Research ArticleClinical Investigations

TGF-β Antibody Uptake in Recurrent High-Grade Glioma Imaged with 89Zr-Fresolimumab PET

Martha W. den Hollander, Frederike Bensch, Andor W.J.M. Glaudemans, Thijs H. Oude Munnink, Roelien H. Enting, Wilfred F.A. den Dunnen, Mart A.A.M. Heesters, Frank A.E. Kruyt, Marjolijn N. Lub-de Hooge, Jan Cees de Groot, Joseph Pearlberg, Jourik A. Gietema, Elisabeth G.E. de Vries and Annemiek M.E. Walenkamp
Journal of Nuclear Medicine September 2015, 56 (9) 1310-1314; DOI: https://doi.org/10.2967/jnumed.115.154401

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    (A) Representative example of 89Zr-fresolimumab PET on day 4 and uptake in brain tumor (arrow). (B) Uptake of 89Zr-fresolimumab in different organs (SUVmean) and tumor (SUVmax) on day 4 after tracer injection. Blood pool uptake was measured in sinus confluens. Blood, brain, and tumor values were measured in 12 patients, other organs in 7 patients.

  • FIGURE 2.
    FIGURE 2.

    (A) PET/MR images of patient with 2 contrast-enhancing lesions. High uptake is visible in frontal lesion (left) but not in previously irradiated occipital lesion (right). (B) PET/MR images of patient with 2 contrast-enhancing lesions. SUVmax was 5.5 in progressive right frontal lesion and 2.1 in previously irradiated right paraventricular lesion. (C) Whole-body PET scans on days 2 (left) and 4 (right) showing increase in SUVmax from 4.0 to 5.5 in frontal brain lesion (arrows). Tumor-to-blood ratio increased from 0.8 to 1.2. (D) Tumor-to-blood ratios on 89Zr-fresolimumab PET in 4 patients on days 2 and 4.

  • FIGURE 3.
    FIGURE 3.

    Correlation between TGF-β1 in plasma and mean SUVmax of 89Zr-fresilimumab in brain tumor lesions on day 4 after injection (r = 0.61, P = 0.04).

  • FIGURE 4.
    FIGURE 4.

    GBM with central necrosis on hematoxylin and eosin (A) and p-SMAD2 (B) staining of same area.

Tables

  • TABLE 1

    Patient Characteristics

    CharacteristicNo.
    Number of patients12
    Age (y)
     Median51
     Range32–68
    Sex
     Male6
     Female6
    Tumor type
     GBM10
     Anaplastic astrocytoma1
     Anaplastic oligodendroglioma1
    No. of previous treatments
     Median2
     Range1–8
    Previous treatment
     Surgery11
     Radiotherapy + temozolomide9
     Radiotherapy2
     Repeated resection5
     Reirradiation4
     Temozolomide3
     Lomustine2
     Bevacizumab1
  • TABLE 2

    Hematologic Adverse Events and Most Common Nonhematologic Adverse Events

    Adverse eventNo. of casesGrade 1Grade 2Grade 3
    Neurologic deterioration16385
    Headache12732
    Skin disorders871
    Nausea7331
    Fatigue624
    Thrombocytopenia66
    Anemia55
    Leukopenia22
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