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Histomolecular Validation of [18F]-FACBC in Gliomas Using Image-Localized Biopsies

Abstract

Background: Gliomas have a heterogeneous nature, and identifying the most aggressive parts of the tumor and defining tumor borders are important for histomolecular diagnosis, surgical resection, and radiation therapy planning. This study evaluated [18F]-FACBC PET for glioma tissue classification. Methods: Pre-surgical [18F]-FACBC PET/MR images were used during surgery and image-localized biopsy sampling in patients with high- and low-grade glioma. TBR was compared to histomolecular results to determine optimal threshold values, sensitivity, specificity, and AUC values for the classification of tumor tissue. Additionally, PET volumes were determined in patients with glioblastoma based on the optimal threshold. [18F]-FACBC PET volumes and diagnostic accuracy were compared to ce-T1 MRI. In total, 48 biopsies from 17 patients were analyzed. Results: [18F]-FACBC had low uptake in non-glioblastoma tumors, but overall higher sensitivity and specificity for the classification of tumor tissue (0.63 and 0.57) than ce-T1 MRI (0.24 and 0.43). Additionally, [18F]-FACBC TBR was an excellent classifier for IDH1-wildtype tumor tissue (AUC: 0.83, 95% CI: 0.71–0.96). In glioblastoma patients, PET tumor volumes were on average eight times larger than ce-T1 MRI volumes and included 87.5% of tumor-positive biopsies compared to 31.5% for ce-T1 MRI. Conclusion: The addition of [18F]-FACBC PET to conventional MRI could improve tumor classification and volume delineation.
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Category

Academic article

Language

English

Author(s)

  • Benedikte Emilie Vindstad
  • Anne Jarstein Skjulsvik
  • Lars Kjelsberg Pedersen
  • Erik Magnus Berntsen
  • Ole Skeidsvoll Solheim
  • Tor Ingebrigtsen
  • Ingerid Reinertsen
  • Håkon Johansen
  • Live Eikenes
  • Anna Maria Karlberg

Affiliation

  • SINTEF Digital / Health Research
  • UiT The Arctic University of Norway
  • University Hospital of North Norway
  • St. Olavs Hospital, Trondheim University Hospital
  • Norwegian University of Science and Technology

Year

2024

Published in

Cancers

Volume

16

Issue

14

View this publication at Norwegian Research Information Repository