The role of amino-acid PET in the light of the new WHO classification 2016 for brain tumors

2018 ◽  
Vol 62 (3) ◽  
Author(s):  
Bogdana Suchorska ◽  
Nathalie L. Albert ◽  
Elena K. Bauer ◽  
Jörg-Christian Tonn ◽  
Norbert Galldiks
Keyword(s):  
Amino Acid ◽  
Brain Tumors ◽  
Who Classification ◽  
Amino Acid Pet ◽  
Who Classification 2016

scholarly journals Comparison of Amino Acid PET to Advanced and Emerging MRI Techniques for Neurooncology Imaging: A Systematic Review of the Recent Studies

2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Brittany M. Stopa ◽  
Csaba Juhász ◽  
Sandeep Mittal
Keyword(s):  
Systematic Review ◽  
Amino Acid ◽  
Brain Tumors ◽  
Tumor Imaging ◽  
Imaging Techniques ◽  
Diagnostic Potential ◽  
Cest Imaging ◽  
Pubmed Search ◽  
Amino Acid Pet ◽  
Improved Performance

Introduction. Standard neuroimaging protocols for brain tumors have well-known limitations. The clinical use of additional modalities including amino acid PET (aaPET) and advanced MRI (aMRI) techniques (including DWI, PWI, and MRS) is emerging in response to the need for more accurate detection of brain tumors. In this systematic review of the past 2 years of the literature, we discuss the most recent studies that directly compare or combine aaPET and aMRI for brain tumor imaging. Methods. A PubMed search was conducted for human studies incorporating both aaPET and aMRI and published between July 2018 and August 2020. Results. A total of 22 studies were found in the study period. Recent studies of aaPET with DWI showed a superiority of MET, FET, FDOPA, and AMT PET for detecting tumor, predicting recurrence, diagnosing progression, and predicting survival. Combining modalities further improved performance. Comparisons of aaPET with PWI showed mixed results about spatial correlation. However, both modalities were able to detect high-grade tumors, identify tumor recurrence, differentiate recurrence from treatment effects, and predict survival. aaPET performed better on these measures than PWI, but when combined, they had the strongest results. Studies of aaPET with MRS demonstrated that both modalities have diagnostic potential but MET PET and FDOPA PET performed better than MRS. MRS suffered from some data quality issues that limited analysis in two studies, and, in one study that combined modalities, overall performance actually decreased. Four recent studies compared aaPET with emerging MRI approaches (such as CEST imaging, MR fingerprinting, and SISTINA), but the initial results remain inconclusive. Conclusions. aaPET outperformed the aMRI imaging techniques in most recent studies. DWI and PWI added meaningful complementary data, and the combination of aaPET with aMRI yielded the best results in most studies.

scholarly journals Maximizing the use of batch production of 18F-FDOPA for imaging of brain tumors to increase availability of hybrid PET/MR imaging in clinical setting

2020 ◽  
Author(s):  
M S Aboian ◽  
R Barajas ◽  
J Shatalov ◽  
V Ravanfar ◽  
E Bahroos ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Amino Acid ◽  
Brain Tumors ◽  
Pet Imaging ◽  
Critical Role ◽  
Normal Brain ◽  
Mri Imaging ◽  
Pet Tracer ◽  
Amino Acid Pet ◽  
The Cost

Abstract Background Amino acid PET imaging of brain tumors has been shown to play an important role in predicting tumor grade, delineation of tumor margins, and differentiating tumor recurrence from the background of post-radiation changes, but is not commonly used in clinical practice due to high cost. We propose that PET/MRI imaging of patients grouped to the day of tracer radiosynthesis will significantly decrease the cost of PET imaging, which will improve patient access to PET. Methods Seventeen patients with either primary brain tumors or metastatic brain tumors were recruited for imaging on 3T PET/MRI and were scanned on 4 separate days in groups of 3-5 patients. The first group of consecutively imaged patients contained three patients, followed by two groups of 5 patients, and last group of 4 patients. Results For each of the patients, standard of care gadolinium enhanced MRI and dynamic PET imaging with 18F-FDOPA amino acid tracer was obtained. The total cost savings of scanning 17 patients in batches of 4 as opposed to individual radiosynthesis was 48.5% ($28,321). Semiquantitative analysis of tracer uptake in normal brain were performed with appropriate accumulation and expected subsequent washout. Conclusion Amino acid PET tracers have been shown to play a critical role in characterization of brain tumors but their adaptation to clinical practice has been limited due to high cost of PET. Scheduling patient imaging to maximally utilize the radiosynthesis of imaging tracer significantly reduces the cost of PET and results in increased availability of PET tracer use in neuro-oncology.

