Prognostic value of molecular and imaging biomarkers in patients with supratentorial glioma

Egesta Lopci, Marco Riva, Laura Olivari, Fabio Raneri, Riccardo Soffietti, Arnoldo Piccardo, Alberto Bizzi, Pierina Navarria, Anna Maria Ascolese, Roberta Rudà, Bethania Fernandes, Federico Pessina, Marco Grimaldi, Matteo Simonelli, Marco Rossi, Tommaso Alfieri, Paolo Andrea Zucali, Marta Scorsetti, Lorenzo Bello, Arturo Chiti

Research output: Contribution to journalArticle

Abstract

Purpose: We evaluated the relationship between 11C-methionine PET (11C-METH PET) findings and molecular biomarkers in patients with supratentorial glioma who underwent surgery. Methods: A consecutive series of 109 patients with pathologically proven glioma (64 men, 45 women; median age 43 years) referred to our Institution from March 2012 to January 2015 for tumour resection and who underwent preoperative 11C-METH PET were analysed. Semiquantitative evaluation of the 11C-METH PET images included SUVmax, region of interest-to-normal brain SUV ratio (SUVratio) and metabolic tumour volume (MTV). Imaging findings were correlated with disease outcome in terms of progression-free survival (PFS), and compared with other clinical biological data, including IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation. The patients were monitored for a mean period of 16.7 months (median 13 months). Results: In all patients, the tumour was identified on 11C-METH PET. Significant differences in SUVmax, SUVratio and MTV were observed in relation to tumour grade (p < 0.001). IDH1 mutation was found in 49 patients, 1p/19q codeletion in 58 patients and MGMT promoter methylation in 74 patients. SUVmax and SUVratio were significantly inversely correlated with the presence of IDH1 mutation (p < 0.001). Using the 2016 WHO classification, SUVmax and SUVratio were significantly higher in patients with primary glioblastoma (IDH1-negative) than in those with other diffuse gliomas (p < 0.001). Relapse or progression was documented in 48 patients (median PFS 8.7 months). Cox regression analysis showed that SUVmax and SUVratio, tumour grade, tumour type on 2016 WHO classification, IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation were significantly associated with PFS. None of these factors was found to be an independent prognostic factor in multivariate analysis. Conclusion: 11C-METH PET parameters are significantly correlated with histological grade and IDH1 mutation status in patients with glioma. Grade, pathological classification, molecular biomarkers, SUVmax and SUVratio were prognostic factors for PFS in this cohort of patients. The trial was registered with ClinicalTrials.gov (registration: NCT02518061).

Original languageEnglish
Pages (from-to)1155-1164
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume44
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

Fingerprint

Molecular Imaging
Glioma
Biomarkers
Methionine
Disease-Free Survival
Mutation
Methylation
Neoplasms
Tumor Burden
Glioblastoma
Multivariate Analysis
Regression Analysis

Keywords

  • C-methionine PET
  • 1p/19q codeletion
  • Glioma prognosis
  • IDH1 mutation
  • MGMT promoter methylation
  • WHO classification

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{ba8054d0166e4a909c50c2d95ac903e3,
title = "Prognostic value of molecular and imaging biomarkers in patients with supratentorial glioma",
abstract = "Purpose: We evaluated the relationship between 11C-methionine PET (11C-METH PET) findings and molecular biomarkers in patients with supratentorial glioma who underwent surgery. Methods: A consecutive series of 109 patients with pathologically proven glioma (64 men, 45 women; median age 43 years) referred to our Institution from March 2012 to January 2015 for tumour resection and who underwent preoperative 11C-METH PET were analysed. Semiquantitative evaluation of the 11C-METH PET images included SUVmax, region of interest-to-normal brain SUV ratio (SUVratio) and metabolic tumour volume (MTV). Imaging findings were correlated with disease outcome in terms of progression-free survival (PFS), and compared with other clinical biological data, including IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation. The patients were monitored for a mean period of 16.7 months (median 13 months). Results: In all patients, the tumour was identified on 11C-METH PET. Significant differences in SUVmax, SUVratio and MTV were observed in relation to tumour grade (p < 0.001). IDH1 mutation was found in 49 patients, 1p/19q codeletion in 58 patients and MGMT promoter methylation in 74 patients. SUVmax and SUVratio were significantly inversely correlated with the presence of IDH1 mutation (p < 0.001). Using the 2016 WHO classification, SUVmax and SUVratio were significantly higher in patients with primary glioblastoma (IDH1-negative) than in those with other diffuse gliomas (p < 0.001). Relapse or progression was documented in 48 patients (median PFS 8.7 months). Cox regression analysis showed that SUVmax and SUVratio, tumour grade, tumour type on 2016 WHO classification, IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation were significantly associated with PFS. None of these factors was found to be an independent prognostic factor in multivariate analysis. Conclusion: 11C-METH PET parameters are significantly correlated with histological grade and IDH1 mutation status in patients with glioma. Grade, pathological classification, molecular biomarkers, SUVmax and SUVratio were prognostic factors for PFS in this cohort of patients. The trial was registered with ClinicalTrials.gov (registration: NCT02518061).",
keywords = "C-methionine PET, 1p/19q codeletion, Glioma prognosis, IDH1 mutation, MGMT promoter methylation, WHO classification",
author = "Egesta Lopci and Marco Riva and Laura Olivari and Fabio Raneri and Riccardo Soffietti and Arnoldo Piccardo and Alberto Bizzi and Pierina Navarria and Ascolese, {Anna Maria} and Roberta Rud{\`a} and Bethania Fernandes and Federico Pessina and Marco Grimaldi and Matteo Simonelli and Marco Rossi and Tommaso Alfieri and Zucali, {Paolo Andrea} and Marta Scorsetti and Lorenzo Bello and Arturo Chiti",
year = "2017",
month = "7",
day = "1",
doi = "10.1007/s00259-017-3618-3",
language = "English",
volume = "44",
pages = "1155--1164",
journal = "European Journal of Pediatrics",
issn = "0340-6199",
publisher = "Springer Berlin Heidelberg",
number = "7",

