2-[18F]fluoro-2-deoxyglucose and glucose uptake in malignant gliomas before and after radiotherapy: Correlation with outcome

Alexander M SPENCE; Mark MUZI; Kenneth A KROHN; Michael M GRAHAM; Finbarr O'SULLIVAN; Jeanne M LINK; Thomas K LEWELLEN; Barbara LEWELLEN; Scott D FREEMAN; David A MANKOFF; Janet F EARY

2-[18F]fluoro-2-deoxyglucose and glucose uptake in malignant gliomas before and after radiotherapy: Correlation with outcome

Journal article

Peer reviewed

2-[18F]fluoro-2-deoxyglucose and glucose uptake in malignant gliomas before and after radiotherapy: Correlation with outcome

Alexander M SPENCE, Mark MUZI, Kenneth A KROHN, Michael M GRAHAM, Finbarr O'SULLIVAN, Jeanne M LINK, Thomas K LEWELLEN, Barbara LEWELLEN, Scott D FREEMAN, David A MANKOFF, …

Clinical cancer research, Vol.8(4), pp.971-979

2002

PMID: 11948102

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Abstract

Purpose: To examine whether quantitative 1-[(11)C]glucose- or 2-[(18)F]fluoro-2-deoxyglucose (FDG)-positron emission tomography performed before and/or after radiotherapy (RT) of malignant gliomas correlates with treatment outcome. Changes in metabolism between the start and finish of RT, and immediate post-RT studies have received little attention. Experimental design: Adults with malignant gliomas were imaged within 2 weeks before and/or 2 weeks after RT. Four patients were imaged only before RT, 12 only after RT, and 14 both before and after RT. Each 1-[(11)C]glucose and FDG study included arterial plasma sampling. Kinetic parameters, glucose metabolic rate (MRGlc), and FDG metabolic rate (MRFDG) were estimated by an optimization program based on a three compartment, four rate constant model. Changes in MRGlc or MRFDG from pre-RT to post-RT were calculated for the 14 patients studied at both times. Overall survival was examined, and survival was computed relative to historical controls in matched prognostic classes. Results: Low pre-RT MRGlc (P < 0.02) or MRFDG (P < 0.03), or an increase from pre- to post-RT in MRGlc (P < 0.004) or MRFDG (P < 0.006) are correlating with longer survival (4 patients still alive). Strikingly, the post-RT studies (n = 26) showed no correlation between MRGlc or MRFDG and survival (P = 0.73 and P = 0.46 respectively). Conclusions: Low MRGlc or MRFDG before RT probably indicates less aggressive disease. An increase in MRGlc or MRFDG from pre- to post-RT in the tumors of patients with longer survival could be because of one or more of the following or other reasons: (a) apoptosis of tumor cells in response to RT requires energy; (b) decreased tumor cell density by the RT leaving normal cells with higher metabolism; or (c) inflammatory cells infiltrate and take up glucose or FDG where tumor cells are dying. Quantitative 1-[(11)C]glucose or FDG uptake in the early weeks post-RT correlates poorly with survival.

Tumors

Diseases of the nervous system

Biological and medical sciences

Treatment. General aspects

Treatment with physical agents

Medical sciences

Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)

Radiation therapy and radiosensitizing agent

Details

Title: Subtitle: 2-[18F]fluoro-2-deoxyglucose and glucose uptake in malignant gliomas before and after radiotherapy: Correlation with outcome
Creators: Alexander M SPENCE - Department of Neurology, University of Washington School of Medicine,, Seattle, Washington 98195, United States
Mark MUZI - Department of Radiology, University of Washington School of Medicine, Seattle, Washington 98195, United States
Kenneth A KROHN - Department of Radiology, University of Washington School of Medicine, Seattle, Washington 98195, United States
Michael M GRAHAM - Department of Radiology, University of Washington School of Medicine, Seattle, Washington 98195, United States
Finbarr O'SULLIVAN - Department of Statistics, University of Washington School of Medicine, Seattle, Washington 98195, United States
Jeanne M LINK - Department of Radiology, University of Washington School of Medicine, Seattle, Washington 98195, United States
Thomas K LEWELLEN - Department of Radiology, University of Washington School of Medicine, Seattle, Washington 98195, United States
Barbara LEWELLEN - Department of Radiology, University of Washington School of Medicine, Seattle, Washington 98195, United States
Scott D FREEMAN - Department of Radiology, University of Washington School of Medicine, Seattle, Washington 98195, United States
David A MANKOFF - Department of Radiology, University of Washington School of Medicine, Seattle, Washington 98195, United States
Janet F EARY - Department of Radiology, University of Washington School of Medicine, Seattle, Washington 98195, United States
Resource Type: Journal article
Publication Details: Clinical cancer research, Vol.8(4), pp.971-979
Publisher: American Association for Cancer Research; Philadelphia, PA
PMID: 11948102
ISSN: 1078-0432
eISSN: 1557-3265
Language: English
Date published: 2002
Academic Unit: Radiology; Radiation Oncology
Record Identifier: 9984047984702771

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