Glioblastoma multiforme recurrence: An exploratory study of 18 F FPPRGD 2 PET/CT

Andrei Iagaru, Camila Mosci, Erik Mittra, Greg Zaharchuk, Nancy Fischbein, Griffith Harsh, Gordon Li, Seema Nagpal, Lawrence Recht, Sanjiv Sam Gambhir

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To prospectively evaluate fluorine 18 ( 18 F) 2-fluoropropionyl-labeled PEGylated dimeric arginine-glycine-aspartic acid (RGD) peptide (PEG3-E[c{RGDyk}]2) (FPPRGD 2 ) positron emission tomography (PET) in patients with glioblastoma multiforme (GBM). Materials and Methods: The institutional review board approved this HIPAA-compliant protocol. Written informed consent was obtained from each patient. 18 F FPPRGD 2 uptake was measured semiquantitatively in the form of maximum standardized uptake values (SUV max ) and uptake volumes before and after treatment with bevacizumab. Vital signs and laboratory results were collected before, during, and after the examinations. A nonparametric version of multivariate analysis of variance was used to assess safety outcome measures simultaneously across time points. A paired two-sample t test was performed to compare SUV max . Results: A total of 17 participants (eight men, nine women; age range, 25-65 years) were enrolled prospectively. 18 F FPPRGD 2 PET/computed tomography (CT), 18 F fluorodeoxyglucose (FDG) PET/CT, and brain magnetic resonance (MR) imaging were performed within 3 weeks, prior to the start of bevacizumab therapy. In eight of the 17 patients (47%), 18 F FPPRGD 2 PET/CT was repeated 1 week after the start of bevacizumab therapy; six patients (35%) underwent 18 F FPPRGD 2 PET/CT a third time 6 weeks after starting bevacizumab therapy. There were no changes in vital signs, electrocardiographic findings, or laboratory values that qualified as adverse events. One patient (6%) had recurrent GBM identified only on 18 F FPPRGD 2 PET images, and subsequent MR images enabled confirmation of recurrence. Of the 17 patients, 14 (82%) had recurrent GBM identified on 18 F FPPRGD 2 PET and brain MR images, while 18 F FDG PET enabled identification of recurrence in 13 (76%) patients. Two patients (12%) had no recurrent GBM. Conclusion: 18 F FPPRGD 2 is a safe PET radiopharmaceutical that has increased uptake in GBM lesions. Larger cohorts are required to confirm these preliminary findings.

Original languageEnglish (US)
Pages (from-to)497-506
Number of pages10
JournalRADIOLOGY
Volume277
Issue number2
DOIs
StatePublished - Nov 2015
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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