scholarly journals NIMG-46. IMPACT OF FET PET ON MULTIDISCIPLINARY NEUROONCOLOGICAL TUMOR BOARD DECISIONS IN PATIENTS WITH BRAIN TUMORS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi171-vi172
Author(s):  
Garry Ceccon ◽  
Jan-Michael Werner ◽  
Maximilian Ruge ◽  
Jürgen Hampl ◽  
Stefan Grau ◽  
...  
Keyword(s):  
Decision Making ◽  
Amino Acid ◽  
Brain Tumors ◽  
Clinical Status ◽  
Palliative Therapy ◽  
Tumor Board ◽  
Mri Findings ◽  
Fet Pet ◽  
Tumor Boards ◽  
Amino Acid Pet

Abstract BACKGROUND Following neurooncological treatment of brain tumors, neurooncologists are frequently confronted with equivocal MRI findings (e.g., treatment-related changes, nonmeasurable (speckled) contrast-enhancing lesions, increase of T2/FLAIR signal alterations, pseudoresponse). Especially in Europe, amino acid PET is increasingly being integrated into multidisciplinary neurooncological tumor boards (MNTB) to overcome these diagnostic uncertainties as well as to improve patient management. We here evaluated the correctness of MNTB decisions, in which amino acid PET findings were taken into account. METHODS In a single university center, we retrospectively evaluated 114 MNTB decisions concerning 99 patients with malignant glioma (n=81) (glioblastoma, n=54; anaplastic glioma, n=26; gliosarcoma, n=1) or brain metastases (n=18) secondary to NSCLC, melanoma, breast cancer, or colorectral cancer, presenting with equivocal MRI findings following neurooncological treatment. All patients underwent amino acid PET imaging using O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) as an adjunct for decision-making. Additionally, the patients’ clinical status, pretreatment, and multimodal MRI findings were considered for decision-making. Presence of neoplastic tissue in PET was considered if the mean FET uptake as assessed by tumor-to-brain ratios was >2. The decisions’ diagnostic performance was evaluated by 2x2 contingency tables using the neuropathological results or clinicoradiological follow-up. RESULTS In the majority of MNTB decisions (n=102; 89%), FET PET results were integrated into the decision-making with considerable impact on the clinical management. In particular, 85% of MNTB decisions (n=87) prompted a treatment change (i.e., resection, radiotherapy, chemotherapy, or combinations thereof, as well as palliative therapy), or, in the case of suspected treatment-related changes, the continuation of the initial treatment regimen (15%; n=15). The MNTB decisions were validated using neuropathological data in 38% (n=39) or clinicoradiological information in 62% (n=63) and yielded a diagnostic accuracy of 88% (sensitivity, 89%; specificity, 75%; P=0.008). CONCLUSIONS Our results suggest that the integration of FET PET derived information significantly aids MNTB decisions.

