Dynamic study of methionine positron emission tomography in patients with glioblastoma with oligodendroglial components.

Anaplastic oligoastrocytoma (AOA) with necrosis is classified as glioblastoma (GBM) with oligodendroglioma component (GBMO), according to the 2007 World Health Organization classification. The prognosis of GBMO remains controversial because definitive diagnostic criteria regarding the percentage of the oligodendroglial components (OC) in the GBM do not exist. We previously reported dynamic methionine (MET) positron emission tomography (PET) in patients with these tumors. A significant decrease in the MET signal was seen in oligodendrocytic tumors, in contrast to a significant MET increase in GBMs. In this study, we analyzed the dynamic MET PET signal in four patients with primary (n = 2) and secondary (n = 2) GBMOs. Static PET scanning was performed in three consecutive phases. Both cases of primary GBMOs and one case of secondary GBMO presented with a gradual decrease in MET PET signal over the consecutive phases. In contrast, the remaining case of secondary GBMO presented with a pattern of slight increase. It is likely that the dynamic change of MET in patients with GBMO resemble those in patients with oligodendroglial tumor, however, further studies are needed to confirm them. We discuss the mechanisms from a viewpoint of pathological findings.

Quantitative susceptibility mapping differentiates between blood depositions and calcifications in patients with glioblastoma.

OBJECTIVES: The application of susceptibility weighted imaging (SWI) in brain tumor imaging is mainly used to assess tumor-related "susceptibility based signals" (SBS). The origin of SBS in glioblastoma is still unknown, potentially representing calcifications or blood depositions. Reliable differentiation between both entities may be important to evaluate treatment response and to identify glioblastoma with oligodendroglial components that are supposed to present calcifications. Since calcifications and blood deposits are difficult to differentiate using conventional MRI, we investigated whether a new post-processing approach, quantitative susceptibility mapping (QSM), is able to distinguish between both entities reliably. MATERIALS AND METHODS: SWI, FLAIR, and T1-w images were acquired from 46 patients with glioblastoma (14 newly diagnosed, 24 treated with radiochemotherapy, 8 treated with radiochemotherapy and additional anti-angiogenic medication). Susceptibility maps were calculated from SWI data. All glioblastoma were evaluated for the appearance of hypointense or hyperintense correlates of SBS on the susceptibility maps. RESULTS: 43 of 46 glioblastoma presented only hyperintense intratumoral SBS on susceptibility maps, indicating blood deposits. Additional hypointense correlates of tumor-related SBS on susceptibility maps, indicating calcification, were identified in 2 patients being treated with radiochemotherapy and in one patient being treated with additional anti-angiogenic medication. Histopathologic reports revealed an oligodendroglial component in one patient that presented calcifications on susceptibility maps. CONCLUSIONS: QSM provides a quantitative, local MRI contrast, which reliably differentiates between blood deposits and calcifications. Thus, quantitative susceptibility mapping appears promising to identify rare variants of glioblastoma with oligodendroglial components non-invasively and may allow monitoring the role of calcification in the context of different therapy regimes.

11C-methionine uptake correlates with combined 1p and 19q loss of heterozygosity in oligodendroglial tumors.

BACKGROUND AND PURPOSE: Oligodendroglial tumors with 1p/19q LOH are known to show longer patient survival than those without 1p/19q LOH, but the reason for this clinical difference has not been elucidated, to our knowledge. This study was designed to clarify whether uptake of MET correlates with 1p/19q LOH of oligodendroglial tumors. MATERIALS AND METHODS: This study included 102 consecutive patients with supratentorial WHO grade II and III oligodendroglial tumors (39 oligoastrocytic and 63 oligodendroglial tumors) that were resected and diagnosed between January 2008 and August 2011 at Tokyo Women's Medical University Hospital. These patients underwent MET PET T/N ratio measurement before treatment. T/N ratios were calculated by dividing the maximum SUV for the tumor by the mean SUV of the contralateral normal frontal cortex. After surgery, FISH for resected tissues was used to determine 1p/19q LOH. RESULTS: The mean T/N ratio of tumors with 1p/19q LOH was significantly greater than that of tumors without 1p/19q LOH (P = .0166). The threshold T/N ratio value of 2.46 was found to correlate significantly with 1p/19q LOH by univariate (P = .0011) and multivariate analyses (P = .0209) in all tumors. CONCLUSIONS: The T/N ratio on MET PET might be a useful aid to the diagnosis of 1p/19q LOH. Our data add new information on the biology and imaging characteristics of oligodendroglial tumors with 1p/19q LOH.

