Stefanie Bette1, Patrick Peschke2, Johannes Kaesmacher3, Claire Delbridge4, Thomas Pyka5, Friederike Schmidt-Graf6, Claus Zimmer3, Bernhard Meyer2, Florian Ringel2, Jens Gempt2. 1. Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: Stefanie.bette@tum.de. 2. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 3. Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 4. Department of Neuropathology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 5. Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 6. Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Abstract
OBJECTIVE: O-(2-[18F]-fluoroethyl)-L-tyrosine-positron emission tomography (FET-PET) imaging is an additional tool for tumor grading and surgery planning. Up to now, not much is known about FET-PET imaging in anaplastic gliomas. Our objective was to assess the FET uptake in anaplastic gliomas, compared with magnetic resonance imaging (MRI), histopathologic markers, and its prognostic value. PATIENTS AND METHODS: Forty-six patients (27 males/19 females) with an anaplastic glioma (WHO III) who received MRI and FET-PET imaging before surgery were retrospectively analyzed. Tumor volume was calculated in MRI and FET-PET imaging using a tumor-to-background ratio (TBR), and maximum FET uptake (TBRmax) was calculated. Overall survival (OS) and histopathologic markers (isocitrate-dehydrogenase 1/2-mutation, oligodendrial differentiation, and Ki67 proliferation index) were assessed. Univariate and multivariate analysis was performed for OS. RESULTS: In univariate analysis a significant correlation of TBRmax to OS was observed (P = 0.031). Tumor volume in FET-PET imaging (TBR > 2.0) (P = 0.028) showed a higher correlation to OS than the volume of the contrast-enhancing tumor part (P = 0.031). The highest correlation was observed for intersection of volume TBR > 1.3 and the volume of the contrast-enhancing tumor part (P = 0.005); fluid-attenuated inversion recovery volume showed no significant correlation to OS (P = 0.401) in the univariate analysis. Anaplastic glioma with oligodendrial differentiation showed significantly higher TBRmax values (P = 0.029), while no significant difference was observed for isocitrate hydrogenase 1/2-mutation (P = 0.752). CONCLUSION: Static FET-PET provides significant prognostic information in anaplastic gliomas, which adds to the value of MRI, supporting the use of both modalities preoperatively to assess individual risks and estimate prognosis. Definition of the histopathologic subtype using static FET-PET remains challenging.
OBJECTIVE:O-(2-[18F]-fluoroethyl)-L-tyrosine-positron emission tomography (FET-PET) imaging is an additional tool for tumor grading and surgery planning. Up to now, not much is known about FET-PET imaging in anaplastic gliomas. Our objective was to assess the FET uptake in anaplastic gliomas, compared with magnetic resonance imaging (MRI), histopathologic markers, and its prognostic value. PATIENTS AND METHODS: Forty-six patients (27 males/19 females) with an anaplastic glioma (WHO III) who received MRI and FET-PET imaging before surgery were retrospectively analyzed. Tumor volume was calculated in MRI and FET-PET imaging using a tumor-to-background ratio (TBR), and maximum FET uptake (TBRmax) was calculated. Overall survival (OS) and histopathologic markers (isocitrate-dehydrogenase 1/2-mutation, oligodendrial differentiation, and Ki67 proliferation index) were assessed. Univariate and multivariate analysis was performed for OS. RESULTS: In univariate analysis a significant correlation of TBRmax to OS was observed (P = 0.031). Tumor volume in FET-PET imaging (TBR > 2.0) (P = 0.028) showed a higher correlation to OS than the volume of the contrast-enhancing tumor part (P = 0.031). The highest correlation was observed for intersection of volume TBR > 1.3 and the volume of the contrast-enhancing tumor part (P = 0.005); fluid-attenuated inversion recovery volume showed no significant correlation to OS (P = 0.401) in the univariate analysis. Anaplastic glioma with oligodendrial differentiation showed significantly higher TBRmax values (P = 0.029), while no significant difference was observed for isocitrate hydrogenase 1/2-mutation (P = 0.752). CONCLUSION: Static FET-PET provides significant prognostic information in anaplastic gliomas, which adds to the value of MRI, supporting the use of both modalities preoperatively to assess individual risks and estimate prognosis. Definition of the histopathologic subtype using static FET-PET remains challenging.
Authors: Sied Kebir; Laurèl Rauschenbach; Norbert Galldiks; Max Schlaak; Elke Hattingen; Jennifer Landsberg; Ralph A Bundschuh; Karl-Josef Langen; Björn Scheffler; Ulrich Herrlinger; Martin Glas Journal: Neuro Oncol Date: 2016-09-02 Impact factor: 12.300