Osamu Manabe1, Shigeru Yamaguchi2, Kenji Hirata3, Kentaro Kobayashi3, Hiroyuki Kobayashi4, Shunsuke Terasaka4, Takuya Toyonaga5, Keiichi Magota6, Yuji Kuge7, Nagara Tamaki8, Tohru Shiga3, Kohsuke Kudo3,9. 1. Department of Radiology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Saitama-shi 330-8503, Saitama-ken, Japan. 2. Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan. 3. Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan. 4. Department of Neurosurgery, Kashiwaba Neurosurgery Hospital, Sapporo 062-8513, Japan. 5. PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA. 6. Division of Medical Imaging and Technology, Hokkaido University Hospital, Sapporo 060-8648, Japan. 7. Central Institute of Isotope Science, Hokkaido University, Sapporo 060-8638, Japan. 8. Department of Radiology, Kyoto Prefectural University, Kyoto 606-8522, Japan. 9. Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo 060-8638, Japan.
Abstract
BACKGROUND: Positron emission tomography with 11C-methionine (MET) is well established in the diagnostic work-up of malignant brain tumors. Texture analysis is a novel technique for extracting information regarding relationships among surrounding voxels, in order to quantify their inhomogeneity. This study evaluated whether the texture analysis of MET uptake has prognostic value for patients with glioma. METHODS: We retrospectively analyzed adults with glioma who had undergone preoperative metabolic imaging at a single center. Tumors were delineated using a threshold of 1.3-fold of the mean standardized uptake value for the contralateral cortex, and then processed to calculate the texture features in glioma. RESULTS: The study included 42 patients (median age: 56 years). The World Health Organization classifications were grade II (7 patients), grade III (17 patients), and grade IV (18 patients). Sixteen (16.1%) all-cause deaths were recorded during the median follow-up of 18.8 months. The univariate analyses revealed that overall survival (OS) was associated with age (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.01-1.08, p = 0.0093), tumor grade (HR 3.64, 95% CI 1.63-9.63, p = 0.0010), genetic status (p < 0.0001), low gray-level run emphasis (LGRE, calculated from the gray-level run-length matrix) (HR 2.30 × 1011, 95% CI 737.11-4.23 × 1019, p = 0.0096), and correlation (calculated from the gray-level co-occurrence matrix) (HR 5.17, 95% CI 1.07-20.93, p = 0.041). The multivariate analyses revealed OS was independently associated with LGRE and correlation. The survival curves were also significantly different (both log-rank p < 0.05). CONCLUSION: Textural features obtained using preoperative MET positron emission tomography may compliment the semi-quantitative assessment for prognostication in glioma cases.
BACKGROUND: Positron emission tomography with 11C-methionine (MET) is well established in the diagnostic work-up of malignant brain tumors. Texture analysis is a novel technique for extracting information regarding relationships among surrounding voxels, in order to quantify their inhomogeneity. This study evaluated whether the texture analysis of MET uptake has prognostic value for patients with glioma. METHODS: We retrospectively analyzed adults with glioma who had undergone preoperative metabolic imaging at a single center. Tumors were delineated using a threshold of 1.3-fold of the mean standardized uptake value for the contralateral cortex, and then processed to calculate the texture features in glioma. RESULTS: The study included 42 patients (median age: 56 years). The World Health Organization classifications were grade II (7 patients), grade III (17 patients), and grade IV (18 patients). Sixteen (16.1%) all-cause deaths were recorded during the median follow-up of 18.8 months. The univariate analyses revealed that overall survival (OS) was associated with age (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.01-1.08, p = 0.0093), tumor grade (HR 3.64, 95% CI 1.63-9.63, p = 0.0010), genetic status (p < 0.0001), low gray-level run emphasis (LGRE, calculated from the gray-level run-length matrix) (HR 2.30 × 1011, 95% CI 737.11-4.23 × 1019, p = 0.0096), and correlation (calculated from the gray-level co-occurrence matrix) (HR 5.17, 95% CI 1.07-20.93, p = 0.041). The multivariate analyses revealed OS was independently associated with LGRE and correlation. The survival curves were also significantly different (both log-rank p < 0.05). CONCLUSION: Textural features obtained using preoperative MET positron emission tomography may compliment the semi-quantitative assessment for prognostication in glioma cases.
Authors: László Papp; Nina Pötsch; Marko Grahovac; Victor Schmidbauer; Adelheid Woehrer; Matthias Preusser; Markus Mitterhauser; Barbara Kiesel; Wolfgang Wadsak; Thomas Beyer; Marcus Hacker; Tatjana Traub-Weidinger Journal: J Nucl Med Date: 2017-11-24 Impact factor: 10.057