PT  - JOURNAL ARTICLE
AU  - Tateishi, K.
AU  - Tateishi, U.
AU  - Sato, M.
AU  - Yamanaka, S.
AU  - Kanno, H.
AU  - Murata, H.
AU  - Inoue, T.
AU  - Kawahara, N.
TI  - Application of <sup>62</sup>Cu-Diacetyl-Bis (N<sup>4</sup>-Methylthiosemicarbazone) PET Imaging to Predict Highly Malignant Tumor Grades and Hypoxia-Inducible Factor-1α Expression in Patients with Glioma
AID  - 10.3174/ajnr.A3159
DP  - 2013 Jan 01
TA  - American Journal of Neuroradiology
PG  - 92--99
VI  - 34
IP  - 1
4099  - http://www.ajnr.org/content/34/1/92.short
4100  - http://www.ajnr.org/content/34/1/92.full
SO  - Am. J. Neuroradiol.2013 Jan 01; 34
AB  - BACKGROUND AND PURPOSE: Hypoxic tissue evaluation in glioma is important for predicting treatment response and establishing antihypoxia therapy. In this preliminary study, 62Cu-ATSM PET was used to determine its validity as a biomarker for distinguishing tumor grade and tissue hypoxia. MATERIALS AND METHODS: 62Cu-ATSM PET was performed in 22 patients with glioma, and the 62Cu-ATSM SUVmax and T/B ratio were semiquantitatively evaluated. 62Cu-ATSM uptake distribution was qualitatively evaluated and compared with MR imaging findings. HIF-1α expression, a hypoxia marker, was compared with 62Cu-ATSM uptake values. RESULTS: The 62Cu-ATSM SUVmax and T/B ratio were significantly higher in grade IV than in grade III gliomas (P = .014 and .018, respectively), whereas no significant differences were found between grade III and grade II gliomas. At a T/B ratio cutoff threshold of 1.8, 62Cu-ATSM uptake was predictive of HIF-1α expression, with 92.3% sensitivity and 88.9% specificity. The mean T/B ratio was also significantly higher in HIF-1α-positive glioma tissue than in HIF-1α-negative tissue (P = .001). Using this optimal threshold of T/B ratio, 62Cu-ATSM PET showed regional uptake in 61.9% (13/21) of tumors within the contrast-enhanced region on MR imaging, which was significantly correlated with presence of a necrotic component (P = .002). CONCLUSIONS: Our results demonstrated that 62Cu-ATSM uptake is relatively high in grade IV gliomas and correlates with the MR imaging findings of necrosis. Moreover, the 62Cu-ATSM T/B ratio showed significant correlation with HIF-1α expression. Thus, 62Cu-ATSM appears to be a suitable biomarker for predicting highly malignant grades and tissue hypoxia in patients with glioma. 62Cu-ATSM62Cu-diacetyl-bis (N4-methylthiosemicarbazone)18F-FMISO18F-fluoromisonidazoleHIF-1αhypoxia-inducible factor-1αpO2partial pressure of oxygenROCreceiver operating characteristicSUVstandard uptake valueT/B ratiotumor/ background ratioWHOWorld Health Organization