ArticleEuropean journal of nuclear medicine and molecular imaging2026
Amino acid PET imaging to monitor mIDH inhibitor treatments in patients with refractory IDH-mutant gliomas.
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07017790 (Amino Acid PET Imaging to Assess the Efficacy of IDH Inhibitor Treatments for Patients With Refractory IDH Mutated Gliomas), which is not on this map. Not yet cited in PubMed.
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Amino Acid PET Imaging to Assess the Efficacy of IDH Inhibitor Treatments for Patients With Refractory IDH Mutated Gliomas
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7 authors.
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Abstract
purposeMutant IDH (mIDH) inhibitors represent a novel therapeutic approach for IDH-mutant gliomas. This study aimed to evaluate the role of amino acid PET in monitoring the response to mIDH inhibitor treatment in patients with refractory IDH-mutant gliomas.
methodsPatients with confirmed IDH-mutant gliomas who received mIDH inhibitor treatments, ivosidenib or vorasidenib, between February 2022 and November 2024, with baseline [¹⁸F]-FDOPA scans, were included. Lesions were assessed using the RANO 2.0 and PET RANO criteria to determine measurability and, in patients with early follow-up imaging, to predict 6-month progression-free survival (PFS-6).
resultsTwenty-two patients were included (mean age: 42.1 ± 10.5 years; 8 women; 14 with IDH-mutant astrocytomas). Among them, 11 underwent follow-up imaging with both MRI and PET within the first 100 days of treatment. At baseline, MRI identified measurable lesions in 10 of 22 patients (45%), whereas amino acid PET identified lesions in 20 of 22 patients (91%) (p < 0.01). In patients with early follow-up, the RANO 2.0 criteria predicted PFS-6 with 91% accuracy (10/11) compared with 82% accuracy (9/11) with PET RANO (p > 0.05). The only discordant case showed progression on PET but stability on MRI, with confirmed clinical progression at 10 months post-treatment initiation.
conclusionAmino acid PET is a valuable tool for identifying measurable lesions in patients with refractory IDH-mutant gliomas. Moreover, in this specific population, its performance for monitoring treatment with mIDH inhibitors is at least comparable to that of MRI. CLINICAL
trial registrationTrial was registered at ClinicalTrials.gov (NCT07017790) and complied with the principles of the Declaration of Helsinki.
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