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Intra-individual comparison of p-[123I]-iodo-L-phenylalanine and L-3-[123I]-iodo-α-methyl-tyrosine for SPECT imaging of gliomas

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Objectives

Radioactive amino-acids accumulate in gliomas even with an intact blood-brain-barrier. L-3-[123I]-iodo-α-methyl-tyrosine (IMT) is well established for SPECT imaging of gliomas. Recently, we introduced p-[123I]-iodo-L-phenylalanine (IPA) for the characterisation of brain lesions. This study compares both tracers in glioma patients.

Methods

Eleven patients with gliomas (1 WHO grade 1, 5 grade 2, 1 grade 3, 2 grade 4 gliomas, 1 unconfirmed upgrading and 1 post-therapeutic non-neoplastic lesion) underwent SPECT imaging with IPA (early and delayed acquisitions at 30 min and 3 h) and IMT (early only). Maximum tumour-to-brain ratios (TBR) were calculated using region-of-interest analysis to assess uptake of IMT and IPA. Imaging results were compared to histopathological findings.

Results

Early TBRs of IMT and IPA were strongly correlated (r = 0.828, p = 0.002). TBRs were higher for IMT than IPA (1.95±0.50 versus 1.79±0.42; p < 0.05), but independent from tumour cell density (p > 0.1). Visual interpretation by different observers was more concordant for IMT-SPECT than IPA-SPECT (kappa 1.0 versus 0.774). No differences in early TBRs were observed between low-grade and high-grade gliomas for IMT (1.97±0.53 versus 2.21±0.44, p > 0.5) or IPA (1.70±0.23 versus 2.21±0.56, p = 0.167) with a trend to higher TBRs in low-grade tumours for IMT (p = 0.093). In contrast to the known wash-out of IMT, we observed persistent accumulation of IPA in gliomas.

Conclusions

IPA shows lower TBRs than IMT, especially in low-grade tumours, so IMT should be preferred for the delineation of low-grade gliomas by SPECT imaging. Due to its prolonged retention, however, IPA remains promising for therapeutic use in gliomas after labelling with I-131.

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Acknowledgements

The authors thank the staff of the Department of Nuclear Medicine for their excellent assistance in patient studies and Ms. Susanne Bock for her assistance with the quantification of the SPECT data. This study was supported by a grant of the “Deutsche Krebshilfe” (70-3024-He 1).

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Author notes

  1. Bernd F. M. Romeike

    Present address: Department of Neuropathology, Friedrich-Schiller-University, 07747, Jena, Germany

Authors and Affiliations

  1. Department of Nuclear Medicine, Saarland University Medical Center, 66421, Homburg, Germany

    Dirk Hellwig, Carl-Martin Kirsch & Samuel Samnick

  2. Institute of Neuropathology, Saarland University Medical Center, 66421, Homburg, Germany

    Bernd F. M. Romeike

  3. Department of Neurosurgery, Saarland University Medical Center, 66421, Homburg, Germany

    Ralf Ketter & Jean R. Moringlane

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  1. Dirk Hellwig
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Correspondence to Dirk Hellwig.

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This work was supported by a grant from the “Deutsche Krebshilfe” (70-3024-He 1).

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Hellwig, D., Romeike, B.F.M., Ketter, R. et al. Intra-individual comparison of p-[123I]-iodo-L-phenylalanine and L-3-[123I]-iodo-α-methyl-tyrosine for SPECT imaging of gliomas. Eur J Nucl Med Mol Imaging 35, 24–31 (2008). https://doi.org/10.1007/s00259-007-0514-2

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