A prospective clinical study of the influence of oral protein intake on [18F]FET-PET uptake and test–retest repeatability in glioma
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A prospective clinical study of the influence of oral protein intake on [18F]FET-PET uptake and test–retest repeatability in glioma. / Chehri, Sarah; Henriksen, Otto Mølby; Marner, Lisbeth; Christensen, Mette; Muhic, Aida; Poulsen, Hans Skovgaard; Law, Ian.
In: EJNMMI Research, Vol. 14, No. 1, 58, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - A prospective clinical study of the influence of oral protein intake on [18F]FET-PET uptake and test–retest repeatability in glioma
AU - Chehri, Sarah
AU - Henriksen, Otto Mølby
AU - Marner, Lisbeth
AU - Christensen, Mette
AU - Muhic, Aida
AU - Poulsen, Hans Skovgaard
AU - Law, Ian
N1 - Publisher Copyright: © The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - Background: O-(2-[18F]fluoroethyl)-l-tyrosine positron emission tomography ([18F]FET PET) scanning is used in routine clinical management and evaluation of gliomas with a recommended 4 h prior fasting. Knowledge of test–retest variation of [18F]FET PET imaging uptake metrics and the impact of accidental protein intake can be critical for interpretation. The aim of this study was to investigate the repeatability of [18F]FET-PET metrics and to assess the impact of protein-intake prior to [18F]FET PET scanning of gliomas. Results: Test–retest variability in the non-protein group was good with absolute (and relative) upper and lower limits of agreement of + 0.15 and − 0.13 (+ 9.7% and − 9.0%) for mean tumour-to-background ratio (TBRmean), + 0.43 and − 0.28 (+ 19.6% and − 11.8%) for maximal tumour-to-background ratio (TBRmax), and + 2.14 cm3 and − 1.53 ml (+ 219.8% and − 57.3%) for biological tumour volume (BTV). Variation was lower for uptake ratios than for BTV. Protein intake was associated with a 27% increase in the total sum of plasma concentration of the l-type amino acid transporter 1 (LAT1) relevant amino acids and with decreased standardized uptake value (SUV) in both healthy appearing background brain tissue (mean SUV − 25%) and in tumour (maximal SUV − 14%). Oral intake of 24 g of protein 1 h prior to injection of tracer tended to increase variability, but the effects on derived tumour metrics TBRmean and TBRmax were only borderline significant, and changes generally within the variability observed in the group with no protein intake. Conclusion: The test–retest repeatability was found to be good, and better for TBRmax and TBRmean than BTV, with the methodological limitation that tumour growth may have influenced results. Oral intake of 24 g of protein one hour before a [18F]FET PET scan decreases uptake of [18F]FET in both tumour and in healthy appearing brain, with no clinically significant difference on the most commonly used tumour metrics.
AB - Background: O-(2-[18F]fluoroethyl)-l-tyrosine positron emission tomography ([18F]FET PET) scanning is used in routine clinical management and evaluation of gliomas with a recommended 4 h prior fasting. Knowledge of test–retest variation of [18F]FET PET imaging uptake metrics and the impact of accidental protein intake can be critical for interpretation. The aim of this study was to investigate the repeatability of [18F]FET-PET metrics and to assess the impact of protein-intake prior to [18F]FET PET scanning of gliomas. Results: Test–retest variability in the non-protein group was good with absolute (and relative) upper and lower limits of agreement of + 0.15 and − 0.13 (+ 9.7% and − 9.0%) for mean tumour-to-background ratio (TBRmean), + 0.43 and − 0.28 (+ 19.6% and − 11.8%) for maximal tumour-to-background ratio (TBRmax), and + 2.14 cm3 and − 1.53 ml (+ 219.8% and − 57.3%) for biological tumour volume (BTV). Variation was lower for uptake ratios than for BTV. Protein intake was associated with a 27% increase in the total sum of plasma concentration of the l-type amino acid transporter 1 (LAT1) relevant amino acids and with decreased standardized uptake value (SUV) in both healthy appearing background brain tissue (mean SUV − 25%) and in tumour (maximal SUV − 14%). Oral intake of 24 g of protein 1 h prior to injection of tracer tended to increase variability, but the effects on derived tumour metrics TBRmean and TBRmax were only borderline significant, and changes generally within the variability observed in the group with no protein intake. Conclusion: The test–retest repeatability was found to be good, and better for TBRmax and TBRmean than BTV, with the methodological limitation that tumour growth may have influenced results. Oral intake of 24 g of protein one hour before a [18F]FET PET scan decreases uptake of [18F]FET in both tumour and in healthy appearing brain, with no clinically significant difference on the most commonly used tumour metrics.
KW - Amino acid positron emission tomography
KW - Brain tumour
KW - Glioma
KW - Neuro-oncology
KW - Test–retest
U2 - 10.1186/s13550-024-01119-0
DO - 10.1186/s13550-024-01119-0
M3 - Journal article
C2 - 38922458
AN - SCOPUS:85197267404
VL - 14
JO - EJNMMI Research
JF - EJNMMI Research
SN - 2191-219X
IS - 1
M1 - 58
ER -
ID: 397714055