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68Ga-NOTA-Aca-BBN(7-14) PET imaging of GRPR in children with optic pathway glioma

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

Abstract

Purpose

Optic pathway glioma (OPG) is a rare neoplasm that arises predominantly during childhood. Its location in a sensitive region involving the optic pathways, onset in young patients and controversial therapy choice make the management of OPG a challenge in paediatric neuro-oncology. In this study we assessed gastrin-releasing peptide receptor (GRPR)-targeted positron emission tomography (PET) imaging in children with OPG, and the application of a PET/MRI imaging-guided surgery navigation platform.

Methods

Eight children (five boys, mean age 8.81 years, range 5–14 years) with suspicion of optic pathway glioma on MRI were recruited. Written informed consent was obtained from all patients and legal guardians. Brain PET/CT or PET/MRI acquisitions were performed 30 min after intravenous injection of 1.85 MBq/kg body weight of 68Ga-NOTA-Aca-BBN(7-14). Four patients also underwent 18F-FDG brain PET/CT for comparison. All patients underwent surgical resection within 1 week.

Results

All 11 lesions (100%) in the eight patients showed prominent 68Ga-NOTA-Aca-BBN(7-14) uptake with excellent contrast in relation to surrounding normal brain tissue. Tumour-to-background ratios (SUVmax and SUVmean) were significantly higher for 68Ga-NOTA-Aca-BBN(7-14) than for 18F-FDG (28.4 ± 5.59 vs. 0.47 ± 0.11 and 18.3 ± 4.99 vs. 0.35 ± 0.07, respectively). Fusion images for tumour delineation were obtained in all patients using the PET/MRI navigation platform. All lesions were pathologically confirmed as OPGs with positive GRPR expression, and 75% were pilocytic astrocytoma WHO grade I and 25% were diffuse astrocytoma WHO grade II. There was a positive correlation between the SUV of 68Ga-NOTA-Aca-BBN(7-14) and the expression level of GRPR (r2 = 0.56, P < 0.01, for SUVmax; r2 = 0.47, P < 0.05, for SUVmean).

Conclusion

This prospective study showed the feasibility of 68Ga-NOTA-Aca-BBN(7-14) PET in children with OPG for tumour detection and localization. 68Ga-NOTA-Aca-BBN(7-14) PET/MRI may be helpful for assisting surgery planning in OPG patients with severe symptoms, GRPR-targeted PET has the potential to provide imaging guidance for further GRPR-targeted therapy in patients with OPG.

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Acknowledgments

This work was supported in part by the Intramural Research Program (IRP) of the National Institute of Biomedical Imaging and Bioengineering (NIBIB), the National Institutes of Health (NIH), and the National Natural Science Foundation of China (81701742).

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Author notes

  1. Jingjing Zhang, Yongji Tian and Deling Li contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China

    Jingjing Zhang, Fang Li & Zhaohui Zhu

  2. Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Science and PUMC, Beijing, 100730, China

    Jingjing Zhang, Fang Li & Zhaohui Zhu

  3. THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, 99437, Bad Berka, Germany

    Jingjing Zhang

  4. Department of Pediatric Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing Key Laboratory of Brain Tumor, Beijing, 100730, China

    Yongji Tian & Yuhan Liu

  5. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing Key Laboratory of Brain Tumor, Beijing, 100730, China

    Deling Li

  6. Laboratory of Molecular Imaging and Nanomedicine (LOMIN), National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda, MD, 20892, USA

    Gang Niu, Lixin Lang & Xiaoyuan Chen

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Zhang, J., Tian, Y., Li, D. et al. 68Ga-NOTA-Aca-BBN(7-14) PET imaging of GRPR in children with optic pathway glioma. Eur J Nucl Med Mol Imaging 46, 2152–2162 (2019). https://doi.org/10.1007/s00259-019-04392-7

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