Abstract
Aim: To evaluate the proliferation activity in gliomas using 18F-fluorothymidine (18F-FLT)-positron emission tomography/computed tomography (PET/CT). Patients and Methods: Samples of 26 tumors were analyzed (mean age=51.6; range=26-72 years; 16 males, 10 females).
All examinations were performed using a PET/CT scanner equipped with lutetium oxyorthosilicate (LSO) detectors. All data were acquired with a delay of 15 min, following intravenous application of 18F-FLT (dosed 2 MBq/kg of body weight).
The PET/CT contained CT after intravenous application of iodinated contrast agent and high-resolution brain PET acquired during 15 min in one position. PET/CT was performed before confirmation of the histological diagnosis and the level of 18F-FLT accumulation was compared to the grading of the tumor evaluated using immunohistochemistry staining of Ki-67.
Samples were obtained by stereotactic biopsy (5x) or surgical resection (21x). Results: Five tumors of grade IV, 7 tumors of grade III and 14 tumors of grade II were found.
Pre-bioptical discrimination between high-grade and low-grade tumors reached accuracy 92.3% (24/26), sensitivity 92.3% (12/13) and specificity 92.9 (13/14). The mean maximum standardized uptake value (SUVmax) in high-grade tumors was 2.23, significantly different from low-grade tumors (mean SUVmax 0.61, T=7.803, p<0.0001).
Conclusion: 18F-FLT-PET/CT enables to estimate the proliferation activity of glioma before biopsy.