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Correlation of molecular genetics with
molecular and morphological imaging in gliomas with an
oligodendroglial component
Walker C, du Plessis DG, Fildes D, Haylock B, Husband D, Jenkinson
MD, Joyce KA, Broome J, Kopitski K, Prosser J, Smith T, Vinjamuri S,
Warnke PC
JK Douglas Laboratories and Clatterbridge Centre for Oncology,
Clatterbridge Hospital, Bebington, Wirral, United Kingdom.
carol.walker@ccrt.nhs.uk
Purpose. Since the recognition that oligodendrogliomas
may be chemosensitive, their diagnosis and clinical management has
become highly controversial.
Histopathology diagnosis remains challenging and new tools such as
molecular genetics or molecular imaging require evaluation.
Experimental Design. In a
single-center, population-based prospective study, allelic imbalance
in chromosomes 1p36, 19q13, 17p13, 10p12-15, and 10q22-26 has been
investigated in 19 oligodendroglioma WHO grade 2 (OII), 20
oligoastrocytoma WHO grade 2 (OAII), 8 oligodendroglioma WHO grade 3
(OIII), and 12 oligoastrocytoma WHO grade 3 (OAIII), and compared with
pretherapy histopathology, computed tomography and/or magnetic
resonance (CT and/or MR), [fluorine-18]fluoro-2-deoxyglucose
(18F-FDG), and thallium-201 single-photon emission computed tomography
(201Tl SPECT).
Results. In 50 cases,
18F-FDG uptake correlated with 201Tl uptake; however, 8 cases had
increased 201Tl uptake but were hypometabolic for 18F-FDG, and 1 case
was hypermetabolic with normal 201Tl uptake.
Sixteen cases enhanced on CT/MR but failed to show 201Tl uptake; and 2
low-grade non-enhancing oligodendrogliomas had increased 201Tl
uptake.
Increased metabolism was more likely in high-grade cases, with 201Tl
uptake more strongly correlated with grade than was 18F-FDG
uptake.
Tumors with 1p/19q loss were more likely to show increased 201Tl
uptake and, to a lesser degree, increased 18F-FDG uptake than those
without these losses.
Elevated metabolism in 28% of low-grade tumors was significantly more
common in tumors with 1p/19q loss, and increased uptake of both
18F-FDG and 201Tl in low-grade cases was found only in those with
1p/19q loss.
Conclusions. In this
study, dissociation of uptake of contrast agents and radiotracers
suggests independent deregulation of the blood-brain barrier breakdown
and metabolism during disease progression of oligodendroglial
neoplasms, and the association of elevated metabolism with 1p/19q
loss, particularly in low-grade tumors, may have implications for
clinical management.
PMID: 15534091 [PubMed - indexed for MEDLINE]
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