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01-10-2016 | Special Annual Issue

PET and SPECT studies in children with hemispheric low-grade gliomas

Authors: Csaba Juhász, Edit Bosnyák

Published in: Child's Nervous System | Issue 10/2016

Abstract

Molecular imaging is playing an increasing role in the pretreatment evaluation of low-grade gliomas. While glucose positron emission tomography (PET) can be helpful to differentiate low-grade from high-grade tumors, PET imaging with amino acid radiotracers has several advantages, such as better differentiation between tumors and non-tumorous lesions, optimized biopsy targeting, and improved detection of tumor recurrence. This review provides a brief overview of single-photon emission computed tomography (SPECT) studies followed by a more detailed review of the clinical applications of glucose and amino acid PET imaging in low-grade hemispheric gliomas. We discuss key differences in the performance of the most commonly utilized PET radiotracers and highlight the advantage of PET/MRI fusion to obtain optimal information about tumor extent, heterogeneity, and metabolism. Recent data also suggest that simultaneous acquisition of PET/MR images and the combination of advanced MRI techniques with quantitative PET can further improve the pretreatment and post-treatment evaluation of pediatric brain tumors.

Alkonyi B, Mittal S, Zitron I et al (2012) Increased tryptophan transport in epileptogenic dysembryoplastic neuroepithelial tumors. J Neurooncol 107:365–372CrossRefPubMed

Bagni B, Pinna L, Tamarozzi R et al (1995) SPET imaging of intracranial tumours with ⁹⁹Tcm-sestamibi. Nucl Med Commun 16:258–264CrossRefPubMed

Batista CE, Juhasz C, Muzik O et al (2009) Imaging correlates of differential expression of indoleamine 2,3-dioxygenase in human brain tumors. Mol Imaging Biol 11:460–466CrossRefPubMedPubMedCentral

Black KL, Hawkins RA, Kim KT, Becker DP, Lerner C, Marciano D (1989) Use of thallium-201 SPECT to quantitate malignancy grade of gliomas. J Neurosurg 71:342–346CrossRefPubMed

Borgwardt L, Larsen HJ, Pedersen K, Højgaard L (2003) Practical use and implementation of PET in children in a hospital PET centre. Eur J Nucl Med Mol Imaging 30:1389–1397CrossRefPubMed

Borgwardt L, Højgaard L, Carstensen H et al (2005) Increased fluorine-18 2-fluoro-2-deoxy-d-glucose (FDG) uptake in childhood CNS tumors is correlated with malignancy grade: a study with FDG positron emission tomography/magnetic resonance imaging coregistration and image fusion. J Clin Oncol 1(23):3030–3037CrossRef

Bosnyák E, Kamson DO, Guastella AR et al (2015) Molecular imaging correlates of tryptophan metabolism via the kynurenine pathway in human meningiomas. Neuro Oncol 17:1284–1292CrossRefPubMedPubMedCentral

Chen W (2007) Clinical applications of PET in brain tumors. J Nucl Med 48:1468–1481CrossRefPubMed

Chugani DC, Muzik O (2000) Alpha[C-11]methyl-l-tryptophan PET maps brain serotonin synthesis and kynurenine pathway metabolism. J Cereb Blood Flow Metab 20:2–9CrossRefPubMed

10.

Dunkl V, Cleff C, Stoffels G et al (2015) The usefulness of dynamic O-(2-¹⁸F-fluoroethyl)-l-tyrosine PET in the clinical evaluation of brain tumors in children and adolescents. J Nucl Med 56:88–92CrossRefPubMed

11.

Fulham MJ, Melisi JW, Nishimiya J, Dwyer AJ, Di Chiro G (1993) Neuroimaging of juvenile pilocytic astrocytomas: an enigma. Radiology 189:221–225CrossRefPubMed

12.

Hipp SJ, Steffen-Smith EA, Patronas N et al (2012) Molecular imaging of pediatric brain tumors: comparison of tumor metabolism using ¹⁸F-FDG-PET and MRSI. J Neurooncol 109:521–527CrossRefPubMedPubMedCentral

13.

