Characterization of Diffuse Gliomas With Histone H3-G34 Mutation by MRI and Dynamic 18F-FET PET.

Abstract

BACKGROUND:

Recent data suggest that diffuse gliomas carrying mutations in codon 34 of the H3 histone family 3A protein represent a very rare, distinct subgroup of IDH-wild type malignant astrocytic gliomas. However, characteristics detectable by MRI and F-FET PET in H3-G34-mutant gliomas are unknown.

METHODS:

We report on MRI and F-FET PET findings in 8 patients from 4 German centers with H3-G34-mutant diffuse gliomas. MRI analyses included multifocality, contrast enhancement, necrosis, cysts, hemorrhages, calcification, and edema. F-FET PET characteristics were evaluated on the basis of static F-FET PET parameters, such as maximal tumor-to-background ratio (TBRmax) and biological tumor volume (BTV), as well as the minimal time-to-peak (TTPmin) obtained from dynamic F-FET PET data.

RESULTS:

MRI showed multifocal lesions in 2 of 8, contrast enhancement in 6 of 8, necrosis in 3 of 8, cysts in 3 of 8, hemorrhage in 1 of 8, and calcifications in 1 of 8 patients. None of the tumors showed marked peritumoral edema. However, all 8 H3-G34-mutant gliomas were characterized by a high uptake intensity on F-FET PET with a median TBRmax of 3.4 (range, 2.5-11.7) and a relatively diffuse uptake pattern leading to a large BTV (median, 41.9 mL; range, 7.5-115.6). Dynamic PET data revealed a short median TTPmin of 12.5 minutes.

CONCLUSIONS:

MRI features of diffuse gliomas with H3-G34 mutation may present very heterogeneously with some cases not even fulfilling the imaging criteria of high-grade glioma. In contrast, in F-FET PET, these tumors show an extensive and diffuse tracer uptake resulting in large BTV with a high TBRmax and a short TTPmin, thus resembling PET characteristics of aggressive high-grade gliomas, namely, glioblastomas.

• Authors: Franziska J Vettermann, Jörg Felsberg, Guido Reifenberger, Martin Hasselblatt, Robert Forbrig, Georg Berding, Christian la Fougère, Norbert Galldiks, Jens Schittenhelm, Joachim Weis, Nathalie L Albert, Ulrich Schüller
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 43 Issue 12 Pg. 895-898 (Dec 2018) ISSN: 1536-0229 [Electronic] United States
• PMID: 30358620 (Publication Type: Journal Article)

Chemical References

• Histones
• Radiopharmaceuticals
• (18F)fluoroethyltyrosine
• Tyrosine

Topics

• Adolescent
• Adult
• Brain Neoplasms (diagnostic imaging, genetics)
• Child
• Female
• Glioma (diagnostic imaging, genetics)
• Histones (genetics)
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Mutation
• Positron-Emission Tomography
• Radiopharmaceuticals
• Tyrosine (analogs & derivatives)