(62)Cu-diacetyl-bis (N(4)-methylthiosemicarbazone) PET in human gliomas: comparative study with [(18)F]fluorodeoxyglucose and L-methyl-[(11)C]methionine PET.

Abstract

BACKGROUND AND PURPOSE:

(62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) was developed as a hypoxic radiotracer in PET. We compared imaging features among MR imaging and (62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone)-PET, FDG-PET, and L-methyl-[(11)C]methionine)-PET in gliomas.

MATERIALS AND METHODS:

We enrolled 23 patients who underwent (62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone)-PET and FDG-PET and 19 (82.6%) who underwent L-methyl-[(11)C]methionine)-PET, with all 23 patients undergoing surgery and their diagnosis being then confirmed by histologic examination as a glioma. Semiquantitative and volumetric analysis were used for the comparison.

RESULTS:

There were 10 newly diagnosed glioblastoma multiforme and 13 nonglioblastoma multiforme (grades II and III), including 4 recurrences without any adjuvant treatment. The maximum standardized uptake value and tumor/background ratios of (62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone), as well as L-methyl-[(11)C]methionine, were significantly higher in glioblastoma multiforme than in nonglioblastoma multiforme (P = .03 and P = .03, respectively); no significant differences were observed on FDG. At a tumor/background ratio cutoff threshold of 1.9, (62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) was most predictive of glioblastoma multiforme, with 90.0% sensitivity and 76.9% specificity. The positive and negative predictive values, respectively, for glioblastoma multiforme were 75.0% and 85.7% on (62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone), 83.3% and 60.0% on L-methyl-[(11)C]methionine, and 72.7% and 75.0% on MR imaging. In glioblastoma multiforme, volumetric analysis demonstrated that (62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) uptake had significant correlations with FDG (r = 0.68, P = .03) and L-methyl-[(11)C]methionine (r = 0.87, P = .03). However, the (62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone)-active region was heterogeneously distributed in 50.0% (5/10) of FDG-active and 0% (0/6) of L-methyl-[(11)C]methionine)-active regions.

CONCLUSIONS:

(62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) may be a practical radiotracer in the prediction of glioblastoma multiforme. In addition to FDG-PET, L-methyl-[(11)C]methionine)-PET, and MR imaging, (62)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone)-PET may provide intratumoral hypoxic information useful in establishing targeted therapeutic strategies for patients with glioblastoma multiforme.

• Authors: K Tateishi, U Tateishi, S Nakanowatari, M Ohtake, R Minamimoto, J Suenaga, H Murata, K Kubota, T Inoue, N Kawahara
• Journal: AJNR. American journal of neuroradiology (AJNR Am J Neuroradiol) Vol. 35 Issue 2 Pg. 278-84 (Feb 2014) ISSN: 1936-959X [Electronic] United States
• PMID: 23928140 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Coordination Complexes
• Copper Radioisotopes
• Organometallic Compounds
• Radiopharmaceuticals
• Thiosemicarbazones
• copper (II) diacetyl-di(N(4)-methylthiosemicarbazone)
• Fluorodeoxyglucose F18
• Methionine
• methionine methyl ester

Topics

• Adult
• Aged
• Aged, 80 and over
• Brain Neoplasms (diagnostic imaging, metabolism)
• Coordination Complexes
• Copper Radioisotopes
• Female
• Fluorodeoxyglucose F18 (pharmacokinetics)
• Glioma (diagnostic imaging, metabolism)
• Humans
• Male
• Methionine (analogs & derivatives, pharmacokinetics)
• Middle Aged
• Organometallic Compounds (pharmacokinetics)
• Positron-Emission Tomography (methods)
• Radiopharmaceuticals (pharmacokinetics)
• Reproducibility of Results
• Sensitivity and Specificity
• Thiosemicarbazones (pharmacokinetics)
• Young Adult