• Andrei G Vlassenko, Jonathan McConathy, Lars E Couture, Yi Su, Parinaz Massoumzadeh, Hayden S Leeds, Michael R Chicoine, David D Tran, Jiayi Huang, Sonika Dahiya, Daniel S Marcus, Sarah Jost Fouke, Keith M Rich, Marcus E Raichle, and Tammie L S Benzinger.
• Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
• Dis. Markers. 2015 Jan 1; 2015: 874904.

ObjectivesGlucose metabolism outside of oxidative phosphorylation, or aerobic glycolysis (AG), is a hallmark of active cancer cells that is not directly measured with standard (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET). In this study, we characterized tumor regions with elevated AG defined based on PET measurements of glucose and oxygen metabolism.MethodsFourteen individuals with high-grade brain tumors underwent structural MR scans and PET measurements of cerebral blood flow (CBF), oxygen (CMRO2) and glucose (CMRGlu) metabolism, and AG, using (15)O-labeled CO, O2 and H2O, and FDG, and were compared to a normative cohort of 20 age-matched individuals.ResultsElevated AG was observed in most high-grade brain tumors and it was associated with decreased CMRO2 and CBF, but not with significant changes in CMRGlu. Elevated AG was a dramatic and early sign of tumor growth associated with decreased survival. AG changes associated with tumor growth were differentiated from the effects of nonneoplastic processes such as epileptic seizures.ConclusionsOur findings demonstrate that high-grade brain tumors exhibit elevated AG as a marker of tumor growth and aggressiveness. AG may detect areas of active tumor growth that are not evident on conventional FDG PET.

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