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Amino Acid PET/MRI in Neuro-oncology

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Hybrid PET/MR Neuroimaging

Abstract

FDG-PET is the most common modality for metabolic imaging in brain tumors that can provide prognostic information at initial assessment of patients with brain tumors. However, high normal background uptake of FDG limits its diagnostic performance in brain tumors. Amino acid-based PET tracers provide excellent evaluation of brain tumors due to their low background uptake by normal brain tissue and provide critical insight into biological and genetic profile of brain tumors. Furthermore, amino acid PET tracers can pass through intact blood-brain barrier (BBB) via amino acid transporters located at the luminal surface of the BBB and are further transported into tumor cells by amino acid transporters that are overexpressed on the cell surface (LAT1 and ASCT2). This ability to cross BBB allows amino acid tracers to clearly delineate non-enhancing portions of brain tumors. Clinical applications of amino acid PET tracers in brain tumors include tumor grade prediction, tumor volume delineation, differentiation between tumor progression and post-treatment changes, stereotactic tumor biopsy guidance, pre-surgical resection planning, pre-radiotherapy target delineation, and noninvasive prediction of tumor genetic mutations. This chapter will concisely discuss principles of amino acid transportation across the BBB and cellular membrane of brain tumor cells. We will also review biochemical characteristics of amino acid tracers, technical imaging aspects of amino acid PET scans, and clinical application of available amino acid PET tracers in brain tumors.

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Authors and Affiliations

  1. The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran

    Hossein Shooli & Majid Assadi

  2. University of Pennsylvania/Perelman School of Medicine, Philadelphia, Philadelphia, PA, USA

    S. Ali Nabavizadeh

  3. Yale University School of Medicine, New Haven, CT, USA

    Mariam Aboian

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  1. Hossein Shooli
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  2. Majid Assadi
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  3. S. Ali Nabavizadeh
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  4. Mariam Aboian
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Correspondence to Mariam Aboian .

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  1. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, The Feinstein Institutes for Medical Research, Manhasset, NY, USA

    Ana M. Franceschi

  2. Stony Brook University Hospital, Stony Brook, NY, USA

    Dinko Franceschi

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Shooli, H., Assadi, M., Nabavizadeh, S.A., Aboian, M. (2022). Amino Acid PET/MRI in Neuro-oncology. In: Franceschi, A.M., Franceschi, D. (eds) Hybrid PET/MR Neuroimaging. Springer, Cham. https://doi.org/10.1007/978-3-030-82367-2_14

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