TY - JOUR
T1 - Lower Grade Gliomas
T2 - Relationships Between Metabolic and Structural Imaging with Grading and Molecular Factors
AU - Riva, Marco
AU - Lopci, Egesta
AU - Castellano, Antonella
AU - Olivari, Laura
AU - Gallucci, Marcello
AU - Pessina, Federico
AU - Fernandes, Bethania
AU - Simonelli, Matteo
AU - Navarria, Pierina
AU - Grimaldi, Marco
AU - Rudà, Roberta
AU - Castello, Angelo
AU - Rossi, Marco
AU - Alfiero, Tommaso
AU - Soffietti, Riccardo
AU - Chiti, Arturo
AU - Bello, Lorenzo
N1 - Copyright © 2019 Elsevier Inc. All rights reserved.
PY - 2019/6
Y1 - 2019/6
N2 - BACKGROUND: Positron emission tomography (PET) is a valuable tool for the characterization of brain tumors in vivo. However, few studies have investigated the correlation between carbon-11-methionine (11C-METH) PET metrics and the clinical, radiological, histological, and molecular features of patients affected by lower grade gliomas (LGGs). The present observational study evaluated the relationships between 11C-METH PET metrics and structural magnetic resonance imaging (MRI) findings with the histomolecular biomarkers in patients with LGGs who were candidates for surgery.METHODS: We enrolled 96 patients with pathologically proven LGG (51 men, 45 women; age 44.1 ± 13.7 years; 45 with grade II, 51 with grade III), who had been referred from March 2012 to January 2015 for tumor resection and had undergone preoperative 11C-METH PET. The semiquantitative metrics for 11C-METH PET included maximum standardized uptake value (SUVmax), SUV ratio to normal brain, and metabolic tumor burden (MTB). The PET semiquantitative metrics were analyzed and compared with the MRI features, histological diagnosis, isocitrate dehydrogenase-1/2 status, and 1p/19q codeletion.RESULTS: Histological grade was associated with SUVmax (P = 0.002), SUV ratio (P = 0.011), and MTB (P = 0.001), with grade III lesions showing higher values. Among the nonenhancing lesions on MRI, SUVmax (P = 0.001), SUV ratio (P = 0.003) and MTB (P < 0.001) were significantly different statistically for grade II versus grade III. The MRI lesion volume correlated poorly with MTB (r2 = 0.13). The SUVmax and SUV ratio were greater (P < 0.05) in isocitrate dehydrogenase-1/2 wild-type lesions, and the SUV ratio was associated with the presence of the 1p19q codeletion.CONCLUSIONS: The 11C-METH PET metrics correlated significantly with histological grade and the molecular profile. Semiquantitative PET metrics can improve the preoperative evaluation of LGGs and thus support clinical decision-making.
AB - BACKGROUND: Positron emission tomography (PET) is a valuable tool for the characterization of brain tumors in vivo. However, few studies have investigated the correlation between carbon-11-methionine (11C-METH) PET metrics and the clinical, radiological, histological, and molecular features of patients affected by lower grade gliomas (LGGs). The present observational study evaluated the relationships between 11C-METH PET metrics and structural magnetic resonance imaging (MRI) findings with the histomolecular biomarkers in patients with LGGs who were candidates for surgery.METHODS: We enrolled 96 patients with pathologically proven LGG (51 men, 45 women; age 44.1 ± 13.7 years; 45 with grade II, 51 with grade III), who had been referred from March 2012 to January 2015 for tumor resection and had undergone preoperative 11C-METH PET. The semiquantitative metrics for 11C-METH PET included maximum standardized uptake value (SUVmax), SUV ratio to normal brain, and metabolic tumor burden (MTB). The PET semiquantitative metrics were analyzed and compared with the MRI features, histological diagnosis, isocitrate dehydrogenase-1/2 status, and 1p/19q codeletion.RESULTS: Histological grade was associated with SUVmax (P = 0.002), SUV ratio (P = 0.011), and MTB (P = 0.001), with grade III lesions showing higher values. Among the nonenhancing lesions on MRI, SUVmax (P = 0.001), SUV ratio (P = 0.003) and MTB (P < 0.001) were significantly different statistically for grade II versus grade III. The MRI lesion volume correlated poorly with MTB (r2 = 0.13). The SUVmax and SUV ratio were greater (P < 0.05) in isocitrate dehydrogenase-1/2 wild-type lesions, and the SUV ratio was associated with the presence of the 1p19q codeletion.CONCLUSIONS: The 11C-METH PET metrics correlated significantly with histological grade and the molecular profile. Semiquantitative PET metrics can improve the preoperative evaluation of LGGs and thus support clinical decision-making.
KW - Adult
KW - Biomarkers
KW - Brain/pathology
KW - Brain Neoplasms/diagnostic imaging
KW - Female
KW - Glioma/diagnostic imaging
KW - Humans
KW - Isocitrate Dehydrogenase/analysis
KW - Magnetic Resonance Imaging
KW - Male
KW - Methionine
KW - Middle Aged
KW - Neoplasm Grading
KW - Positron-Emission Tomography
KW - Radiopharmaceuticals
KW - Sensitivity and Specificity
U2 - 10.1016/j.wneu.2019.02.031
DO - 10.1016/j.wneu.2019.02.031
M3 - Article
C2 - 30797926
VL - 126
SP - e270-e280
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -