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11 C-Acetate PET/CT Detects Reactive Astrogliosis Helping Glioma Classification

 Dongwoo Kim  ;  Joong Hyun Chun  ;  Ju Hyeon Yi  ;  Hae Young Ko  ;  Jee-In Chung  ;  Misu Lee  ;  Yongmin Mason Park  ;  Min-Ho Nam  ;  Jisu Kim  ;  Seon Yoo Kim  ;  Youngjoo Park  ;  Ju Hyung Moon  ;  Seok-Gu Kang  ;  Jong Hee Chang  ;  C Justin Lee  ;  Se Hoon Kim  ;  Mijin Yun 
 CLINICAL NUCLEAR MEDICINE, Vol.47(10) : 863-868, 2022-10 
Journal Title
Issue Date
Acetates ; Brain Neoplasms* / metabolism ; Glioma* / pathology ; Gliosis ; Humans ; Isocitrate Dehydrogenase / genetics ; Isocitrate Dehydrogenase / metabolism ; Mutation ; Positron Emission Tomography Computed Tomography ; Prospective Studies ; Tumor Microenvironment
Purpose: 11 C-acetate ( 11 C-ACE) uptake on PET/CT was recently discovered to represent reactive astrocytes in the tumor microenvironment. This study aimed at evaluating the role of 11 C-ACE PET/CT as an imaging biomarker of reactive astrogliosis in characterizing different types of gliomas.

Methods: In this prospective study, a total of 182 patients underwent 11 C-ACE PET/CT before surgery. The ratio of SUV max of a glioma to the SUV mean of the contralateral choroid plexus ( 11 C-ACE TCR) on PET/CT was calculated. 11 C-ACE TCRs were compared with the World Health Organization grades and isocitrate dehydrogenase 1 ( IDH1 ) mutation status. Grade 2 was considered low-grade tumor, and grades 3 and 4 were considered high-grade tumors.

Results: The median 11 C-ACE TCR was significantly higher in IDH1 wild-type (wt) tumors (n = 91) than in IDH1 -mutant (mt) tumors (n = 91) (2.38 vs 1.30, P < 0.001). Of the 91 IDH1 -mt tumors, there were no differences in the median 11 C-ACE TCRs between oligodendrogliomas (ODs) and astrocytic tumors (1.40 vs 1.20, P > 0.05). In grading low- versus high-grade gliomas, the receiver operating characteristic curve analyses showed a higher area under the curve (0.951) in IDH1 -wt tumors than in IDH1 -mt tumors (0.783, P = 0.002). Grade 2 ODs were well differentiated from high-grade gliomas. The 11 C-ACE TCR of grade 3 ODs was significantly lower than that of IDH1 -wt glioblastomas.

Conclusions: High 11 C-ACE uptake is associated with high-grade IDH1 -wt tumors, thus facilitating differentiation from high-grade IDH1-mt and low-grade gliomas. In particular, low 11 C-ACE uptake in ODs is advantageous in overcoming the limitation of radiolabeled amino acid tracers.
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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
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Kim, Dongwoo(김동우) ORCID logo https://orcid.org/0000-0002-1723-604X
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Moon, Ju Hyung(문주형)
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Chun, Joong-Hyun(전중현) ORCID logo https://orcid.org/0000-0002-9665-7829
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