Immuno-PET for Glioma Imaging: An Update
Source abstract
Abstract
Despite significant advances in glioma diagnosis and treatment, overall outcomes remain suboptimal. Exploring novel therapeutic avenues show promise in advancing the field. Theranostics, an evolving discipline integrating diagnosis and therapy, emerges as a particularly auspicious approach. However, an unmet need exists for glioma-associated biomarkers as theranostic targets. Immuno-positron emission tomography (Immuno-PET), a pioneering method uniting PET diagnostic precision with antibody specificity, holds potential for identifying cancer-associated biomarkers. This review aims to provide an updated overview of immuno-PET applications in gliomas. Notably, [44Sc]-CHX-A″-DTPA-Cetuximab-Fab targeting Epidermal Growth Factor Receptor (EGFR) has displayed promise in glioma xenografts, enabling potential imaging at 4 h post-injection. Similarly, [89Zr]-bevacizumab targeting vascular endothelial growth factor (VEGF) yielded encouraging results in preclinical models and a pioneering clinical trial for pediatric patients with diffuse intrinsic pontine glioma (DIPG). Several cell differentiation markers, including CD146, indicative of tumor aggressiveness, and CD11b, reflecting tumor-associated myeloid cells (TAMCs), proved effective targets for immuno-PET. Additionally, immuno-PET directed at prostate-specific antigen (PSMA) demonstrated efficacy in imaging glioma-associated neovasculature. While holding promise for precise diagnosis and treatment guidance, challenges persist in achieving target specificity and selecting suitable radionuclides. Further studies are imperative to advance the field and bridge a translational gap from bench to bedside.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Glioma Diagnosis and Treatment · Medical Imaging Techniques and Applications · Radiomics and Machine Learning in Medical Imaging
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy
Section of Nuclear Medicine and Health Physics, Department of Medicine and Surgery, University of Perugia, Piazza Lucio Severi 1, 06132 Perugia, Italy
Nuclear Medicine Unit, Department of Oncology and Hematology, University Hospital of Modena, Via del Pozzo 71, 41124 Modena, Italy
Nuclear Medicine Unit, Department of Oncohaematology, Fondazione PTV, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
References (73)
Show source-provided references
1. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2015–201910.1093/neuonc/noac202 ↗
2. Malignant Gliomas in Adults10.1056/NEJMra0708126 ↗
3. Liang, J., Lv, X., Lu, C., Ye, X., Chen, X., Fu, J., Luo, C., and Zhao, Y. (2020). Prognostic Factors of Patients with Gliomas—An Analysis on 335 Patients with Glioblastoma and Other Forms of Gliomas. BMC Cancer, 20.10.1186/s12885-019-6511-6 ↗
4. Frosina, G. (2023). Recapitulating the Key Advances in the Diagnosis and Prognosis of High-Grade Gliomas: Second Half of 2021 Update. Int. J. Mol. Sci., 24.10.3390/ijms24076375 ↗
5. Treatment of Adult Gliomas: A Current Update10.12786/bn.2022.15.e24 ↗
6. Immunotherapy for Malignant Gliomas10.1007/978-3-319-12048-5_9 ↗
7. Insights into Molecular Therapy of Glioma: Current Challenges and next Generation Blueprint10.1038/aps.2016.167 ↗
8. Werner, R.A., Higuchi, T., Pomper, M.G., and Rowe, S.P. (2021). Theranostics in Oncology-Thriving, Now More than Ever. Diagnostics, 11.10.3390/diagnostics11050805 ↗
