11C-methionine PET as a prognostic marker in patients with glioma: comparison with 18F-FDG PET
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The purpose of this study was to compare the prognostic value of 11C-methionine (MET) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in glioma patients.
The study population comprised 47 patients with gliomas (19 glioblastoma, 28 others). Pretreatment magnetic resonance imaging, MET PET and FDG PET were performed within a time interval of 2 weeks in all patients. The uptake ratio and standard uptake values were calculated. Univariate and multivariate analyses were done to determine significant prognostic factors. Ki-67 index was measured by immunohistochemical staining, and compared with FDG and MET uptake in glioma.
Among the several clinicopathological prognostic factors, tumour pathology (glioblastoma or not), age (≥60 or <60 years), Karnofsky performance status (KPS) (≥70 or <70) and MET PET (higher uptake or not compared with normal cortex) were found to be significant predictors by univariate analysis. In multivariate analysis, tumour pathology, KPS and MET PET were identified as significant independent predictors. The Ki-67 proliferation index was significantly correlated with MET uptake (r=0.64), but not with FDG uptake.
Compared with FDG PET in glioma, MET PET was an independent significant prognostic factor and MET uptake was correlated with cellular proliferation. MET PET may be a useful biological prognostic marker in glioma patients.
KeywordsPET Malignant glioma 11C-methionine 18F-FDG Prognosis
- 2.Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 2001;95:190–8.Google Scholar
- 3.Russell D, Rubinstein L. Tumours of central neuroepithelial origin. In: Rubinstein LJ, editor. Pathology of tumours of the central nervous system. Baltimore: Williams & Wilkins; 1989. p. 83–350.Google Scholar
- 4.Bampoe JO, Bauman G, Cairncross JG. Adult low-grade glioma: natural history, prognostic factors, and timing of treatment. In: Rock JP, Rosenblum ML, Shaw EG, Cairncross JG, editors. The practical management of low-grade primary brain tumors. Philadelphia: Williams & Wilkins; 1999. p. 135–48.Google Scholar
- 17.Ishiwata K, Ido T, Vaalburg W. Increased amounts of d-enantiomer dependent on alkaline concentration in the synthesis of l-[methyl-11C]methionine. Appl Radiat Isot 1988;39:310–4.Google Scholar
- 18.Vecht C, Acesaat CJJ, Van Putten WLJ, et al. The influence of the extent of surgery on the neurological function and survival in malignant glioma. A retrospective analysis in 243 patients. J Neurol Neurosurg Psychiatry 1990;53:466–71.Google Scholar
- 19.Albert FK, Forsting M, Sator K, et al. Early postoperative magnetic resonance imaging after resection of malignant glioma: objective evaluation of residual tumor and its influence on regrowth prognosis. Neurosurgery 1994;34(6):45–61.Google Scholar