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[18F]Fluciclovine PET discrimination between high- and low-grade gliomas

Overview of attention for article published in EJNMMI Research, July 2018
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[18F]Fluciclovine PET discrimination between high- and low-grade gliomas
Published in
EJNMMI Research, July 2018
DOI 10.1186/s13550-018-0415-3
Pubmed ID

Ephraim E. Parent, Marc Benayoun, Ijeoma Ibeanu, Jeffrey J. Olson, Constantinos G. Hadjipanayis, Daniel J. Brat, Vikram Adhikarla, Jonathon Nye, David M. Schuster, Mark M. Goodman


The ability to accurately and non-invasively distinguish high-grade glioma from low-grade glioma remains a challenge despite advances in molecular and magnetic resonance imaging. We investigated the ability of fluciclovine (18F) PET as a means to identify and distinguish these lesions in patients with known gliomas and to correlate uptake with Ki-67. Sixteen patients with a total of 18 newly diagnosed low-grade gliomas (n = 6) and high grade gliomas (n = 12) underwent fluciclovine PET imaging after histopathologic assessment. Fluciclovine PET analysis comprised tumor SUVmax and SUVmean, as well as metabolic tumor thresholds (1.3*, 1.6*, 1.9*) to normal brain background (TBmax, and TBmean). Comparison was additionally made to the proliferative status of the tumor as indicated by Ki-67 values. Fluciclovine uptake greater than normal brain parenchyma was found in all lesions studied. Time activity curves demonstrated statistically apparent flattening of the curves for both high-grade gliomas and low-grade gliomas starting 30 min after injection, suggesting an influx/efflux equilibrium. The best semiquantitative metric in discriminating HGG from LGG was obtained utilizing a metabolic 1 tumor threshold of 1.3* contralateral normal brain parenchyma uptake to create a tumor: background (TBmean1.3) cutoff of 2.15 with an overall sensitivity of 97.5% and specificity of 95.5%. Additionally, using a SUVmax > 4.3 cutoff gave a sensitivity of 90.9% and specificity of 97.5%. Tumor SUVmean and tumor SUVmax as a ratio to mean normal contralateral brain were both found to be less relevant predictors of tumor grade. Both SUVmax (R = 0.71, p = 0.0227) and TBmean (TBmean1.3: R = 0.81, p = 0.00081) had a high correlation with the tumor proliferative index Ki-67. Fluciclovine PET produces high-contrast images between both low-grade and high grade gliomas and normal brain by visual and semiquantitative analysis. Fluciclovine PET appears to discriminate between low-grade glioma and high-grade glioma, but must be validated with a larger sample size.

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Mendeley readers

The data shown below were compiled from readership statistics for 16 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 16 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 4 25%
Student > Ph. D. Student 3 19%
Other 2 13%
Unspecified 1 6%
Student > Master 1 6%
Other 3 19%
Unknown 2 13%
Readers by discipline Count As %
Medicine and Dentistry 5 31%
Neuroscience 3 19%
Biochemistry, Genetics and Molecular Biology 1 6%
Chemistry 1 6%
Mathematics 1 6%
Other 1 6%
Unknown 4 25%

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