}

TY - JOUR

T1 - Prognostic value of molecular and imaging biomarkers in patients with supratentorial glioma

AU - Lopci, Egesta

AU - Riva, Marco

AU - Olivari, Laura

AU - Raneri, Fabio

AU - Soffietti, Riccardo

AU - Piccardo, Arnoldo

AU - Bizzi, Alberto

AU - Navarria, Pierina

AU - Ascolese, Anna Maria

AU - Rudà, Roberta

AU - Fernandes, Bethania

AU - Pessina, Federico

AU - Grimaldi, Marco

AU - Simonelli, Matteo

AU - Rossi, Marco

AU - Alfieri, Tommaso

AU - Zucali, Paolo Andrea

AU - Scorsetti, Marta

AU - Bello, Lorenzo

AU - Chiti, Arturo

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Purpose: We evaluated the relationship between 11C-methionine PET (11C-METH PET) findings and molecular biomarkers in patients with supratentorial glioma who underwent surgery. Methods: A consecutive series of 109 patients with pathologically proven glioma (64 men, 45 women; median age 43 years) referred to our Institution from March 2012 to January 2015 for tumour resection and who underwent preoperative 11C-METH PET were analysed. Semiquantitative evaluation of the 11C-METH PET images included SUVmax, region of interest-to-normal brain SUV ratio (SUVratio) and metabolic tumour volume (MTV). Imaging findings were correlated with disease outcome in terms of progression-free survival (PFS), and compared with other clinical biological data, including IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation. The patients were monitored for a mean period of 16.7 months (median 13 months). Results: In all patients, the tumour was identified on 11C-METH PET. Significant differences in SUVmax, SUVratio and MTV were observed in relation to tumour grade (p < 0.001). IDH1 mutation was found in 49 patients, 1p/19q codeletion in 58 patients and MGMT promoter methylation in 74 patients. SUVmax and SUVratio were significantly inversely correlated with the presence of IDH1 mutation (p < 0.001). Using the 2016 WHO classification, SUVmax and SUVratio were significantly higher in patients with primary glioblastoma (IDH1-negative) than in those with other diffuse gliomas (p < 0.001). Relapse or progression was documented in 48 patients (median PFS 8.7 months). Cox regression analysis showed that SUVmax and SUVratio, tumour grade, tumour type on 2016 WHO classification, IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation were significantly associated with PFS. None of these factors was found to be an independent prognostic factor in multivariate analysis. Conclusion: 11C-METH PET parameters are significantly correlated with histological grade and IDH1 mutation status in patients with glioma. Grade, pathological classification, molecular biomarkers, SUVmax and SUVratio were prognostic factors for PFS in this cohort of patients. The trial was registered with ClinicalTrials.gov (registration: NCT02518061).

AB - Purpose: We evaluated the relationship between 11C-methionine PET (11C-METH PET) findings and molecular biomarkers in patients with supratentorial glioma who underwent surgery. Methods: A consecutive series of 109 patients with pathologically proven glioma (64 men, 45 women; median age 43 years) referred to our Institution from March 2012 to January 2015 for tumour resection and who underwent preoperative 11C-METH PET were analysed. Semiquantitative evaluation of the 11C-METH PET images included SUVmax, region of interest-to-normal brain SUV ratio (SUVratio) and metabolic tumour volume (MTV). Imaging findings were correlated with disease outcome in terms of progression-free survival (PFS), and compared with other clinical biological data, including IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation. The patients were monitored for a mean period of 16.7 months (median 13 months). Results: In all patients, the tumour was identified on 11C-METH PET. Significant differences in SUVmax, SUVratio and MTV were observed in relation to tumour grade (p < 0.001). IDH1 mutation was found in 49 patients, 1p/19q codeletion in 58 patients and MGMT promoter methylation in 74 patients. SUVmax and SUVratio were significantly inversely correlated with the presence of IDH1 mutation (p < 0.001). Using the 2016 WHO classification, SUVmax and SUVratio were significantly higher in patients with primary glioblastoma (IDH1-negative) than in those with other diffuse gliomas (p < 0.001). Relapse or progression was documented in 48 patients (median PFS 8.7 months). Cox regression analysis showed that SUVmax and SUVratio, tumour grade, tumour type on 2016 WHO classification, IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation were significantly associated with PFS. None of these factors was found to be an independent prognostic factor in multivariate analysis. Conclusion: 11C-METH PET parameters are significantly correlated with histological grade and IDH1 mutation status in patients with glioma. Grade, pathological classification, molecular biomarkers, SUVmax and SUVratio were prognostic factors for PFS in this cohort of patients. The trial was registered with ClinicalTrials.gov (registration: NCT02518061).

KW - C-methionine PET

KW - 1p/19q codeletion

KW - Glioma prognosis

KW - IDH1 mutation

KW - MGMT promoter methylation

KW - WHO classification

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U2 - 10.1007/s00259-017-3618-3

DO - 10.1007/s00259-017-3618-3

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JO - European Journal of Pediatrics

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SN - 0340-6199

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