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Preferential tumor localization in relation to 18F-FDOPA uptake for lower‐grade gliomas

  • Clinical Study
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Abstract

Purpose

Although tumor localization and 3,4-dihydroxy-6-18F-fluoro-l-phenylalanine (FDOPA) uptake may have an association, preferential tumor localization in relation to FDOPA uptake is yet to be investigated in lower-grade gliomas (LGGs). This study aimed to identify differences in the frequency of tumor localization between FDOPA hypometabolic and hypermetabolic LGGs using a probabilistic radiographic atlas.

Methods

Fifty-one patients with newly diagnosed LGG (WHO grade II, 29; III, 22; isocitrate dehydrogenase wild-type, 21; mutant 1p19q non-codeleted,16; mutant codeleted, 14) who underwent FDOPA positron emission tomography (PET) were retrospectively selected. Semiautomated tumor segmentation on FLAIR was performed. Patients with LGGs were separated into two groups (FDOPA hypometabolic and hypermetabolic LGGs) according to the normalized maximum standardized uptake value of FDOPA PET (a threshold of the uptake in the striatum) within the segmented regions. Spatial normalization procedures to build a 3D MRI-based atlas using each segmented region were validated by an analysis of differential involvement statistical mapping.

Results

Superimposition of regions of interest showed a high number of hypometabolic LGGs localized in the frontal lobe, while a high number of hypermetabolic LGGs was localized in the insula, putamen, and temporal lobe. The statistical mapping revealed that hypometabolic LGGs occurred more frequently in the superior frontal gyrus (close to the supplementary motor area), while hypermetabolic LGGs occurred more frequently in the insula.

Conclusion

Radiographic atlases revealed preferential frontal lobe localization for FDOPA hypometabolic LGGs, which may be associated with relatively early detection.

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Funding

Grant from the Society of Nuclear Medicine and Molecular Imaging (SNMMI) (Tatekawa); American Cancer Society (ACS) Research Scholar Grant (RSG-15-003-01-CCE) (Ellingson); American Brain Tumor Association (ABTA) Research Collaborators Grant (ARC1700002) (Ellingson); National Brain Tumor Society (NBTS) Research Grant (Ellingson, Cloughesy); NIH/NCI UCLA Brain Tumor SPORE (1P50CA211015-01A1) (Ellingson, Lai, Cloughesy, Nghiemphu); NIH/NCI (1R21CA223757-01) (Ellingson).

Author information

Authors and Affiliations

  1. UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA

    Hiroyuki Tatekawa, Akifumi Hagiwara, Jingwen Yao, Talia C. Oughourlian, Catalina Raymond & Benjamin M. Ellingson

  2. Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Hiroyuki Tatekawa, Hiroyuki Uetani, Akifumi Hagiwara, Jingwen Yao, Talia C. Oughourlian, Issei Ueda, Catalina Raymond, Whitney B. Pope, Noriko Salamon & Benjamin M. Ellingson

  3. Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan

    Hiroyuki Tatekawa

  4. Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan

    Akifumi Hagiwara

  5. Department of Bioengineering, Henry Samueli School of Engineering, University of California Los Angeles, Los Angeles, CA, USA

    Jingwen Yao & Benjamin M. Ellingson

  6. Neuroscience Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Talia C. Oughourlian & Benjamin M. Ellingson

  7. UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Albert Lai, Timothy F. Cloughesy, Phioanh L. Nghiemphu, Linda M. Liau & Benjamin M. Ellingson

  8. Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Albert Lai, Timothy F. Cloughesy & Phioanh L. Nghiemphu

  9. Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Linda M. Liau

  10. Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    Shadfar Bahri

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  1. Hiroyuki Tatekawa
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Contributions

HT: study design, data analysis, drafting the manuscript, approving the final content. HU: study design, data analysis, revising the manuscript, approving the final content. AH: study design, data analysis, revising the manuscript, approving the final content. JY: study design, data analysis, revising the manuscript, approving the final content. TCO: study design, data analysis, revising the manuscript, approving the final content. IU: study design, data analysis, revising the manuscript, approving the final content. CR: data analysis, revising the manuscript, approving the final content. AL: data acquisition, revising the manuscript, approving the final content. TFC: data acquisition, revising the manuscript, approving the final content. PLN: data acquisition, revising the manuscript, approving the final content. LML: data acquisition, revising the manuscript, approving the final content. SB: study design, data analysis, revising the manuscript, approving the final content. WBP: study design, revising the manuscript, approving the final content. NS: study design, revising the manuscript, approving the final content. BME: study design, data analysis, revising the manuscript, approving the final content.

Corresponding author

Correspondence to Benjamin M. Ellingson.

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Conflicts of interest

Ellingson—Advisory Board—Hoffman La-Roche; Siemens; Nativis; Medicenna; MedQIA; Bristol-Myers Squibb; Imaging Endpoints; Agios. Paid Consultant—Nativis; MedQIA; Siemens; Hoffman La-Roche; Imaging Endpoints; Medicenna; Agios. Grant Funding—Hoffman La-Roche; Siemens; Agios; Janssen. Ellingson also holds a patent on this technology (US Patent #15/577,664; International PCT/US2016/034886). Cloughesy—Advisory Board—Roche/ Genentech, Amgen, Tocagen, NewGen, LPath, Proximagen, Celgene, Vascular Biogenics Ltd, Insys, Agios, Cortice Bioscience, Pfizer, Human Longevity, BMS, Merck, Notable Lab, MedQIA.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants to have their imaging, clinical, and molecular data included in our research database (IRB IRB#10-000655).

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Tatekawa, H., Uetani, H., Hagiwara, A. et al. Preferential tumor localization in relation to 18F-FDOPA uptake for lower‐grade gliomas. J Neurooncol 152, 573–582 (2021). https://doi.org/10.1007/s11060-021-03730-w

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