9. WHO 2016 Classification of Gliomas10.1111/nan.12432 ↗
10. The 2021 WHO Classification of Tumors of the Central Nervous System: A Summary10.1093/neuonc/noab106 ↗
11. World Health Organization 2021 Classification of Central Nervous System Tumors and Implications for Therapy for Adult-Type Gliomas: A Review10.1001/jamaoncol.2022.2844 ↗
12. Cancer Genome Atlas Research Network, Brat, D.J., Verhaak, R.G.W., Aldape, K.D., Yung, W.K.A., Salama, S.R., Cooper, L.A.D., Rheinbay, E., Miller, C.R., and Vitucci, M. (2015). Comprehensive, Integrative Genomic Analysis of Diffuse Lower-Grade Gliomas. N. Engl. J. Med., 372, 2481–2498.10.1056/NEJMoa1402121 ↗
13. Natural History and Growth Patterns of Incidentally Discovered Diffusely Infiltrating Low-Grade Gliomas: A Volumetric Study10.1016/j.wneu.2019.08.235 ↗
14. Natural History of de Novo High Grade Glioma: First Description of Growth Parabola10.23736/S0390-5616.17.04067-X ↗
15. Lombardi, G., Barresi, V., Castellano, A., Tabouret, E., Pasqualetti, F., Salvalaggio, A., Cerretti, G., Caccese, M., Padovan, M., and Zagonel, V. (2020). Clinical Management of Diffuse Low-Grade Gliomas. Cancers, 12.10.3390/cancers12103008 ↗
16. Evidence for Potentials and Limitations of Brain Plasticity Using an Atlas of Functional Resectability of WHO Grade II Gliomas: Towards a “Minimal Common Brain”10.1016/j.neuroimage.2011.03.022 ↗
17. Radiation plus Procarbazine, CCNU, and Vincristine in Low-Grade Glioma10.1056/NEJMoa1500925 ↗
18. Prospective Randomized Trial of Low- versus High-Dose Radiation Therapy in Adults with Supratentorial Low-Grade Glioma: Initial Report of a North Central Cancer Treatment Group/Radiation Therapy Oncology Group/Eastern Cooperative Oncology Group Study10.1200/JCO.2002.09.126 ↗
19. Low-Grade Glioma Radiotherapy Treatment and Trials10.1016/j.nec.2018.08.008 ↗
20. Radiotherapy of High-Grade Gliomas: Dealing with a Stalemate10.1016/j.critrevonc.2023.104110 ↗
21. Chemotherapy for Malignant Gliomas
22. Chemotherapy in Adults with Gliomas10.47102/annals-acadmedsg.V36N5p364 ↗
23. Imaging Using Radiolabelled Targeted Proteins: Radioimmunodetection and Beyond10.1186/s41181-020-00094-w ↗
24. Radioimmunoscintigraphy of Intracranial Glioma Xenograft with a Technetium-99m-Labeled Mouse Monoclonal Antibody Specifically Recognizing Type III Mutant Epidermal Growth Factor Receptor10.1023/A:1024320516341 ↗
25. Usefulness of SPECT/CT with a Hybrid Camera for the Functional Anatomical Mapping of Primary Brain Tumors by [Tc99m] Tetrofosmin
26. Scintimammography with a Hybrid SPECT/CT Imaging System
27. ImmunoPET: Concept, Design, and Applications10.1021/acs.chemrev.9b00738 ↗
28. Immuno-PET: Design Options and Clinical Proof-of-Concept10.3389/fmed.2022.1026083 ↗
29. Yoon, J.-K., Park, B.-N., Ryu, E.-K., An, Y.-S., and Lee, S.-J. (2020). Current Perspectives on 89Zr-PET Imaging. Int. J. Mol. Sci., 21.10.3390/ijms21124309 ↗
30. Innovations in PET/CT
31. Meikle, S.R., Sossi, V., Roncali, E., Cherry, S.R., Banati, R., Mankoff, D., Jones, T., James, M., Sutcliffe, J., and Ouyang, J. (2021). Quantitative PET in the 2020s: A Roadmap. Phys. Med. Biol., 66.10.1088/1361-6560/abd4f7 ↗
32. Prognostic Value of 18F-FDG PET/CT in Patients with Advanced or Metastatic Non-Small-Cell Lung Cancer Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis10.3389/fimmu.2022.1014063 ↗
