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Glucose Loading Enhances the Value of 18 F-FDG PET/CT for the Characterization and Delineation of Cerebral Gliomas

 Dongwoo Kim  ;  Hae Young Ko  ;  Sangwon Lee  ;  Yong-Ho Lee  ;  Sujin Ryu  ;  Seon Yoo Kim  ;  Jee-In Chung  ;  Misu Lee  ;  Ju Hyung Moon  ;  Jong Hee Chang  ;  Mijin Yun 
 CANCERS, Vol.12(7) : 1977, 2020-07 
Journal Title
Issue Date
18F-FDG PET/CT ; glioma ; glucose loading ; grading
This study aimed to assess how to enhance the value of 18F-Fluorodeoxyglucose (FDG) PET/CTs for glioma grading and better delineation of the tumor boundary by glucose loading. In mouse models of brain tumor using U87MG cells, 18F-FDG-PET images were obtained after fasting and after glucose loading. There was a significant difference in the tumor-to-normal cortex-uptake ratio (TNR) between the fasting and glucose-loading scans. 14C-2-Deoxy-D-glucose (14C-DG) uptake was measured in vitro using U87MG, U373MG and primary neurons cultured with different concentrations of glucose. The tumor-to-neuron ratio of 14C-DG uptake increased with up to 10 mM of glucose. Finally, 10 low-grade and 17 high-grade glioma patients underwent fasting and glucose loading 18F-FDG PET/CT and the TNR was compared between scans. The effect of glucose loading was significant in high-grade but not in low-grade gliomas. The receiver operating characteristic curve analyses with a cut-off TNR of 0.81 showed a higher area under the curve after glucose loading than fasting for differentiating low-grade versus high-grade gliomas. In addition, the glucose loading PET/CT was more useful than the fasting PET/CT for the discrimination of oligodendrogliomas from IDH-wildtype glioblastomas. Glucose loading resulted in a greater reduction in 18F-FDG uptake in the normal cortex than in tumors, which increases the usefulness of 18F-FDG PET/CT for grading.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dongwoo(김동우) ORCID logo https://orcid.org/0000-0002-1723-604X
Moon, Ju Hyung(문주형)
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Misu(이미수)
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
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