Semi-quantification of Methionine Uptake and Flair Signal for the Evaluation of Chemotherapy in Low-grade Oligodendroglioma

Overview

Journal J Neurooncol

Publisher Springer

Date 2005 Feb 4

PMID 15690133

Citations 9

Authors

Bich-Ngoc-Thanh Tang

Niloufar Sadeghi

Fabrice Branle

Olivier De Witte

David Wikler

Serge Goldman

Affiliations

Soon will be listed here.

Abstract

Unlabelled: 11C-Methionine (MET) is a useful positron emission tomography (PET) tracer for the evaluation of low-grade gliomas. Among these tumors, a high percentage of low-grade oligodendrogliomas (ODG) are sensitive to chemotherapy with procarbazine, CCNU, and vincristine (PCV). We aimed at: (1) objectively assessing ODG response to PCV by a metabolic index (the Activity Volume Index or AVI) generated from an automated semi-quantification of PET with MET (PET-MET); (2) comparing AVI and quantitative magnetic resonance imaging (MRI) measurements of response to PCV.

Methods: seven patients with ODG were followed for a period of 19.9+/-6.6 months after the completion of PCV chemotherapy. Regions of interest (ROI) were generated by covering all voxels with count values above a threshold level set at 120% of the mean cerebellar activity. On each slice, ROI volume and mean count values were calculated. AVI was calculated as the sum over all ROI of tumor volumex(tumor mean count/cerebellum count). Tumor volume measurements on MRI, were based on signal abnormalities visually detected on fluid-attenuated inversion recovery (FLAIR) sequences.

Results: PCV therapy was associated with a drastic decrease in AVI (mean+/-SD, cm3): AVI post-PCV=0.80+/-1.45 vs. AVI prior PCV=12.94+/-11.46 (P=0.03). Likewise, we observed a decrease in tumor volume estimated from the FLAIR signal (31.37+/-11.99 post-PCV vs. 67.95+/-39.96 prior PCV, P=0.03) although AVI decrease after PCV was significantly more pronounced (P=0.015).

Conclusion: This study, based on limited number of patients and follow-up period indicates that AVI may be a sensitive and observer-independent method applicable to the assessment of ODG responsiveness to PCV treatment and may offer a major added value to both clinical assessment and MRI evaluation of chemotherapeutic outcomes.

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References

Diabira S, Rousselet M, Gamelin E, Soulier P, Jadaud E, Menei P . PCV chemotherapy for oligodendroglioma: response analyzed on T2 weighted-MRI. J Neurooncol. 2002; 55(1):45-50. DOI: 10.1023/a:1012986422074. View

Smith J, Perry A, Borell T, Lee H, OFallon J, Hosek S . Alterations of chromosome arms 1p and 19q as predictors of survival in oligodendrogliomas, astrocytomas, and mixed oligoastrocytomas. J Clin Oncol. 2000; 18(3):636-45. DOI: 10.1200/JCO.2000.18.3.636. View

Kelly P . Computed tomography and histologic limits in glial neoplasms: tumor types and selection for volumetric resection. Surg Neurol. 1993; 39(6):458-65. DOI: 10.1016/0090-3019(93)90031-u. View

Bustany P, Chatel M, Derlon J, Darcel F, Sgouropoulos P, Soussaline F . Brain tumor protein synthesis and histological grades: a study by positron emission tomography (PET) with C11-L-Methionine. J Neurooncol. 1986; 3(4):397-404. DOI: 10.1007/BF00165590. View

Mason W, Krol G, DeAngelis L . Low-grade oligodendroglioma responds to chemotherapy. Neurology. 1996; 46(1):203-7. DOI: 10.1212/wnl.46.1.203. View

Comar D, CARTRON J, Maziere M, Marazano C . Labelling and metabolism of methionine-methyl-11 C. Eur J Nucl Med. 1976; 1(1):11-4. DOI: 10.1007/BF00253260. View

Daumas-Duport C, Varlet P, Tucker M, Beuvon F, Cervera P, Chodkiewicz J . Oligodendrogliomas. Part I: Patterns of growth, histological diagnosis, clinical and imaging correlations: a study of 153 cases. J Neurooncol. 1997; 34(1):37-59. DOI: 10.1023/a:1005707203596. View