33. Patlak-Ki Derived from Ultra-High Sensitivity Dynamic Total Body [18F]FDG PET/CT Correlates with the Response to Induction Immuno-Chemotherapy in Locally Advanced Non-Small Cell Lung Cancer Patients10.1007/s00259-023-06298-x ↗
34. Matching Chelators to Radiometals for Radiopharmaceuticals10.1039/C3CS60304K ↗
35. A Review of Approaches to 18F Radiolabelling Affinity Peptides and Proteins10.1002/jlcr.3634 ↗
36. Lee, T.S., Song, I.H., Shin, J., Park, Y.S., Kim, J.Y., Kim, K., Lee, Y.J., and Kang, J.H. (2018). PET Imaging Biomarkers of Anti-EGFR Immunotherapy in Esophageal Squamous Cell Carcinoma Models. Cells, 7.10.3390/cells7110187 ↗
37. Matching the Decay Half-Life with the Biological Half-Life: ImmunoPET Imaging with (44)Sc-Labeled Cetuximab Fab Fragment10.1021/bc500415x ↗
38. Expression of Vascular Endothelial Growth Factor (VEGF) and VEGF Receptor Flk-1 in Benign, Premalignant, and Malignant Prostate Tissue10.1309/1LBM-6X32-JH6W-ENUD ↗
39. Immuno-PET Imaging of Tumor Endothelial Marker 8 (TEM8)10.1021/mp500056d ↗
40. Genes Expressed in Human Tumor Endothelium10.1126/science.289.5482.1197 ↗
41. Bevacizumab Targeting Diffuse Intrinsic Pontine Glioma: Results of 89Zr-Bevacizumab PET Imaging in Brain Tumor Models10.1158/1535-7163.MCT-15-0558 ↗
42. Molecular Drug Imaging: 89Zr-Bevacizumab PET in Children with Diffuse Intrinsic Pontine Glioma10.2967/jnumed.116.180216 ↗
43. CD146, from a Melanoma Cell Adhesion Molecule to a Signaling Receptor10.1038/s41392-020-00259-8 ↗
44. Targeting CD146 with a 64Cu-Labeled Antibody Enables in Vivo ImmunoPET Imaging of High-Grade Gliomas10.1073/pnas.1502648112 ↗
45. ImmunoPET Imaging of CD146 Expression in Malignant Brain Tumors10.1021/acs.molpharmaceut.6b00372 ↗
46. Glioblastoma-Infiltrated Innate Immune Cells Resemble M0 Macrophage Phenotype10.1172/jci.insight.85841 ↗
47. Lapa, C., Linsenmann, T., Lückerath, K., Samnick, S., Herrmann, K., Stoffer, C., Ernestus, R.-I., Buck, A.K., Löhr, M., and Monoranu, C.-M. (2015). Tumor-Associated Macrophages in Glioblastoma Multiforme-a Suitable Target for Somatostatin Receptor-Based Imaging and Therapy?. PLoS ONE, 10.10.1371/journal.pone.0122269 ↗
48. Preclinical ImmunoPET Imaging of Glioblastoma-Infiltrating Myeloid Cells Using Zirconium-89 Labeled Anti-CD11b Antibody10.1007/s11307-019-01427-1 ↗
49. PSMA Expression in Glioblastoma as a Basis for Theranostic Approaches: A Retrospective, Correlational Panel Study Including Immunohistochemistry, Clinical Parameters and PET Imaging10.3389/fonc.2021.646387 ↗
50. Muoio, B., Albano, D., Dondi, F., Bertagna, F., Garibotto, V., Kunikowska, J., Piccardo, A., Annunziata, S., Espeli, V., and Migliorini, D. (2022). Diagnostic Accuracy of PET/CT or PET/MRI Using PSMA-Targeting Radiopharmaceuticals in High-Grade Gliomas: A Systematic Review and a Bivariate Meta-Analysis. Diagnostics, 12.10.3390/diagnostics12071665 ↗
51. A Phase I/II Study for Analytic Validation of 89Zr-J591 ImmunoPET as a Molecular Imaging Agent for Metastatic Prostate Cancer10.1158/1078-0432.CCR-15-0552 ↗
52. [89Zr]Zr-HuJ591 Immuno-PET Targeting PSMA in IDH Mutant Anaplastic Oligodendroglioma10.1007/s00259-021-05543-5 ↗
53. Lenffer, B., Ruben, J., Senthi, S., Millar, J., and Ong, W.L. (2023). Management and Outcomes of Glioblastoma: 20-Year Experience in a Single Australian Institution. J. Med. Imaging Radiat. Oncol., online ahead of print.10.1111/1754-9485.13607 ↗
