Glioblastoma multiforme recurrence: An exploratory study of 18F FPPRGD2 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 journalArticle

22 Citations (Scopus)

Abstract

Purpose: To prospectively evaluate fluorine 18 (18F) 2-fluoropropionyl-labeled PEGylated dimeric arginine-glycine-aspartic acid (RGD) peptide (PEG3-E[c{RGDyk}]2) (FPPRGD2) 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. 18F FPPRGD2 uptake was measured semiquantitatively in the form of maximum standardized uptake values (SUVmax) 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 SUVmax. Results: A total of 17 participants (eight men, nine women; age range, 25-65 years) were enrolled prospectively. 18F FPPRGD 2 PET/computed tomography (CT), 18F 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%), 18F FPPRGD2 PET/CT was repeated 1 week after the start of bevacizumab therapy; six patients (35%) underwent 18F FPPRGD2 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 18F FPPRGD2 PET images, and subsequent MR images enabled confirmation of recurrence. Of the 17 patients, 14 (82%) had recurrent GBM identified on 18F FPPRGD2 PET and brain MR images, while 18F FDG PET enabled identification of recurrence in 13 (76%) patients. Two patients (12%) had no recurrent GBM. Conclusion: 18F FPPRGD2 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 - Jan 1 2015
Externally publishedYes

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Glioblastoma
Recurrence
Positron-Emission Tomography
Vital Signs
Fluorodeoxyglucose F18
Magnetic Resonance Spectroscopy
Health Insurance Portability and Accountability Act
Radiopharmaceuticals
Fluorine
2-fluoropropionyl-PEG3-E(c(RGDyk))2
Positron Emission Tomography Computed Tomography
Research Ethics Committees
Brain
Therapeutics
Informed Consent
Aspartic Acid
Glycine
Arginine
Analysis of Variance
Multivariate Analysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Iagaru, A., Mosci, C., Mittra, E., Zaharchuk, G., Fischbein, N., Harsh, G., ... Gambhir, S. S. (2015). Glioblastoma multiforme recurrence: An exploratory study of 18F FPPRGD2 PET/CT. Radiology, 277(2), 497-506. https://doi.org/10.1148/radiol.2015141550

Glioblastoma multiforme recurrence : An exploratory study of 18F FPPRGD2 PET/CT. / Iagaru, Andrei; Mosci, Camila; Mittra, Erik; Zaharchuk, Greg; Fischbein, Nancy; Harsh, Griffith; Li, Gordon; Nagpal, Seema; Recht, Lawrence; Gambhir, Sanjiv Sam.

In: Radiology, Vol. 277, No. 2, 01.01.2015, p. 497-506.

Research output: Contribution to journalArticle

Iagaru, A, Mosci, C, Mittra, E, Zaharchuk, G, Fischbein, N, Harsh, G, Li, G, Nagpal, S, Recht, L & Gambhir, SS 2015, 'Glioblastoma multiforme recurrence: An exploratory study of 18F FPPRGD2 PET/CT', Radiology, vol. 277, no. 2, pp. 497-506. https://doi.org/10.1148/radiol.2015141550
Iagaru, Andrei ; Mosci, Camila ; Mittra, Erik ; Zaharchuk, Greg ; Fischbein, Nancy ; Harsh, Griffith ; Li, Gordon ; Nagpal, Seema ; Recht, Lawrence ; Gambhir, Sanjiv Sam. / Glioblastoma multiforme recurrence : An exploratory study of 18F FPPRGD2 PET/CT. In: Radiology. 2015 ; Vol. 277, No. 2. pp. 497-506.
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abstract = "Purpose: To prospectively evaluate fluorine 18 (18F) 2-fluoropropionyl-labeled PEGylated dimeric arginine-glycine-aspartic acid (RGD) peptide (PEG3-E[c{RGDyk}]2) (FPPRGD2) 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. 18F FPPRGD2 uptake was measured semiquantitatively in the form of maximum standardized uptake values (SUVmax) 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 SUVmax. Results: A total of 17 participants (eight men, nine women; age range, 25-65 years) were enrolled prospectively. 18F FPPRGD 2 PET/computed tomography (CT), 18F 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{\%}), 18F FPPRGD2 PET/CT was repeated 1 week after the start of bevacizumab therapy; six patients (35{\%}) underwent 18F FPPRGD2 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 18F FPPRGD2 PET images, and subsequent MR images enabled confirmation of recurrence. Of the 17 patients, 14 (82{\%}) had recurrent GBM identified on 18F FPPRGD2 PET and brain MR images, while 18F FDG PET enabled identification of recurrence in 13 (76{\%}) patients. Two patients (12{\%}) had no recurrent GBM. Conclusion: 18F FPPRGD2 is a safe PET radiopharmaceutical that has increased uptake in GBM lesions. Larger cohorts are required to confirm these preliminary findings.",
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AU - Mosci, Camila

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AU - Zaharchuk, Greg

AU - Fischbein, Nancy

AU - Harsh, Griffith

AU - Li, Gordon

AU - Nagpal, Seema

AU - Recht, Lawrence

AU - Gambhir, Sanjiv Sam

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N2 - Purpose: To prospectively evaluate fluorine 18 (18F) 2-fluoropropionyl-labeled PEGylated dimeric arginine-glycine-aspartic acid (RGD) peptide (PEG3-E[c{RGDyk}]2) (FPPRGD2) 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. 18F FPPRGD2 uptake was measured semiquantitatively in the form of maximum standardized uptake values (SUVmax) 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 SUVmax. Results: A total of 17 participants (eight men, nine women; age range, 25-65 years) were enrolled prospectively. 18F FPPRGD 2 PET/computed tomography (CT), 18F 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%), 18F FPPRGD2 PET/CT was repeated 1 week after the start of bevacizumab therapy; six patients (35%) underwent 18F FPPRGD2 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 18F FPPRGD2 PET images, and subsequent MR images enabled confirmation of recurrence. Of the 17 patients, 14 (82%) had recurrent GBM identified on 18F FPPRGD2 PET and brain MR images, while 18F FDG PET enabled identification of recurrence in 13 (76%) patients. Two patients (12%) had no recurrent GBM. Conclusion: 18F FPPRGD2 is a safe PET radiopharmaceutical that has increased uptake in GBM lesions. Larger cohorts are required to confirm these preliminary findings.

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