RT Journal Article SR Electronic T1 62Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) PET in Human Gliomas: Comparative Study with [18F]Fluorodeoxyglucose and L-Methyl-[11C]Methionine PET JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology DO 10.3174/ajnr.A3679 A1 K. Tateishi A1 U. Tateishi A1 S. Nakanowatari A1 M. Ohtake A1 R. Minamimoto A1 J. Suenaga A1 H. Murata A1 K. Kubota A1 T. Inoue A1 N. Kawahara YR 2013 UL http://www.ajnr.org/content/early/2013/08/14/ajnr.A3679.abstract AB BACKGROUND AND PURPOSE: 62Cu-diacetyl-bis(N4-methylthiosemicarbazone) was developed as a hypoxic radiotracer in PET. We compared imaging features among MR imaging and 62Cu-diacetyl-bis(N4-methylthiosemicarbazone)-PET, FDG-PET, and L-methyl-[11C]methionine)-PET in gliomas. MATERIALS AND METHODS: We enrolled 23 patients who underwent 62Cu-diacetyl-bis(N4-methylthiosemicarbazone)-PET and FDG-PET and 19 (82.6%) who underwent L-methyl-[11C]methionine)–PET, with all 23 patients undergoing surgery and their diagnosis being then confirmed by histologic examination as a glioma. Semiquantitative and volumetric analysis were used for the comparison. RESULTS: There were 10 newly diagnosed glioblastoma multiforme and 13 nonglioblastoma multiforme (grades II and III), including 4 recurrences without any adjuvant treatment. The maximum standardized uptake value and tumor/background ratios of 62Cu-diacetyl-bis(N4-methylthiosemicarbazone), as well as L-methyl-[11C]methionine, were significantly higher in glioblastoma multiforme than in nonglioblastoma multiforme (P = .03 and P = .03, respectively); no significant differences were observed on FDG. At a tumor/background ratio cutoff threshold of 1.9, 62Cu-diacetyl-bis(N4-methylthiosemicarbazone) was most predictive of glioblastoma multiforme, with 90.0% sensitivity and 76.9% specificity. The positive and negative predictive values, respectively, for glioblastoma multiforme were 75.0% and 85.7% on 62Cu-diacetyl-bis(N4-methylthiosemicarbazone), 83.3% and 60.0% on L-methyl-[11C]methionine, and 72.7% and 75.0% on MR imaging. In glioblastoma multiforme, volumetric analysis demonstrated that 62Cu-diacetyl-bis(N4-methylthiosemicarbazone) uptake had significant correlations with FDG (r = 0.68, P = .03) and L-methyl-[11C]methionine (r = 0.87, P = .03). However, the 62Cu-diacetyl-bis(N4-methylthiosemicarbazone)–active region was heterogeneously distributed in 50.0% (5/10) of FDG-active and 0% (0/6) of L-methyl-[11C]methionine)–active regions. CONCLUSIONS: 62Cu-diacetyl-bis(N4-methylthiosemicarbazone) may be a practical radiotracer in the prediction of glioblastoma multiforme. In addition to FDG-PET, L-methyl-[11C]methionine)–PET, and MR imaging, 62Cu-diacetyl-bis(N4-methylthiosemicarbazone)-PET may provide intratumoral hypoxic information useful in establishing targeted therapeutic strategies for patients with glioblastoma multiforme. Abbreviations 62Cu-ATSM62Cu-diacetyl-bis(N4-methylthiosemicarbazone)GBMglioblastoma multiformeMETL-methyl-[11C]methioninenon-GBM gliomasWorld Health Organization grade II and III gliomasSUVmaxmaximum standardized uptake valueT/B ratiotumor/background ratio