54. Park, J.E., Kim, H.S., Kim, N., Borra, R., Mouridsen, K., Hansen, M.B., Kim, Y.-H., Hong, C.-K., and Kim, J.H. (2023). Prediction of Pseudoprogression in Post-Treatment Glioblastoma Using Dynamic Susceptibility Contrast-Derived Oxygenation and Microvascular Transit Time Heterogeneity Measures. Eur. Radiol., online ahead of print.10.1007/s00330-023-10324-9 ↗
55. Muoio, B., Espeli, V., and Treglia, G. (2023). Neuro-Oncology and Positron Emission Tomography: “Just Can’t Get Enough”. Cancers, 15.10.3390/cancers15194739 ↗
56. SPECT and PET Serve as Molecular Imaging Techniques and in Vivo Biomarkers for Brain Metastases10.3390/ijms15069878 ↗
57. De Marco, R., Pesaresi, A., Bianconi, A., Zotta, M., Deandreis, D., Morana, G., Zeppa, P., Melcarne, A., Garbossa, D., and Cofano, F. (2022). A Systematic Review of Amino Acid PET Imaging in Adult-Type High-Grade Glioma Surgery: A Neurosurgeon’s Perspective. Cancers, 15.10.3390/cancers15010090 ↗
58. Current and Potential Roles of Immuno-PET/-SPECT in CAR T-Cell Therapy10.3389/fmed.2023.1199146 ↗
59. Sharma, S., and Pandey, M.K. (2023). Radiometals in Imaging and Therapy: Highlighting Two Decades of Research. Pharmaceuticals, 16.10.3390/ph16101460 ↗
60. Imaging-Pathologic Correlation in Corticobasal Degeneration10.3174/ajnr.A1721 ↗
61. Reactive polymer enables efficient in vivo bioorthogonal chemistry10.1073/pnas.1113466109 ↗
62. Triumbari, E.K.A., Morland, D., Laudicella, R., Bauckneht, M., Albano, D., and Annunziata, S. (2022). Clinical Applications of Immuno-PET in Lymphoma: A Systematic Review. Cancers, 14.10.3390/cancers14143488 ↗
63. Engineering antibody and protein therapeutics to cross the blood-brain barrier
64. First in human dose calculation of a single-chain bispecific antibody targeting glioma using the MABEL approach10.1136/jitc-2019-000213 ↗
65. Cavaco, M., Gaspar, D., Arb Castanho, M., and Neves, V. (2020). Antibodies for the Treatment of Brain Metastases, a Dream or a Reality?. Pharmaceutics, 12.10.3390/pharmaceutics12010062 ↗
66. Lepareur, N., Ramée, B., Mougin-Degraef, M., and Bourgeois, M. (2023). Clinical Advances and Perspectives in Targeted Radionuclide Therapy. Pharmaceutics, 15.10.20944/preprints202305.1507.v1 ↗
67. Singh, A., Patel, A., Chaudhary, H., Yadav, K., and Minocha, N. (2023). Nanotheranostics: The Fabrication of Theranostics with Nanoparticles and Their Application to Treat the Neurological Disorders. Recent Pat. Nanotechnol., online ahead of print.
68. Filippi, L., Frantellizzi, V., De Vincentis, G., Schillaci, O., and Evangelista, L. (2023). Clinical Applications of TSPO PET for Glioma Imaging: Current Evidence and Future Perspective-A Systematic Review. Diagnostics, 13.10.3390/diagnostics13101813 ↗
69. Peng, C.L., Shih, Y.H., Chiang, P.F., Chen, C.T., and Chang, M.C. (2021). Multifunctional Cyanine-Based Theranostic Probe for Cancer Imaging and Therapy. Int. J. Mol. Sci., 22.10.3390/ijms222212214 ↗
70. Near IR heptamethine cyanine dye-mediated cancer imaging10.1158/1078-0432.CCR-10-0059 ↗
71. Looking and listening to light: The evolution of whole-body photonic imaging10.1038/nbt1074 ↗
72. Using bioluminescence imaging in glioma research10.1016/j.jocn.2014.11.001 ↗
73. Bioluminescence Tomography Based on Gaussian Weighted Laplace Prior Regularization for In Vivo Morphological Imaging of Glioma10.1109/TMI.2017.2737661 ↗