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Uptake of AV-1451 in meningiomas

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Abstract

Aim

AV-1451 is an imaging agent labeled with the positron-emitting radiolabel Fluorine-18. 18F-AV-1451 binds paired helical filament tau (PHF-tau), a pathology related to Alzheimer’s disease. In our study of AV-1451 uptake in the brains of cognitively normal subjects, we noted a case of a meningioma with visually significant uptake of AV-1451.

Objective

We initiated the present retrospective study to further examine cases of meningioma that underwent AV-1451 imaging.

Methods

We searched the patient records of 650 patients who had undergone AV-1451 at our institution for the keyword “meningioma” to identify potential cases. PET/CT and MRI results were visually reviewed and semi-quantitative analysis of PET was performed. A paired student’s t test was run between background and tumor standard uptake values. Fisher’s exact test was used to examine the association between AV-1451 uptake and presence of calcifications on CT.

Results

We identified 12 cases of meningioma, 58% (7/12) of which demonstrated uptake greater than background using both visual analysis and tumor-to-normal cortex ratios (T/N + 1.90 ± 0.83). The paired student’s t test revealed no statistically significant difference between background and tumor standard uptake values (p = 0.09); however, cases with a T/N ratio greater than one showed statistically higher uptake in tumor tissue (p = 0.01). A significant association was noted between AV-1451 uptake and presence of calcifications (p = 0.01).

Conclusion

AV-1451 PET imaging should be reviewed concurrently with anatomic imaging to prevent misleading interpretations of PHF-tau distribution due to meningiomas.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Tyler J. Bruinsma, Derek R. Johnson, Ping Fang, Matthew Senjem, Jennifer L. Whitwell, Mukesh K. Pandey, Kejal Kantarci, David T. Jones, Prashanthi Vemuri, Christopher G. Schwarz, Clifford R. Jack Jr. & Val J. Lowe

  2. Department of Neurology, Mayo Clinic, Rochester, MN, USA

    Derek R. Johnson, Keith A. Josephs, Bradley F. Boeve, David T. Jones, Jonathan Graff-Radford, David S. Knopman & Ronald C. Petersen

  3. Department of Information Technology, Mayo Clinic, Rochester, MN, USA

    Matthew Senjem

  4. Department of Neurology, Mayo Clinic, Jacksonville, FL, USA

    Melissa Murray

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  1. Tyler J. Bruinsma
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Corresponding author

Correspondence to Tyler J. Bruinsma.

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Financial support

This research was supported by NIH Grants, P50 AG016574, R01 NS89757, R01 NS089544, R01 DC10367, U01 AG006786, R21 NS094489, by the Robert Wood Johnson Foundation, The Elsie and Marvin Dekelboum Family Foundation, The Liston Family Foundation and by the Robert H. and Clarice Smith and Abigail van Buren Alzheimer’s Disease Research Program, The GHR Foundation, Foundation Dr. Corinne Schuler and the Mayo Foundation.

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Bruinsma, T.J., Johnson, D.R., Fang, P. et al. Uptake of AV-1451 in meningiomas. Ann Nucl Med 31, 736–743 (2017). https://doi.org/10.1007/s12149-017-1205-0

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  • DOI: https://doi.org/10.1007/s12149-017-1205-0

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