Juhász C, Chugani DC, Muzik O et al (2006) In vivo uptake and metabolism of alpha-[¹¹C]methyl-l-tryptophan in human brain tumors. J Cereb Blood Flow Metab 26:345–357CrossRefPubMed

14.

Juhász C, Muzik O, Chugani DC et al (2011) Differential kinetics of α-[¹¹C]methyl-l-tryptophan on PET in low-grade brain tumors. J Neurooncol 102:409–415CrossRefPubMed

15.

Juhász C, Chugani DC, Barger GR et al (2012) Quantitative PET imaging of tryptophan accumulation in gliomas and remote cortex: correlation with tumor proliferative activity. Clin Nucl Med 37:838–842CrossRefPubMedPubMedCentral

16.

Juhász C, Dwivedi S, Kamson DO, Michelhaugh SK, Mittal S (2014). Comparison of amino acid positron emission tomographic radiotracers for molecular imaging of primary and metastatic brain tumors. Mol Imaging 13 doi:10.2310/7290.2014.00015

17.

Kaplan AM, Lawson MA, Spataro J et al (1999) Positron emission tomography using [¹⁸F] fluorodeoxyglucose and [¹¹C] l-methionine to metabolically characterize dysembryoplastic neuroepithelial tumors. J Child Neurol 14:673–677CrossRefPubMed

18.

Kasper BS, Struffert T, Kasper EM et al (2011) ¹⁸Fluoroethyl-l-tyrosine-PET in long-term epilepsy associated glioneuronal tumors. Epilepsia 52:35–44CrossRefPubMed

19.

Kincaid PK, El-Saden SM, Park SH, Goy BW (1998) Cerebral gangliogliomas: preoperative grading using FDG-PET and ²⁰¹Tl-SPECT. AJNR Am J Neuroradiol 19:801–806PubMed

20.

Kirton A, Kloiber R, Rigel J, Wolff J (2002) Evaluation of pediatric CNS malignancies with (⁹⁹m)Tc-methoxyisobutylisonitrile SPECT. J Nucl Med 43:1438–1443PubMed

21.

Kruer MC, Kaplan AM, Etzl MM Jr et al (2009) The value of positron emission tomography and proliferation index in predicting progression in low-grade astrocytomas of childhood. J Neurooncol 95:239–245CrossRefPubMed

22.

Lee DY, Chung CK et al (2000) Dysembryoplastic neuroepithelial tumor: radiological findings (including PET, SPECT, and MRS) and surgical strategy. J Neurooncol 47:167–174CrossRefPubMed

23.

Mason WP, Krol GS, DeAngelis LM (1996) Low-grade oligodendroglioma responds to chemotherapy. Neurology 46:203–207CrossRefPubMed

24.

Messing-Jünger AM, Floeth FW, Pauleit D et al (2002) Multimodal target point assessment for stereotactic biopsy in children with diffuse bithalamic astrocytomas. Childs Nerv Syst 18:445–449CrossRefPubMed

25.

Meyer PT, Spetzger U, Mueller HD, Zeggel T, Sabri O, Schreckenberger M (2000) High F-18 FDG uptake in a low-grade supratentorial ganglioma: a positron emission tomography case report. Clin Nucl Med 25:694–697CrossRefPubMed

26.

Mittal S, Szlaczky MC, Barger GR (2008) Low-grade gliomas in adults. Curr Treat Options Neurol 10:271–284CrossRefPubMed

27.

Morana G, Piccardo A, Milanaccio C et al (2014) Value of ¹⁸F-3,4-dihydroxyphenylalanine PET/MR image fusion in pediatric supratentorial infiltrative astrocytomas: a prospective pilot study. J Nucl Med 55:718–723CrossRefPubMed

28.

Morana G, Piccardo A, Puntoni M et al (2015) Diagnostic and prognostic value of ¹⁸F-DOPA PET and ¹H-MR spectroscopy in pediatric supratentorial infiltrative gliomas: a comparative study. Neuro Oncol 17:1637–1647CrossRefPubMed

29.

