Combining amino acid PET and MRI imaging increases accuracy to define malignant areas in adult glioma

Maciej Harat (), Józefina Rakowska, Marek Harat, Tadeusz Szylberg, Jacek Furtak, Izabela Miechowicz and Bogdan Małkowski ()
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Maciej Harat: Franciszek Lukaszczyk Oncology Center
Józefina Rakowska: 10th Military Research Hospital
Marek Harat: 10th Military Research Hospital
Tadeusz Szylberg: 10th Military Research Hospital
Jacek Furtak: 10th Military Research Hospital
Izabela Miechowicz: University of Medical Sciences
Bogdan Małkowski: Franciszek Lukaszczyk Oncology Center

Nature Communications, 2023, vol. 14, issue 1, 1-10

Abstract: Abstract Accurate determination of the extent and grade of adult-type diffuse gliomas is critical to patient management. In clinical practice, contrast-enhancing areas of diffuse gliomas in magnetic resonance imaging (MRI) sequences are usually used to target biopsy, surgery, and radiation therapy, but there can be discrepancies between these areas and the actual tumor extent. Here we show that adding 18F-fluoro-ethyl-tyrosine positron emission tomography (FET-PET) to MRI sequences accurately locates the most malignant areas of contrast-enhancing gliomas, potentially impacting subsequent management and outcomes. We present a prospective analysis of over 300 serial biopsy specimens from 23 patients with contrast-enhancing adult-type diffuse gliomas using a hybrid PET-MRI scanner to compare T2-weighted and contrast-enhancing MRI images with FET-PET. In all cases, we observe and confirm high FET uptake in early PET acquisitions (5–15 min after 18F-FET administration) outside areas of contrast enhancement on MRI, indicative of high-grade glioma. In 30% cases, inclusion of FET-positive sites changes the biopsy result to a higher tumor grade.

Date: 2023
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DOI: 10.1038/s41467-023-39731-8

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