Background To investigate the correlation between 18F-labeled fluoroazomycinarabinoside (18F-FAZA) PET data and hypoxia immunohistochemical markers in patients with high-grade glioma (HGG). Patients and methods Prospective study including 20 patients with brain MRI suggestive for HGG and undergoing 18F-FAZA PET/CT before treatment for hypoxia assessment. For each 18F-FAZA PET scan SUVmax, SUVmean and 18F-FAZA tumour volume (FTV) at 40, 50 and 60% threshold of SUVmax were calculated; hypoxic volume was estimated by applying different thresholds (1.2, 1.3 and 1.4) to tumour/blood ratio. Seventeen patients were analysed. The immunohistochemical analysis assessed the following parameters: hypoxia-inducible factor 1α, carbonic anhydrase IX (CA-IX), glucose transporter-1, tumour vascularity and Ki-67. Results 18F-FAZA PET showed a single lesion in 15/17 patients and multiple lesions in 2/17 patients. Twelve/17 patients had grade IV glioma and 5/17 with grade III glioma. Bioptic and surgical samples have been analysed separately. In the surgical subgroup (n=7) a positive correlation was observed between CA-IX and SUVmax (P=0.0002), SUVmean40 (P=0.0058), SUVmean50 (P=0.009), SUVmean60 (P=0.0153), FTV–40–50–60 (P=0.0424) and hypoxic volume1.2–1.3–1.4 (P=0.0058). In the bioptic group (n=10) tumour vascularisation was inversely correlated with SUVmax (P=0.0094), SUVmean40 (P=0.0107), SUVmean50 (P=0.0094) and SUVmean60 (P=0.0154). Conclusions The correlation of 18F-FAZA PET parameters with CD31 and CA-IX represents a reliable method for assessing tumour hypoxia in HGG. The inverse correlation between tumour vascularisation, SUVmax and SUVmean suggest that highly vascularized tumours might present more oxygen supply than hypoxia.
18F-FAZA PET/CT in pretreatment assessment of hypoxic status in high-grade glioma: correlation with hypoxia immunohistochemical biomarkers / Mapelli, P.; Callea, M.; Fallanca, F.; Castellano, A.; Bailo, M.; Scifo, P.; Bettinardi, V.; Conte, G. M.; Monterisi, C.; Rancoita, P. M. V.; Incerti, E.; Vuozzo, M.; Gianolli, L.; Terreni, M.; Anzalone, N.; Picchio, M.. - In: NUCLEAR MEDICINE COMMUNICATIONS. - ISSN 0143-3636. - 42:7(2021), pp. 763-771. [10.1097/MNM.0000000000001396]
18F-FAZA PET/CT in pretreatment assessment of hypoxic status in high-grade glioma: correlation with hypoxia immunohistochemical biomarkers
Mapelli P.;Castellano A.;Bailo M.;Conte G. M.;Rancoita P. M. V.;Anzalone N.;Picchio M.
2021-01-01
Abstract
Background To investigate the correlation between 18F-labeled fluoroazomycinarabinoside (18F-FAZA) PET data and hypoxia immunohistochemical markers in patients with high-grade glioma (HGG). Patients and methods Prospective study including 20 patients with brain MRI suggestive for HGG and undergoing 18F-FAZA PET/CT before treatment for hypoxia assessment. For each 18F-FAZA PET scan SUVmax, SUVmean and 18F-FAZA tumour volume (FTV) at 40, 50 and 60% threshold of SUVmax were calculated; hypoxic volume was estimated by applying different thresholds (1.2, 1.3 and 1.4) to tumour/blood ratio. Seventeen patients were analysed. The immunohistochemical analysis assessed the following parameters: hypoxia-inducible factor 1α, carbonic anhydrase IX (CA-IX), glucose transporter-1, tumour vascularity and Ki-67. Results 18F-FAZA PET showed a single lesion in 15/17 patients and multiple lesions in 2/17 patients. Twelve/17 patients had grade IV glioma and 5/17 with grade III glioma. Bioptic and surgical samples have been analysed separately. In the surgical subgroup (n=7) a positive correlation was observed between CA-IX and SUVmax (P=0.0002), SUVmean40 (P=0.0058), SUVmean50 (P=0.009), SUVmean60 (P=0.0153), FTV–40–50–60 (P=0.0424) and hypoxic volume1.2–1.3–1.4 (P=0.0058). In the bioptic group (n=10) tumour vascularisation was inversely correlated with SUVmax (P=0.0094), SUVmean40 (P=0.0107), SUVmean50 (P=0.0094) and SUVmean60 (P=0.0154). Conclusions The correlation of 18F-FAZA PET parameters with CD31 and CA-IX represents a reliable method for assessing tumour hypoxia in HGG. The inverse correlation between tumour vascularisation, SUVmax and SUVmean suggest that highly vascularized tumours might present more oxygen supply than hypoxia.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