Reifenberger J, Reifenberger G, Liu L, James C, WECHSLER W, Collins V . Molecular genetic analysis of oligodendroglial tumors shows preferential allelic deletions on 19q and 1p. Am J Pathol. 1994; 145(5):1175-90. PMC: 1887413. View

Levivier M, Wikler Jr D, Massager N, David P, Devriendt D, Lorenzoni J . The integration of metabolic imaging in stereotactic procedures including radiosurgery: a review. J Neurosurg. 2003; 97(5 Suppl):542-50. DOI: 10.3171/jns.2002.97.supplement. View

10.

Ericson K, Lilja A, Bergstrom M, Collins V, Eriksson L, Ehrin E . Positron emission tomography with ([11C]methyl)-L-methionine, [11C]D-glucose, and [68Ga]EDTA in supratentorial tumors. J Comput Assist Tomogr. 1985; 9(4):683-9. DOI: 10.1097/00004728-198507010-00005. View

11.

Roesdi M, Postma T, Hoekstra O, Van Groeningen C, Wolbers J, Heimans J . Thallium-201 SPECT as response parameter for PCV chemotherapy in recurrent glioma. J Neurooncol. 1999; 40(3):251-5. DOI: 10.1023/a:1006090807678. View

12.

Hashimoto N, Murakami M, Takahashi Y, Fujimoto M, Inazawa J, Mineura K . Correlation between genetic alteration and long-term clinical outcome of patients with oligodendroglial tumors, with identification of a consistent region of deletion on chromosome arm 1p. Cancer. 2003; 97(9):2254-61. DOI: 10.1002/cncr.11322. View

13.

Cairncross J, Ueki K, Zlatescu M, Lisle D, Finkelstein D, Hammond R . Specific genetic predictors of chemotherapeutic response and survival in patients with anaplastic oligodendrogliomas. J Natl Cancer Inst. 1998; 90(19):1473-9. DOI: 10.1093/jnci/90.19.1473. View

14.

Buckner J, Gesme Jr D, OFallon J, Hammack J, Stafford S, Brown P . Phase II trial of procarbazine, lomustine, and vincristine as initial therapy for patients with low-grade oligodendroglioma or oligoastrocytoma: efficacy and associations with chromosomal abnormalities. J Clin Oncol. 2003; 21(2):251-5. DOI: 10.1200/JCO.2003.06.023. View

15.

Ogawa T, Inugami A, Hatazawa J, Kanno I, Murakami M, Yasui N . Clinical positron emission tomography for brain tumors: comparison of fludeoxyglucose F 18 and L-methyl-11C-methionine. AJNR Am J Neuroradiol. 1996; 17(2):345-53. PMC: 8338383. View

16.

van den Bent M, Kros J, Heimans J, Pronk L, Van Groeningen C, Krouwer H . Response rate and prognostic factors of recurrent oligodendroglioma treated with procarbazine, CCNU, and vincristine chemotherapy. Dutch Neuro-oncology Group. Neurology. 1998; 51(4):1140-5. DOI: 10.1212/wnl.51.4.1140. View

17.

Massager N . [Usefulness of PET scan guidance in stereotaxic radioneurosurgery using a gamma knife]. Bull Mem Acad R Med Belg. 2003; 157(7-9):355-62; discussion 363-9. View

18.

Essig M, Metzner R, Bonsanto M, Hawighorst H, Debus J, Tronnier V . Postoperative fluid-attenuated inversion recovery MR imaging of cerebral gliomas: initial results. Eur Radiol. 2001; 11(10):2004-10. DOI: 10.1007/s003300100856. View

19.

Pardridge W . Brain metabolism: a perspective from the blood-brain barrier. Physiol Rev. 1983; 63(4):1481-535. DOI: 10.1152/physrev.1983.63.4.1481. View

20.

Herholz K, Holzer T, Bauer B, Schroder R, Voges J, Ernestus R . 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology. 1998; 50(5):1316-22. DOI: 10.1212/wnl.50.5.1316. View