IMP-SPECTand Amino Acid-PET in Brain Tumors

1986 ◽  
pp. 157-166 ◽  
Author(s):  
O. Schober ◽  
G. J. Meyer ◽  
H. Creutzig ◽  
H. Hundeshagen
Keyword(s):  
Amino Acid ◽  
Brain Tumors ◽  
Amino Acid Pet

An ESR study of the peroxidase reaction catalyzed by human methaemoglobin and methaemoglobin-haptoglobin complex

1991 ◽  
Vol 56 (4) ◽  
pp. 923-932
Author(s):  
Jana Stejskalová ◽  
Pavel Stopka ◽  
Zdeněk Pavlíček
Keyword(s):  
Hydrogen Peroxide ◽  
Ascorbic Acid ◽  
Amino Acid ◽  
Peroxidase Activity ◽  
Amino Acid Analysis ◽  
Superoxide Radical ◽  
Esr Spectra ◽  
The Other ◽  
Delocalized Electron

The ESR spectra of peroxidase systems of methaemoglobin-ascorbic acid-hydrogen peroxide and methaemoglobin-haptoglobin complex-ascorbic acid-hydrogen peroxide have been measured in the acetate buffer of pH 4.5. For the system with methaemoglobin an asymmetrical signal with g ~ 2 has been observed which is interpreted as the perpendicular region of anisotropic spectrum of superoxide radical. On the other hand, for the system with methaemoglobin-haptoglobin complex the observed signal with g ~ 2 is symmetrical and is interpreted as a signal of delocalized electron. After realization of three repeatedly induced peroxidase processes the ESR signal of the perpendicular part of anisotropic spectrum of superoxide radical is distinctly diminished, whereas the signal of delocalized electron remains practically unchanged. An amino acid analysis of methaemoglobin along with results of the ESR measurements make it possible to derive a hypothesis about the role of haptoglobin in increasing of the peroxidase activity of methaemoglobin.

10 THE ROLE OF DIETARY L-SERINE IN THE REGULATION OF INTESTINAL MUCUS BARRIER DURING INFLAMMATION

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S42-S42
Author(s):  
Kohei Sugihara ◽  
Nobuhiko Kamada
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Gut Microbiota ◽  
Control Diet ◽  
Bacterial Strains ◽  
Germ Free ◽  
Intestinal Mucus ◽  
Gnotobiotic Mice ◽  
Mucus Barrier

Abstract Background Recent accumulating evidence suggests that amino acids have crucial roles in the maintenance of intestinal homeostasis. In inflammatory bowel disease (IBD), amino acid metabolism is changed in both host and the gut microbiota. Among amino acids, L-serine plays a central role in several metabolic processes that are essential for the growth and survival of both mammalian and bacterial cells. However, the role of L-serine in intestinal homeostasis and IBD remains incompletely understood. In this study, we investigated the effect of dietary L-serine on intestinal inflammation in a murine model of colitis. Methods Specific pathogen-free (SPF) mice were fed either a control diet (amino acid-based diet) or an L-serine-deficient diet (SDD). Colitis was induced by the treatment of dextran sodium sulfate (DSS). The gut microbiome was analyzed by 16S rRNA sequencing. We also evaluate the effect of dietary L-serine in germ-free mice and gnotobiotic mice that were colonized by a consortium of non-mucolytic bacterial strains or the consortium plus mucolytic bacterial strains. Results We found that the SDD exacerbated experimental colitis in SPF mice. However, the severity of colitis in SDD-fed mice was comparable to control diet-fed mice in germ-free condition, suggesting that the gut microbiota is required for exacerbation of colitis caused by the restriction of dietary L-serine. The gut microbiome analysis revealed that dietary L-serine restriction fosters the blooms of a mucus-degrading bacterium Akkermansia muciniphila and adherent-invasive Escherichia coli in the inflamed gut. Consistent with the expansion of mucolytic bacteria, SDD-fed mice showed a loss of the intestinal mucus layer. Dysfunction of the mucus barrier resulted in increased intestinal permeability, thereby leading to bacterial translocation to the intestinal mucosa, which subsequently increased the severity of colitis. The increased intestinal permeability and subsequent bacterial translocation were observed in SDD-fed gnotobiotic mice that colonized by mucolytic bacteria. In contrast, dietary L-serine restriction did not alter intestinal barrier integrity in gnotobiotic mice that colonized only by non-mucolytic bacteria. Conclusion Our results suggest that dietary L-serine regulates the integrity of the intestinal mucus barrier during inflammation by limiting the expansion of mucus degrading bacteria.

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