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Tumor hypoxia and microscopic diffusion capacity in brain tumors: A comparison of 62Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) PET/CT and diffusion-weighted MR imaging

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Objectives

The aim of this study was to clarify the relationship between tumor hypoxia and microscopic diffusion capacity in primary brain tumors using 62Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) (62Cu-ATSM) PET/CT and diffusion-weighted MR imaging (DWI).

Methods

This study was approved by the institutional human research committee and was HIPAA compliant, and informed consent was obtained from all patients. 62Cu-ATSM PET/CT and DWI were performed in a total of 40 primary brain tumors of 34 patients with low grade glioma (LGG, n = 13), glioblastoma (GBM, n = 20), and primary central nervous system lymphoma (PCNSL, n = 7). 62Cu-ATSM PET/CT parameters and apparent diffusion coefficient (ADC) obtained by DWI were compared.

Results

High intensity signals by 62Cu-ATSM PET/CT and DWI in patients with GBM and PCNSL, and low intensity signals in LGG patients were observed. An inverse correlation was found between maximum SUV (SUVmax) and minimum ADC (ADCmin) (r = −0.583, p < 0.0001), and between tumor/brain ratio (T/Bratio) and ADCmin for all tumors (r = −0.532, p < 0.0001). Both SUVmax and T/Bratio in GBM were higher than LGG (p < 0.0001 and p < 0.0001), and those in PCNSL were also higher than GBM (p = 0.033 and p = 0.044). The ADCmin was lower in GBM (p = 0.011) and PCNSL (p = 0.01) than in LGG, while no significant difference was found between GBM and PCNSL (p = 0.90).

Conclusion

Tumor hypoxia assessed by 62Cu-ATSM PET/CT correlated with microscopic diffusion capacity obtained by DWI in brain tumors. Both 62Cu-ATSM PET/CT and DWI were considered feasible imaging methods for grading glioma. However, 62Cu-ATSM PET/CT provided additional diagnostic information to differentiate between GBM and PCNSL.

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Acknowledgments

The authors declare that they have no conflicts of interest. We thank Tsuneo Saga, Masayuki Inubishi, Toshimitsu Fukumura, and Yasuhisa Fujibayashi of the Diagnostic Imaging and Molecular Probe Groups, Molecular Imaging Center, National Institute of Radiologic Sciences, Chiba, Japan; Hidehiko Okazawa of the Department of Radiology, Biomedical Imaging Research Center, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; and Hirofumi Fujii, Functional Imaging Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan, for their assistance. We also thank our nuclear medicine technologists for acquiring PET/CT scans. This work was also supported (in part) by a Grant-in-Aid for Cancer Research (21-5-2) from the Ministry of Health, Labour and Welfare.

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Authors and Affiliations

  1. Department of Radiology, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Ayako Hino-Shishikura, Ukihide Tateishi, Hirofumi Shibata, Tomohiro Yoneyama, Toshiaki Nishii, Ikuo Torii & Tomio Inoue

  2. Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Kensuke Tateishi, Makoto Ohtake & Nobutaka Kawahara

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  1. Ayako Hino-Shishikura
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  2. Ukihide Tateishi
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Correspondence to Ukihide Tateishi.

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Hino-Shishikura, A., Tateishi, U., Shibata, H. et al. Tumor hypoxia and microscopic diffusion capacity in brain tumors: A comparison of 62Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) PET/CT and diffusion-weighted MR imaging. Eur J Nucl Med Mol Imaging 41, 1419–1427 (2014). https://doi.org/10.1007/s00259-014-2714-x

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  • DOI: https://doi.org/10.1007/s00259-014-2714-x

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