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. 2017 Dec;44(13):2230-2238.
doi: 10.1007/s00259-017-3799-9. Epub 2017 Aug 19.

TSPO PET for glioma imaging using the novel ligand 18F-GE-180: first results in patients with glioblastoma

Nathalie L Albert  1   2   3 , M Unterrainer  4 , D F Fleischmann  5   6 , S Lindner  4 , F Vettermann  4 , A Brunegraf  4 , L Vomacka  4 , M Brendel  4 , V Wenter  4 , C Wetzel  7 , R Rupprecht  7 , J-C Tonn  5   8 , C Belka  5   6 , P Bartenstein  4   5   9 , M Niyazi  5   6
Affiliations

TSPO PET for glioma imaging using the novel ligand 18F-GE-180: first results in patients with glioblastoma

Nathalie L Albert et al. Eur J Nucl Med Mol Imaging. 2017 Dec.

Abstract

Objective: The 18-kDa mitochondrial translocator protein (TSPO) was reported to be upregulated in gliomas. 18F-GE-180 is a novel 3rd generation TSPO receptor ligand with improved target-to-background contrast compared to previous tracers. In this pilot study, we compared PET imaging with 18F-GE-180 and MRI of patients with untreated and recurrent pretreated glioblastoma.

Methods: Eleven patients with histologically confirmed IDH wildtype gliomas (10 glioblastomas, 1 anaplastic astrocytoma) underwent 18F-GE-180 PET at initial diagnosis or recurrence. The PET parameters mean background uptake (SUVBG), maximal tumour-to-background ratio (TBRmax) and PET volume using different thresholds (SUVBG × 1.6, 1.8 and 2.0) were evaluated in the 60-80 min p.i. summation images. The different PET volumes were compared to the contrast-enhancing tumour volume on MRI.

Results: All gliomas were positive on 18F-GE-180 PET and were depicted with extraordinarily high tumour-to-background contrast (median SUVBG 0.47 (0.37-0.93), TBRmax 6.61 (3.88-9.07)). 18F-GE-180 uptake could be found even in areas without contrast enhancement on MRI, leading to significantly larger PET volumes than MRI-based volumes (median 90.5, 74.5, and 63.8 mL vs. 31.0 mL; p = 0.003, 0.004, 0.013). In percentage difference, the PET volumes were on average 179%, 135%, and 90% larger than the respective MRI volumes. The median spatial volumetric correlation (Sørensen-Dice coefficient) of PET volumes and MRI volumes prior to radiotherapy was 0.48, 0.54, and 0.58.

Conclusion: 18F-GE-180 PET provides a remarkably high tumour-to-background contrast in untreated and pretreated glioblastoma and shows tracer uptake even beyond contrast enhancement on MRI. To what extent 18F-GE-180 uptake reflects the tumour extent of human gliomas and inflammatory cells remains to be evaluated in future prospective studies with guided stereotactic biopsies and correlation of histopathological results.

Keywords: 18F-GE-180; Glioma; Radiotherapy planning; TSPO PET.

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