Peroxisomal and mitochondrial status of two murine oligodendrocytic cell lines (158N, 158JP): potential models for the study of peroxisomal disorders associated with dysmyelination processes.

In some neurodegenerative disorders (leukodystrophies) characterized by myelin alterations, the defect of peroxisomal functions on myelin-producing cells (oligodendrocytes) are poorly understood. The development of in vitro models is fundamental to understanding the physiopathogenesis of these diseases. We characterized two immortalized murine oligodendrocyte cell lines: a normal (158N) and a jimpy (158JP) cell line mutated for the proteolipid protein PLP/DM20. Fluorescence microscopy, flow cytometry, and western blotting analysis allow to identify major myelin proteins (PLP colocalizing with mitochondria; myelin basic protein), oligodendrocyte (CNPase and myelin oligodendrocyte glycoprotein), and peroxisomal markers [adrenoleukodystrophy protein, PMP70, acyl-CoA oxidase 1 (ACOX1), l-peroxisomal bifunctional enzyme, and catalase]. Using electron microscopy, peroxisomes were identified in the two cell lines. Gene expression (ATP-binding cassette, Abcd1, Abcd2, Abcd3, and Acox1) involved in peroxisomal transport or beta-oxidation of fatty acids was evaluated using quantitative PCR. 4-phenylbutyrate treatment increases expression of ACOX1, l-peroxisomal bifunctional enzyme, PLP, myelin oligodendrocyte glycoprotein, and CNPase, mainly in 158N cells. In both cell lines, 4-phenylbutyrate-induced ACOX1 and catalase activities while only Abcd2 gene was up-regulated in 158JP. Moreover, the higher mitochondrial activity and content observed in 158JP were associated with higher glutathione content and increased basal production of reactive oxygen species revealing different redox statuses. Altogether, 158N and 158JP cells will permit studying the relationships between peroxisomal defects, mitochondrial activity, and oligodendrocyte functions.

Baseline 11C-methionine PET reflects the natural course of grade 2 oligodendrogliomas.

OBJECTIVES: The aim of the present study was to assess the usefulness of positron emission tomography (PET) with the amino acid tracer 11C-methionine (MET) as a predictor of time to progression (TTP) in patients with supratentorial grade 2 gliomas. METHODS: Twenty-seven patients with glioma grade 2 subjected to a baseline PET scan received no anti-tumour treatment except for a diagnostic operation, and were followed until tumour progression. The prognostic impact of the MET uptake and of other prognostic factors was studied. RESULTS: Twenty-five of the patients (93%) experienced tumour progression after a median of 103 weeks. Low uptake of MET was a predictor for long TTP in patients with oligodendrogliomas (p = 0.04) but not in astrocytomas/oligoastrocytomas. Other predictors for long TTP were oligodendroglioma histology (p = 0.009) and seizures as presenting symptom (p = 0.03). Favourable prognostic factors for overall survival were oligodendroglioma histology (p = 0.002) and good performance status (p = 0.03). CONCLUSIONS: PET MET has a definite role in the therapeutic management of grade 2 gliomas. However, for the optimal use of PET MET in the clinical management of these patients, histological subclassification of the tumour is required.

Response of the oligodendrocyte progenitor cell population (defined by NG2 labelling) to demyelination of the adult spinal cord.

Elucidation of the response of oligodendrocyte progenitor cell populations to demyelination in the adult central nervous system (CNS) is critical to understanding why remyelination fails in multiple sclerosis. Using the anti-NG2 monoclonal antibody to identify oligodendrocyte progenitor cells, we have documented their response to antibody-induced demyelination in the dorsal column of the adult rat spinal cord. The number of NG2+ cells in the vicinity of demyelinated lesions increased by 72% over the course of 3 days following the onset of demyelination. This increase in NG2+ cell numbers did not reflect a nonspecific staining of reactive cells, as GFAP, OX-42, and Rip antibodies did not co-localise with NG2 + cells in double immunostained tissue sections. NG2 + cells incorporated BrdU 48-72 h following the onset of demyelination. After the onset of remyelination (10-14 days), the number of NG2+ cells decreased to 46% of control levels and remained consistently low for 2 months. When spinal cords were exposed to 40 Grays of x-irradiation prior to demyelination, the number of NG2+ cells decreased to 48% of control levels by 3 days following the onset of demyelination and remained unchanged at 3 weeks. Since 40 Grays of x-irradiation kills dividing cells, these studies illustrate a responsive and nonresponsive NG2+ cell population following demyelination in the adult spinal cord and suggest that the responsive NG2+ cell population does not renew itself.