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18F-FDG PET in the assessment of tumor grade and prediction of tumor recurrence in intracranial meningioma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to investigate the role of 18F-fluorodeoxyglucose (FDG) PET in detecting high-grade meningioma and predicting the recurrence in patients with meningioma after surgical resection.

Methods

Fifty-nine patients (27 men and 32 women) with intracranial meningioma who underwent preoperative FDG PET and subsequent surgical resection were enrolled. All patients underwent clinical follow-up for tumor recurrence with a mean duration of 34±20 months. The tumor to gray matter ratio (TGR) of FDG uptake was calculated and a receiver-operating characteristic (ROC) curve of the TGR was drawn to determine the cutoff value of the TGR for detection of high-grade meningioma. Further, univariate analysis with the log-rank test was performed to assess the predictive factors of meningioma recurrence.

Results

The TGR in high-grade meningioma (WHO grade II and III) was significantly higher than that in low-grade ones (WHO grade I) (p=0.002) and significantly correlated with the MIB-1 labeling index (r=0.338, p=0.009) and mitotic count of the tumor (r=0.284, p=0.03). The ROC analysis revealed that the TGR of 1.0 was the best cutoff value for detecting high-grade meningioma with a sensitivity of 43%, specificity of 95%, and accuracy of 81%. Of 59 patients, 5 (9%) had a recurrent event. In the log-rank test, the TGR, MIB-1 labeling index, presence of brain invasion, and WHO grade were significantly associated with tumor recurrence. The cumulative recurrence-free survival rate of patients with a TGR of 1.0 or less was significantly higher than that of patients with a TGR of more than 1.0 (p=0.0003)

Conclusion

FDG uptake in meningioma was the significant predictive factor of tumor recurrence and significantly correlated with the proliferative potential of the tumor.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, Korea

    Jeong Won Lee, Keon Wook Kang, Sang Mi Lee, Jin Chul Paeng, June-Key Chung, Myung Chul Lee & Dong Soo Lee

  2. Cancer Research Institute, Seoul National University, Seoul, Korea

    Jeong Won Lee, Keon Wook Kang, June-Key Chung & Dong Soo Lee

  3. Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea

    Keon Wook Kang, June-Key Chung, Myung Chul Lee & Dong Soo Lee

  4. Department of Pathology, Seoul National University College of Medicine, Seoul, Korea

    Sung-Hye Park

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  1. Jeong Won Lee
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Correspondence to Keon Wook Kang.

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Lee, J.W., Kang, K.W., Park, SH. et al. 18F-FDG PET in the assessment of tumor grade and prediction of tumor recurrence in intracranial meningioma. Eur J Nucl Med Mol Imaging 36, 1574–1582 (2009). https://doi.org/10.1007/s00259-009-1133-x

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  • DOI: https://doi.org/10.1007/s00259-009-1133-x

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