In gratitude of the loyal support of our members, the CNS is offering complimentary 2021 Annual Meeting registration to all members! Learn more.

  • Improved treatment of malignant glioma with clinical use of a Newly Developed PET Molecular Imaging Probe [methyl-11c]-4`-thiothimidine (4DST) to measure DNA synthesis rate.

    Final Number:
    1324

    Authors:
    Tadashi Nariai MD PhD; Motoki Inaji MD; Shihori Hayashi MD; Yoji Tanaka; Taketoshi Maehara MD, PhD; Kiichi Ishiwata PhD; Jun Toyohara

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: PET molecular imaging is now known as an inevitable clinical tool for the treatment of malignant brain tumors. PET amino acid probes such as 11C-methionine (MET) are considered as one of most appropriate probes for clinical use. MET-PET, however, is not almighty and has several cautious points. It may over-estimates tumor malignancy in oligodendroglioma, because of the influence of vascular bed. It may not clearly differentiate low grade tumor and inflammatory disease. Recently we developed [methyl-11C]4`-thiothimidine (4DST) as a radiotracer for DNA synthesis. We evaluated the utility of 4DST-PET in comparison to MET-PET.

    Methods: 56 patients were enrolled in this study; 48 patients with glioma, 5 metastatic brain tumor, 1 malignant lymphoma, mutiple sclerosis, and craniopharyngioma. All subjects underwent 4DST and MET-PET within a week. Regional uptake of tracers in static condition (40-60 min and 20-25 min after injection for 4DST and MET, respectively) was expressed as tumor/normal ratio for MET, and SUV in 4DST-PET.

    Results: 1) 4DST-PET images were almost identical to MET-PET images in astrocytic tumors before treatments. This result suggested the validity of 4DST-PET in preoperative diagnosis of astrocytic tumors. Threshold of malignancy is 1.0 (SUV) in 4DST-PET images. 4DST-PET could distinguish between oligodendroglioma and anaplastic oligodendroglioma clearly. Furthermore, 4DST uptake was far less than 1.0 (SUV) in a case of multiple sclerosis. These results suggested that 4DST-PET image showed cell proliferation precisely and could complement the area that cannot be clarified with MET-PET. 2) The effectiveness of radiation or chemotherapy was clearly demonstrated by the decreased uptake of 4DST, instantly after the treatment.

    Conclusions: The utility and validity of 4DST-PET were demonstrated in our initial clinical trial for malignant brain tumors. As 4DST-PET may reflect cell proliferation rates more clearly than MET-PET, it has great potential as a PET molecular imaging probe for the management of malignant brain tumors.

    Patient Care: We may be able to differentiate tumor type before the operation more precisely, and to monitor the effectiveness and limitation of each treatment promptly by new imaging method.

    Learning Objectives: to learn how a newly developed molecular imaging contribute to the treatment of malignant glioma.

    References: 1. Toyohara J, Nariai T, Sakata M, Oda K, Ishii K, Kawabe T, Irie T, Saga T, Kubota K, Ishiwata K. Whole-Body Distribution and Brain Tumor Imaging with 11C-4DST: A Pilot Study. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2011 Aug;52(8):1322-8. 2. Nariai T, Inaji M, Sakata M, Toyohara J. Use of (11)C-4DST-PET for Imaging Human Brain Tumors. In: Hayat M, editor. Tumors of the central nervous system. Amsterdam: Springer; in press.

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy