Nucl Med Mol Imaging.
2015 Dec;49(4):291-297. 10.1007/s13139-015-0362-0.
Prognostic Value of Metabolic Tumor Volume on 11C-Methionine PET in Predicting Progression-Free Survival in High-Grade Glioma
- Affiliations
-
- 1Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. paengjc@snu.ac.kr
- 2Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of MolecularMedicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
- 4Department of Radiological Sciences, University of California, Irvine, CA, USA.
- KMID: 2132234
- DOI: http://doi.org/10.1007/s13139-015-0362-0
Abstract
- PURPOSE
C-11 methionine (MET) PET is commonly used for diagnosing high-grade glioma (HGG). Recently, volumetric analysis has been widely applied to oncologic PET imaging. In this study, we investigated the prognostic value of metabolic tumor volume (MTV) on MET PET in HGG.
METHODS
A total of 30 patients with anaplastic astrocytoma (n=12) and glioblastoma multiforme (n=18) who underwent MET PET before treatment (surgery followed by chemoradiotherapy) were retrospectively enrolled. Maximal tumorto- normal brain ratio (TNR(max), maximum tumor activity divided by mean of normal tissue) and MTV (volume of tumor tissue that shows uptake>1.3-fold of mean uptake in normal tissue) were measured on MET PET. Adult patients were classified into two subgroups according to Radiation Therapy Oncology Group Recursive Partitioning Analysis (RTOG RPA) classification. Prognostic values of TNR(max), MTV and clinicopathologic factors were evaluated with regard to progression-free survival (PFS).
RESULTS
Median PFS of all patients was 7.9 months (range 1.0-53.8 months). In univariate analysis,MTV (cutoff 35 cm3) was a significant prognostic factor for PFS P=0.01), whereas TNR(max) (cutoff 3.3) and RTOG RPA class were not (P=0.80 and 0.61, respectively). Treatment of surgical resection exhibited a borderline significance (P=0.06). In multivariate analysis, MTV was the only independent prognostic factor for PFS (P=0.03).
CONCLUSION
MTVon MET PET is a significant and independent prognostic factor for PFS in HGG patients, whereas TNR(max) is not. Thus, performing volumetric analysis of MET PET is recommended in HGG for better prognostication.
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