Morana G, Puntoni M, Garrè ML, et al. (2016). Ability of ¹⁸F-DOPA PET/CT and fused ¹⁸F-DOPA PET/MRI to assess striatal involvement in paediatric glioma. Eur J Nucl Med Mol Imaging. 2016 Feb 25. [Epub ahead of print]

30.

Olson JD, Riedel E, DeAngelis LM (2000) Long-term outcome of low-grade oligodendroglioma and mixed glioma. Neurology 54:1442–1448CrossRefPubMed

31.

O’Tuama LA, Treves ST, Larar JN et al (1993) Thallium-201 versus technetium-⁹⁹m-MIBI SPECT in evaluation of childhood brain tumors: a within-subject comparison. J Nucl Med 34:1045–1051PubMed

32.

Patil S, Biassoni L, Borgwardt L (2007) Nuclear medicine in pediatric neurology and neurosurgery: epilepsy and brain tumors. Semin Nucl Med 37:357–381CrossRefPubMed

33.

Phi JH, Paeng JC, Lee HS et al (2010) Evaluation of focal cortical dysplasia and mixed neuronal and glial tumors in pediatric epilepsy patients using ¹⁸F-FDG and ¹¹C-methionine PET. J Nucl Med 51:728–734CrossRefPubMed

34.

Pirotte B, Levivier M, Morelli D et al (2005) Positron emission tomography for the early postsurgical evaluation of pediatric brain tumors. Childs Nerv Syst 21:294–300CrossRefPubMed

35.

Pirotte BJ, Lubansu A, Massager N et al (2010) Clinical impact of integrating positron emission tomography during surgery in 85 children with brain tumors. J Neurosurg Pediatr 5:486–499CrossRefPubMed

36.

Pollack IF (1994) Brain tumors in children. N Engl J Med 331:1500–1507CrossRefPubMed

37.

Puttick S, Bell C, Dowson N, Rose S, Fay M (2015) PET, MRI, and simultaneous PET/MRI in the development of diagnostic and therapeutic strategies for glioma. Drug Discov Today 20:306–317CrossRefPubMed

38.

Roelcke U, Radü EW, Hausmann O, Vontobel P, Maguire RP, Leenders KL (1998) Tracer transport and metabolism in a patient with juvenile pilocytic astrocytoma. A PET study. J Neurooncol 36:279–283CrossRefPubMed

39.

Rollins NK, Lowry PA, Shapiro KN (1995) Comparison of gadolinium-enhanced MR and thallium-201 single photon emission computed tomography in pediatric brain tumors. Pediatr Neurosurg 22:8–14CrossRefPubMed

40.

Rosenberg DS, Demarquay G, Jouvet A et al (2005) [¹¹C]-methionine PET: dysembryoplastic neuroepithelial tumours compared with other epileptogenic brain neoplasms. J Neurol Neurosurg Psychiatry 76:1686–1692CrossRefPubMedPubMedCentral

41.

Utriainen M, Metsähonkala L, Salmi TT et al (2002) Metabolic characterization of childhood brain tumors: comparison of ¹⁸F-fluorodeoxyglucose and ¹¹C-methionine positron emission tomography. Cancer 95:1376–1386CrossRefPubMed

42.

Uyttenhove C, Pilotte L, Theate I et al (2003) Evidence for a tumoral immune resistance mechanism based on tryptophan degradation by indoleamine 2,3-dioxygenase. Nat Med 9:1269–1274CrossRefPubMed

43.

Weckesser M, Matheja P, Rickert CH et al (2001) High uptake of L-3-[¹²³I]iodo-alpha-methyl tyrosine in pilocytic astrocytomas. Eur J Nucl Med 28:273–281CrossRefPubMed

Title: PET and SPECT studies in children with hemispheric low-grade gliomas
Authors: Csaba Juhász
Edit Bosnyák
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 10/2016
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-016-3125-z

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PET and SPECT studies in children with hemispheric low-grade gliomas

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