptide receptor imaging in breast cancer using the receptor antagonist (68)Ga-RM2 and PET. Theranostics. 2016;6:1641–50. https://doi.org/10.7150/thno.14958.CrossRefPubMedPubMedCentral

22.

Maina T, Bergsma H, Kulkarni HR, Mueller D, Charalambidis D, Krenning EP, et al. Preclinical and first clinical experience with the gastrin-releasing peptide receptor-antagonist [68Ga]SB3 and PET/CT. Eur J Nucl Med Mol Imaging. 2016;43:964–73. https://doi.org/10.1007/s00259-015-3232-1.CrossRefPubMed

23.

Nock BA, Kaloudi A, Lymperis E, Giarika A, Kulkarni HR, Klette I, et al. Theranostic perspectives in prostate cancer with the gastrin-releasing peptide receptor antagonist NeoBOMB1: preclinical and first clinical results. J Nucl Med. 2017;58:75–80. https://doi.org/10.2967/jnumed.116.178889.CrossRefPubMed

24.

Nicolas GP, Morgenstern A, Schottelius M, Fani M. New developments in peptide receptor radionuclide therapy. J Nucl Med. 2019;60:167–71. https://doi.org/10.2967/jnumed.118.213496.CrossRef

25.

Zhang J, Niu G, Fan X, Lang L, Hou G, Chen L, et al. PET using a GRPR antagonist (68)Ga-RM26 in healthy volunteers and prostate cancer patients. J Nucl Med. 2018;59:922–8. https://doi.org/10.2967/jnumed.117.198929.CrossRefPubMedPubMedCentral

26.

Flores DG, Meurer L, Uberti AF, Macedo BR, Lenz G, Brunetto AL, et al. Gastrin-releasing peptide receptor content in human glioma and normal brain. Brain Res Bull. 2010;82:95–8. https://doi.org/10.1016/j.brainresbull.2010.02.014.CrossRefPubMed

27.

Zhang J, Li D, Lang L, Zhu Z, Wang L, Wu P, et al. 68Ga-NOTA-aca-BBN(7-14) PET/CT in healthy volunteers and glioma patients. J Nucl Med. 2016;57:9–14. https://doi.org/10.2967/jnumed.115.165316.CrossRefPubMed

28.

Li D, Zhang J, Chi C, Xiao X, Wang J, Lang L, et al. First-in-human study of PET and optical dual-modality image-guided surgery in glioblastoma using (68)Ga-IRDye800CW-BBN. Theranostics. 2018;8:2508–20. https://doi.org/10.7150/thno.25599.CrossRefPubMedPubMedCentral

29.

Dodge HW Jr, Love JG, Craig WM, Dockerty MB, Kearns TP, Holman CB, et al. Gliomas of the optic nerves. AMA Arch Neurol Psychiatry. 1958;79:607–21.CrossRefPubMed

30.

Wang H, Hou B, Lu L, Feng M, Zang J, Yao S, et al. PET/MRI in the diagnosis of hormone-producing pituitary microadenoma: a prospective pilot study. J Nucl Med. 2018;59:523–8. https://doi.org/10.2967/jnumed.117.191916.CrossRefPubMed

31.

Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131:803–20. https://doi.org/10.1007/s00401-016-1545-1.

32.

Miyamoto J, Sasajima H, Owada K, Mineura K. Surgical decision for adult optic glioma based on [18F]fluorodeoxyglucose positron emission tomography study. Neurol Med Chir (Tokyo). 2006;46:500–3. https://doi.org/10.2176/nmc.46.500.CrossRef

33.

Moharir M, London K, Howman-Giles R, North K. Utility of positron emission tomography for tumour surveillance in children with neurofibromatosis type 1. Eur J Nucl Med Mol Imaging. 2010;37:1309–17. https://doi.org/10.1007/s00259-010-1386-4.CrossRefPubMed

34.

Goodden J. Optic pathway hypothalamic glioma. In: Winn HR, editor. Youmans and Winn neurological surgery. 7th ed. Philadelphia: Elsevier; 2016.

35.

Beres SJ, Avery RA. Optic pathway gliomas secondary to neurofibromatosis type 1. Semin Pediatr Neurol. 2017;24:92–9. https://doi.org/10.1016/j.spen.2017.04.006.CrossRefPubMed

36.

Binning MJ, Liu JK, Kestle JR, Brockmeyer DL, Walker ML. Optic pathway gliomas: a review. Neurosurg Focus. 2007;23:E2. https://doi.org/10.3171/FOC-07/11/E2.CrossRefPubMed

37.

Guillamo JS, Creange A, Kalifa C, Grill J, Rodriguez D, Doz F, et al. Prognostic factors of CNS tumours in neurofibromatosis 1 (NF1): a retrospective study of 104 patients. Brain. 2003;126:152–60. https://doi.org/10.1093/brain/awg016.CrossRefPubMed

38.

Jittapiromsak N, Hou P, Liu HL, Sun J, Slopis JM, Chi TL. Prognostic role of conventional and dynamic contrast-enhanced MRI in optic pathway gliomas. J Neuroimaging. 2017;27:594–601. https://doi.org/10.1111/jon.12450.CrossRefPubMed

39.

Maloney E, Stanescu AL, Perez FA, Iyer RS, Otto RK, Leary S, et al. Surveillance magnetic resonance imaging for isolated optic pathway gliomas: is gadolinium necessary? Pediatr Radiol. 2018;48:1472–84. https://doi.org/10.1007/s00247-018-4154-4.CrossRefPubMed

Title: 68Ga-NOTA-Aca-BBN(7-14) PET imaging of GRPR in children with optic pathway glioma
Authors: Jingjing Zhang
Yongji Tian
Deling Li
Gang Niu
Lixin Lang
Fang Li
Yuhan Liu
Zhaohui Zhu
Xiaoyuan Chen
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Keywords: Astrocytoma
Glioma
Glioma
Astrocytoma
Positron Emission Tomography
Astrocytoma
Glioma
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04392-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

⁶⁸Ga-NOTA-Aca-BBN(7-14) PET imaging of GRPR in children with optic pathway glioma

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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