Association between fluorine-18–labeled fluorodeoxyglucose uptake and 1p and 19q loss of heterozygosity in World Health Organization Grade II gliomas

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Object

Oligodendroglial tumors harboring combined 1p and 19q loss (1p/19q LOH) are characterized by a favorable prognosis and response to chemotherapy and radiotherapy, but detection of 1p/19q LOH relies on postoperative procedures. The authors investigated the potential of fluorine-18–labeled fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) to predict 1p/19q LOH preoperatively in tumors whose appearance on initial magnetic resonance images was consistent with that of low-grade glioma.

Methods

The study population comprised 25 patients who had undergone preoperative FDG-PET followed by tumor resection. Neuronavigation ensured a precise match of FDG uptake wi th the site of biopsy. All tumor specimens were graded according to the World Health Organization (WHO) classification system. Microsatellite analysis was used to identify 1p/19q LOH.

In this series, 16 of 25 gliomas corresponded to WHO Grade II. In eight of these 16, 1p/19q LOH was detected. Raised glucose utilization within the tumor was seen in the six of eight WHO Grade II gliomas with 1p/19q LOH and in none of the WHO Grade II gliomas without this genetic alteration (p = 0.003).

Conclusions

These findings demonstrate the potential of FDG-PET to predict 1p/19q LOH in WHO Grade II gliomas.

Abbreviations used in this paper:FDG = fluorine-18–labeled flu-orodeoxyglucose; LOH = loss of heterozygosity; MR = magnetic resonance; PET = positron emission tomography; SPECT = single-photon emission computed tomography; WHO = World Health Organization; 1p/19q LOH = combined 1p and 19q LOH.

Article Information

Address reprint requests to: Florian Stockhammer, M.D., Klinik für Neurochirurgie, Campus Virchow-Klinikum, Charité–Universi-tätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. email: florian.stockhammer@charite.de.

© AANS, except where prohibited by US copyright law.

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Figures

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    Magnetic resonance and FDG-PET images and results of microsatellite analysis from two cases of histologically proven WHO Grade II oligodendroglioma. Upper: Case 10. Axial T2-weighted (A) and T1-weighted contrast-enhanced (B) MR images. An FDG-PET image (C) showing low FDG uptake in an area corresponding to the tumor mass in the left temporal lobe. The results of microsatellite analysis (D) demonstrating the presence of both parental alleles in tumor DNA (TU) and blood DNA from peripheral lymphocytes (BL). Lower: Case 13. Axial T2-weighted (E) and T1-weighted contrast-enhanced (F) MR images. An FDG-PET image (G) showing high FDG uptake in an area corresponding to the tumor mass in the right parietal lobe. The results of microsatellite analysis (H) revealing 1p/19q LOH.

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