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Brain PET/CT using prostate cancer radiopharmaceutical agents in the evaluation of gliomas

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Abstract

Purpose

Non-invasive imaging plays a crucial role in the management of patients with primary gliomas. Since their introduction in the clinical setting, 18F/11C-Choline and afterwards 18F/68Ga-PSMA and 18F-Fluciclovine gained widespread in the evaluation of prostate cancer. More recently, multiple reports and original studies documented the utility of these prostate cancer positron emission tomography (pcPET) radiotracers in the assessment of gliomas. To evaluate the potential role of pcPET radiotracers currently used in brain tumors, we present a review of these radiotracers in the different settings of the diagnostic work-up of patients with gliomas.

Methods

A literature search regarding articles published from 2000 to July 2020 regarding the use of pcPET radiotracers in gliomas was performed in the PubMed and Scopus databases, using combinations of search strings including the following words and acronyms: “choline”, “CHO”, “prostatic specific membrane antigen”, “PSMA”, “Fluciclovine”, FACBC, “Positron Emission Tomography”, “PET”, “brain tumor”, “glioma”, “glioblastoma”.

Results

A total of 27 articles about pcPET radiotracers (Choline N = 14, PSMA N = 7; Fluciclovine N = 6) evaluating every phase of disease in glioma (diagnosis, grading and prognosis, evaluation of recurrence, treatment planning and response to therapy assessment) were discussed.

Conclusions

pcPET tracers present potential utility in the differential diagnosis, estimation of prognosis, evaluation of recurrence and treatment planning in patients with glioma. These radiotracers may hold a complementary role in conjunction with advanced MRI techniques in the non-invasive grading of gliomas.

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  1. Pierpaolo Alongi and Natale Quartuccio contributed equally to the paper.

Authors and Affiliations

  1. Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Contrada Pietrapollastra, 90015, Cefalù, PA, Italy

    Pierpaolo Alongi

  2. Nuclear Medicine Unit, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy

    Natale Quartuccio

  3. Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy

    Annachiara Arnone, Aurora Kokomani & Michela Allocca

  4. Nuclear Medicine Unit, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy

    Anna Giulia Nappi & Giulia Santo

  5. Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy

    Cristina Mantarro & Riccardo Laudicella

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Alongi, P., Quartuccio, N., Arnone, A. et al. Brain PET/CT using prostate cancer radiopharmaceutical agents in the evaluation of gliomas. Clin Transl Imaging 8, 433–448 (2020). https://doi.org/10.1007/s40336-020-00389-7

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