Novel positron emission tomography radiotracers in brain tumor imaging

Monte Carlo Characterization of the Trimage Brain PET System

The TRIMAGE project aims to develop a brain-dedicated PET/MR/EEG (Positron Emission Tomography/Magnetic Resonance/Electroencephalogram) system that is able to perform simultaneous PET, MR and EEG acquisitions. The PET component consists of a full ring with 18 sectors. Each sector includes three square detector modules based on dual sstaggered LYSO:Ce matrices read out by SiPMs. Using Monte Carlo simulations and following NEMA (National Electrical Manufacturers Association) guidelines, image quality procedures have been applied to evaluate the performance of the PET component of the system. The performance are reported in terms of spatial resolution, uniformity, recovery coefficient, spill over ratio, noise equivalent count rate (NECR) and scatter fraction. The results show that the TRIMAGE system is at the top of the current brain PET technologies.

Personalized image-based tumor growth prediction in a convection-diffusion-reaction model

Inter-individual heterogeneity of tumors leads to non-effectiveness of unique therapy plans. This issue has caused a growing interest in the field of personalized medicine and its application in tumor growth evaluation. Accordingly, in this paper, a framework of personalized medicine is presented for growth prediction of brain glioma tumors. A convection-diffusion-reaction model is used as the patient-specific tumor growth model which is associated with multimodal magnetic resonance images (MRIs). Two parameters of intracellular area fraction (ICAF) and metabolic rate have been used to incorporate the physiological data obtained from medical images into the model. The framework is tested on the data of two cases of glioma tumors to document the approach; parameter estimation is made using particle swarm optimization (PSO) and genetic algorithm (GA) and the model is evaluated by comparing the predicted tumors with the observed tumors in terms of root mean square error of the ICAF maps (IRMSE), relative area difference (RAD) and Dice's coefficient (DC). Results show the differences of IRMSE, RAD and DC in 4.1 ∓ 1.15%, 0.099 ∓ 0.041 and 85.5 ∓ 7.5%, respectively. Survival times are estimated by assuming the tumor radius of 35 mm as the fatal burden. Results confirm that less-diffusive tumors lead to higher survival times. The represented framework makes it possible to personally predict the growth behavior of glioma tumors only based on patients' routine MRIs and provides a basis for modeling the personalized therapy and walking in the path of personalized medicine.

Comparative In Vitro Study of 11C-Methionine and 11C-Deuterodeprenyl Uptake in Three Human Glioma Cell Lines

AIM

To compare the uptake of ¹¹C-deuterodeprenyl (¹¹C-DED) and ¹¹C-methionine (¹¹C-MET) in three human glioma cell lines and study the relationship with glial fibrillary acid protein (GFAP) and monoamine oxidase B (MAO B) expression. ¹¹C-DED is used in positron emission tomography imaging as a marker of astrocytosis in various central nervous system pathologies. It binds irreversibly to MAO B, a glial dimeric enzyme with increased activity in some neurological pathologies.

MATERIALS AND METHODS

Binding and internalization studies of ¹¹C-MET and ¹¹C-DED were performed in astrocytoma grade III, glioblastoma grade IV, and radio-resistant glioblastoma grade IV cells. Immunofluorescence was used.

RESULTS

¹¹C-MET specific activity bound to membrane was 9.0%-11.1% and that internalized was 88.9%-91.0%. ¹¹C-DED specific activity bound to membrane was 34.8%-58.0% and that internalized was 38.7%-65.2%. Immunocytochemistry revealed GFAP and MAO B expression.

CONCLUSIONS

The expression of MAO B measured by ¹¹C-DED uptake or immunocytochemistry was not significantly different in grade III or IV cells. The GFAP signal was higher for grade IV compared to grade III. ¹¹C-MET uptake was high in all the tumor cells. ¹¹C-DED is a dopamine analogue and the transport across cell membranes is expected to be mediated by DAT receptors present in astrocytes. Reactive astrocytes surround tumor lesions; so the authors suggest that the ¹¹C-DED uptake might be caused by the reactive astrocytosis and not by MAO B expression in tumor cells.

Combined (18)F-FDG and (11)C-Methionine PET/CT scans in a case of metastatic hepatocellular carcinoma

A 37-year-old male who underwent a central hepatectomy of the liver for hepatocellular carcinoma (HCC) was referred for an ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) study to rule out tumor recurrence or metastases. The scan showed a recurrent hepatic mass at the operative site, along with low-grade uptake in bilateral pulmonary metastases, mediastinal and hilar lymph nodes, and few skeletal sites. A non-FDG avid intracranial extradural mass was visualized in the right frontal lobe. The ¹¹C-methionine PET/CT scan performed subsequently revealed a larger area of involvement at the primary site, along with widespread metastases to the lungs, mediastinal, hilar, and abdominal lymph nodes, and multiple skeletal sites. Further, dural metastasis with high tracer uptake was noted in the frontal region. To the best of our knowledge, this is the first case documented in the literature, wherein ¹¹C-methionine PET/CT played a significant role in delineating the widespread dissemination, including the extremely rare dural involvement in a case of HCC. This report highlights the potential value of ¹¹C-methionine PET/CT in assessing the hepatic and extrahepatic tumor burden in cases of HCC, especially in clinically unexpected locations.