Measuring fatty acid oxidation in gliomas using 18F-FPIA PET/MRI
Research type
Research Study
Full title
Determining the magnitude of early steps of fatty acid oxidation in glioma using 18F-FPIA PET/MRI
IRAS ID
228245
Contact name
Matthew Williams
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Research Summary:
Glioma is the most common form of primary malignant brain tumour in adults with has a very poor prognosis. Its most aggressive form Glioblastoma has a two-year survival rate of only 26.5% on current best therapy which includes surgery followed by combination chemotherapy and radiotherapy. In healthy brain cells, glucose is the major nutrient used for energy creation however recent studies have indicated brain tumours simultaneously use sources other than glucose for energy creation i.e. fatty acids (fatty acid metabolism). It is thought this is due to the increased energy demands of tumours allowing for their rapid growth. We have developed special type of scan which uses Positron Emission Tomography and Magnetic Resonance Imaging (PET-MRI) that might help us detect fatty acid metabolism in brain tumours. The scan involves injection of a substance called a radioactive tracer into a vein. The radioactive tracer used in this study is called 18F-FPIA. It is thought that 18F-FPIA will accumulate in brain tumours which use fatty acids to create energy, from which the signal can be detected using the PET/MRI scanner.This tracer shows high contrast for imaging brain tumours in animal models making it a suitable for the detection of fatty acid metabolism in human brain tumours. We aim to quantify the degree of this process using the PET-MRI scan. Combined PET-MRI imaging allows simultaneous imaging of the tracer in tumour cells, combined with the structural imaging of the tumour. As part of the patients’ routine clinical care, they will all go on to have a biopsy or surgical removal of their tumour. This will give us the opportunity to attain tissue specimens on which we can do certain tests e.g. genetic testing, to identify genes which have been shown to correlate with the aggressiveness of the tumour, as well as study the individual changes in energy metabolism within the tumour, a method called ‘metabolomics.’
Lay summary of study results:
Diagnostic imaging refers to the different medical techniques used to take pictures of the inside of the body. These images help doctors understand the cause of an illness or injury and support them in making a diagnosis.Primary brain tumours, known as gliomas, make up about one‑third of all brain tumours. They are grouped into two main types: lower‑grade and higher‑grade. Lower‑grade gliomas (LGG) contain cells that look more like normal brain cells and tend to grow more slowly. Higher‑grade gliomas (HGG), on the other hand, grow and spread more quickly.
When a glioma is suspected, patients usually undergo standard imaging tests such as a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan. Doctors then use these images to decide on the best treatment plan. Although these scans can show the presence of a tumour, they often cannot reliably distinguish between lower‑grade and higher‑grade gliomas. Being able to make this distinction using a non‑invasive scan is important because it helps guide treatment decisions.
In this study, ten participants with brain tumours confirmed by imaging underwent a combined positron emission tomography (PET)‑MRI scan. A PET scan involves injecting a small amount of a radioactive substance called a tracer. Our research team has developed a new tracer called 18F‑fluoropivalate ([18F]FPIA). This tracer targets the early steps of fatty acid oxidation—a process cancer cells use to produce energy and grow.
Each participant received an injection of [18F]FPIA and then had a PET‑MRI scan. All participants later had either a biopsy or surgery to remove the tumour. A histopathologist examined the tumour cells under a microscope and classified each tumour as either low‑grade or high‑grade.
The [18F]FPIA PET‑MRI scan successfully distinguished between lower‑grade and higher‑grade gliomas in a single visit. High‑grade tumours absorbed more [18F]FPIA than low‑grade tumours. This non‑invasive imaging method therefore shows promise for improving patient care and supports further research into its use.
REC name
Yorkshire & The Humber - South Yorkshire Research Ethics Committee
REC reference
18/YH/0082
Date of REC Opinion
26 Mar 2018
REC opinion
Further Information Favourable Opinion