Diagnosis of Brain Tumors Using Amino Acid Transport PET Imaging with 18F-fluciclovine: A Comparative Study with L-methyl-11C-methionine PET Imaging
Naohiro Tsuyuguchi, Yuzo Terakawa, Takehiro Uda, Kosuke Nakajo, Yonehiro Kanemura, Naohiro Tsuyuguchi, Yuzo Terakawa, Takehiro Uda, Kosuke Nakajo, Yonehiro Kanemura
Abstract
Objectives: 18F-fluciclovine (trans-1-amino-3-[18F] fluorocyclobutanecarboxylic acid, [FACBC]) is an artificial amino acid radiotracer used for positron emission tomography (PET) studies, which is metabolically stable in vivo and has a long half-life. It has already been shown that FACBC-PET is useful for glioma imaging. However, there have been no reports evaluating the efficiency of FACBC-PET in the diagnosis of brain tumors in comparison with other PET tracers in clinical studies. The purpose of this study was to investigate the efficacy of FACBC-PET imaging in glioma diagnosis, compared to L-methyl- 11 C-methionine (MET)-PET.
Methods: Six consecutive patients (four male, two female), who were clinically suspected of having high- or low-grade glioma, received both FACBC-PET and MET-PET within a two-week interval. T1-weighted, contrast-enhanced, T1-weighted, and fluid-attenuated inversion recovery magnetic resonance imaging was performed to assist with subsequent tissue resection. Visual findings and semi-quantitative analyses of FACBC and MET uptake, using standardized uptake values (SUVs) and lesion-to-contralateral normal brain tissue (LN) ratios, were evaluated to compare PET images.
Results: SUVs for FACBC were lower than those for MET in the non-lesion cerebral cortex, brain stem, and cerebellar hemisphere. There was a weak positive correlation between FACBC and MET uptake in glioma tissue, although L/N ratios for FACBC were higher than those for MET in all the cases.
Conclusion: FACBC-PET showed higher contrast than MET-PET by both visual and semi-quantitative analyses and may therefore provide better assessment for the detection of glioma. This study was registered as clinical trial (No. JapicCTI-132289).
Keywords: 11C-Methionine; 18F-Fluciclovine; Glioma; Positron emission tomography.
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References
- Torii K, Tsuyuguchi N, Kawabe J, Sunada I, Hara M, Shiomi S. Correlation of amino-acid uptake using methionine PET and histological classifications in various gliomas. Ann Nucl Med. 2005;19(8):677–83.
- Shinozaki N, Uchino Y, Yoshikawa K, Matsutani T, Hasegawa A, Saeki N, et al. Discrimination between low-grade oligodendrogliomas and diffuse astrocytoma with the aid of 11C-methionine positron emission tomography. J Neurosurg. 2011;114(6):1640–7.
- Nariai T, Tanaka Y, Wakimoto H, Aoyagi M, Tamaki M, Ishiwata K, et al. Usefulness of L-[methyl-11C] methionine-positron emission tomography as a biological monitoring tool in the treatment of glioma. J Neurosurg. 2005;103(3):498–507.
- Terakawa Y, Tsuyuguchi N, Iwai Y, Yamanaka K, Higashiyama S, Takami T, et al. Diagnostic accuracy of 11C-methionine PET for differentiation of recurrent brain tumors from radiation necrosis after radiotherapy. J Nucl Med. 2008;49(5):694–9.
- Takano K, Kinoshita M, Arita H, Okita Y, Chiba Y, Kagawa N, et al. Diagnostic and Prognostic Value of 11C-Methionine PET for Nonenhancing Gliomas. AJNR Am J Neuroradiol. 2016;37(1):44–50.
- Watanabe A, Muragaki Y, Maruyama T, Shinoda J, Okada Y. Usefulness of ¹¹C-methionine positron emission tomography for treatment-decision making in cases of non-enhancing glioma-like brain lesions. J Neurooncol. 2016;126(3):577–83.
- Uda T, Tsuyuguchi N, Terakawa Y, Takami T, Ohata K. Evaluation of the accumulation of (11)C-methionine with standardized uptake value in the normal brain. J Nucl Med. 2010;51(2):219–22.
- Wakabayashi T, Iuchi T, Tsuyuguchi N, Nishikawa R, Arakawa Y, Sasayama T, et al. Diagnostic performance and safety of positron emission tomography using 18F-fluciclovine in patients with clinically suspected high- or low-grade gliomas:a multicenter phase IIb trial. Asia Ocean J Nucl Med Biol. 2017;5(1):10–21.
- Kondo A, Ishii H, Aoki S, Suzuki M, Nagasawa H, Kubota K, et al. Phase IIa clinical study of [18F]fluciclovine:efficacy and safety of a new PET tracer for brain tumors. Ann Nucl Med. 2016;30(9):608–18.
- McConathy J, Voll RJ, Yu W, Crowe RJ, Goodman MM. Improved synthesis of anti- [18F]FACBC:improved preparation of labeling precursor and automated radiosynthesis. Appl Radiat Isot. 2003;58(6):657–66.
- Van Laere K, Ceyssens S, Van Calenbergh F, de Groot T, Menten J, Flamen P, et al. Direct comparison of 18F-FDG and 11C-methionine PET in suspected recurrence of glioma:sensitivity, inter-observer variability and prognostic value 2005. Eur J Nucl Med Mol Imaging. 2005;32(1):39–51.
- Kaschten B, Stevenaert A, Sadzot B, Deprez M, Degueldre C, Del Fiore G, et al. Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med. 1998;39(5):778–85.
- Arita H, Yamasaki K, Matsushita Y, Nakamura T, Shimokawa A, Takami H, et al. A combination of TERT promoter mutation and MGMT methylation status predicts clinically relevant subgroups of newly diagnosed glioblastomas. Acta Neuropathol Commun. 2016;4(1):79.
- Ono M, Oka S, Okudaira H, Schuster DM, Goodman MM, Kawai K, et al. Comparative evaluation of transport mechanisms of trans-1-amino-3-[18F]fluorocyclobutanecarboxylic acid and L-[methyl-¹¹C]methionine in human glioma cell lines. Brain Res. 2013;1535:24–37.
- Okudaira H, Nakanishi T, Oka S, Kobayashi M, Tamagami H, Schuster DM, et al. Kinetic analyses of trans-1-amino-3-[18F]fluorocyclobutanecarboxylic acid transport in Xenopus laevis oocytes expressing human ASCT2 and SNAT2. Nucl Med Biol. 2013;40(5):670–5.
- Oka S, Okudaira H, Yoshida Y, Schuster DM, Goodman MM, Shirakami Y. Transport mechanisms of trans-1-amino-3-fluoro[1-(14)C]cyclobutanecarboxylic acid in prostate cancer cells. Nucl Med Biol. 2012;39(1):109–19.
- Okudaira H, Shikano N, Nishii R, Miyagi T, Yoshimoto M, Kobayashi M, et al. Putative transport mechanism and intracellular fate of trans-1-amino-3-18F-fluorocyclobutanecarboxylic acid in human prostate cancer. J Nucl Med. 2011;52(5):822–9.
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