TY - JOUR
T1 - 2-[18F]fluoro-2-deoxyglucose and glucose uptake in malignant gliomas before and after radiotherapy
T2 - Correlation with outcome
AU - Spence, Alexander M.
AU - Muzi, Mark
AU - Graham, Michael M.
AU - O'Sullivan, Finbarr
AU - Link, Jeanne M.
AU - Lewellen, Thomas K.
AU - Lewellen, Barbara
AU - Freeman, Scott D.
AU - Mankoff, David A.
AU - Eary, Janet F.
AU - Krohn, Kenneth A.
PY - 2002/4/1
Y1 - 2002/4/1
N2 - Purpose: To examine whether quantitative 1-[11C]glucose- or 2-[18F]fluoro-2-deoxyglucose (FDG)-positron emission tomography performed before and/or after radiotherapy (RT) of malignant gliomas correlates with treatment outcome. Changes in metabolism between the start and finish of RT, and immediate post-RT studies have received little attention. Experimental Design: Adults with malignant gliomas were imaged within 2 weeks before and/or 2 weeks after RT. Four patients were imaged only before RT, 12 only after RT, and 14 both before and after RT. Each 1-[11C]glucose and FDG study included arterial plasma sampling. Kinetic parameters, glucose metabolic rate (MRGlc), and FDG metabolic rate (MRFDG) were estimated by an optimization program based on a three compartment, four rate constant model. Changes in MRGlc or MRFDG from pre-RT to post-RT were calculated for the 14 patients studied at both times. Overall survival was examined, and survival was computed relative to historical controls in matched prognostic classes. Results: Low pre-RT MRGlc (P < 0.02) or MRFDG (P < 0.03), or an increase from pre- to post-RT in MRGlc (P < 0.004) or MRFDG (P < 0.006) are correlating with longer survival (4 patients still alive). Strikingly, the post-RT studies (n = 26) showed no correlation between MRGlc or MRFDG and survival (P = 0.73 and P = 0.46 respectively). Conclusions: Low MRGlc or MRFDG before RT probably indicates less aggressive disease. An increase in MRGlc or MRFDG from pre- to post-RT in the tumors of patients with longer survival could be because of one or more of the following or other reasons: (a) apoptosis of tumor cells in response to RT requires energy; (b) decreased tumor cell density by the RT leaving normal cells with higher metabolism; or (c) inflammatory cells infiltrate and take up glucose or FDG where tumor cells are dying. Quantitative 1-[11C]glucose or FDG uptake in the early weeks post-RT correlates poorly with survival.
AB - Purpose: To examine whether quantitative 1-[11C]glucose- or 2-[18F]fluoro-2-deoxyglucose (FDG)-positron emission tomography performed before and/or after radiotherapy (RT) of malignant gliomas correlates with treatment outcome. Changes in metabolism between the start and finish of RT, and immediate post-RT studies have received little attention. Experimental Design: Adults with malignant gliomas were imaged within 2 weeks before and/or 2 weeks after RT. Four patients were imaged only before RT, 12 only after RT, and 14 both before and after RT. Each 1-[11C]glucose and FDG study included arterial plasma sampling. Kinetic parameters, glucose metabolic rate (MRGlc), and FDG metabolic rate (MRFDG) were estimated by an optimization program based on a three compartment, four rate constant model. Changes in MRGlc or MRFDG from pre-RT to post-RT were calculated for the 14 patients studied at both times. Overall survival was examined, and survival was computed relative to historical controls in matched prognostic classes. Results: Low pre-RT MRGlc (P < 0.02) or MRFDG (P < 0.03), or an increase from pre- to post-RT in MRGlc (P < 0.004) or MRFDG (P < 0.006) are correlating with longer survival (4 patients still alive). Strikingly, the post-RT studies (n = 26) showed no correlation between MRGlc or MRFDG and survival (P = 0.73 and P = 0.46 respectively). Conclusions: Low MRGlc or MRFDG before RT probably indicates less aggressive disease. An increase in MRGlc or MRFDG from pre- to post-RT in the tumors of patients with longer survival could be because of one or more of the following or other reasons: (a) apoptosis of tumor cells in response to RT requires energy; (b) decreased tumor cell density by the RT leaving normal cells with higher metabolism; or (c) inflammatory cells infiltrate and take up glucose or FDG where tumor cells are dying. Quantitative 1-[11C]glucose or FDG uptake in the early weeks post-RT correlates poorly with survival.
UR - http://www.scopus.com/inward/record.url?scp=0036554829&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036554829&partnerID=8YFLogxK
M3 - Article
C2 - 11948102
AN - SCOPUS:0036554829
SN - 1078-0432
VL - 8
SP - 971
EP - 979
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 4
ER -