11C-Acetate PET/CT Detects Reactive Astrogliosis Helping Glioma Classification

Dongwoo Kim, Joong Hyun Chun, Ju Hyeon Yi, Hae Young Ko, Jee In Chung, Misu Lee, Yongmin Mason Park, Min Ho Nam, Jisu Kim, Seon Yoo Kim, Youngjoo Park, Ju Hyung Moon, Seok Gu Kang, Jong Hee Chang, C. Justin Lee, Se Hoon Kim, Mijin Yun

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Purpose 11C-acetate (11C-ACE) uptake on PET/CT was recently discovered to represent reactive astrocytes in the tumor microenvironment. This study aimed at evaluating the role of 11C-ACE PET/CT as an imaging biomarker of reactive astrogliosis in characterizing different types of gliomas. Methods In this prospective study, a total of 182 patients underwent 11C-ACE PET/CT before surgery. The ratio of SUVmax of a glioma to the SUVmean of the contralateral choroid plexus (11C-ACE TCR) on PET/CT was calculated. 11C-ACE TCRs were compared with the World Health Organization grades and isocitrate dehydrogenase 1 (IDH1) mutation status. Grade 2 was considered low-grade tumor, and grades 3 and 4 were considered high-grade tumors. Results The median 11C-ACE TCR was significantly higher in IDH1 wild-type (wt) tumors (n = 91) than in IDH1-mutant (mt) tumors (n = 91) (2.38 vs 1.30, P < 0.001). Of the 91 IDH1-mt tumors, there were no differences in the median 11C-ACE TCRs between oligodendrogliomas (ODs) and astrocytic tumors (1.40 vs 1.20, P > 0.05). In grading low- versus high-grade gliomas, the receiver operating characteristic curve analyses showed a higher area under the curve (0.951) in IDH1-wt tumors than in IDH1-mt tumors (0.783, P = 0.002). Grade 2 ODs were well differentiated from high-grade gliomas. The 11C-ACE TCR of grade 3 ODs was significantly lower than that of IDH1-wt glioblastomas. Conclusions High 11C-ACE uptake is associated with high-grade IDH1-wt tumors, thus facilitating differentiation from high-grade IDH1-mt and low-grade gliomas. In particular, low 11C-ACE uptake in ODs is advantageous in overcoming the limitation of radiolabeled amino acid tracers.

Original languageEnglish
Pages (from-to)863-868
Number of pages6
JournalClinical nuclear medicine
Issue number10
Publication statusPublished - 2022 Oct

Bibliographical note

Funding Information:
Conflicts of interest and sources of funding: none declared. This work was supported partially by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science and ICT (NRF-2012R1A1A3008042, NRF-2016R1E1A1A01943303, and NRF-2018M3C7A1056898).

Publisher Copyright:
© 2022 Wolters Kluwer Health, Inc.

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging


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