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Prognostic value of molecular and imaging biomarkers in patients with supratentorial glioma

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

Abstract

Purpose

We evaluated the relationship between 11C-methionine PET (11C-METH PET) findings and molecular biomarkers in patients with supratentorial glioma who underwent surgery.

Methods

A consecutive series of 109 patients with pathologically proven glioma (64 men, 45 women; median age 43 years) referred to our Institution from March 2012 to January 2015 for tumour resection and who underwent preoperative 11C-METH PET were analysed. Semiquantitative evaluation of the 11C-METH PET images included SUVmax, region of interest-to-normal brain SUV ratio (SUVratio) and metabolic tumour volume (MTV). Imaging findings were correlated with disease outcome in terms of progression-free survival (PFS), and compared with other clinical biological data, including IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation. The patients were monitored for a mean period of 16.7 months (median 13 months).

Results

In all patients, the tumour was identified on 11C-METH PET. Significant differences in SUVmax, SUVratio and MTV were observed in relation to tumour grade (p < 0.001). IDH1 mutation was found in 49 patients, 1p/19q codeletion in 58 patients and MGMT promoter methylation in 74 patients. SUVmax and SUVratio were significantly inversely correlated with the presence of IDH1 mutation (p < 0.001). Using the 2016 WHO classification, SUVmax and SUVratio were significantly higher in patients with primary glioblastoma (IDH1-negative) than in those with other diffuse gliomas (p < 0.001). Relapse or progression was documented in 48 patients (median PFS 8.7 months). Cox regression analysis showed that SUVmax and SUVratio, tumour grade, tumour type on 2016 WHO classification, IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation were significantly associated with PFS. None of these factors was found to be an independent prognostic factor in multivariate analysis.

Conclusion

11C-METH PET parameters are significantly correlated with histological grade and IDH1 mutation status in patients with glioma. Grade, pathological classification, molecular biomarkers, SUVmax and SUVratio were prognostic factors for PFS in this cohort of patients.

The trial was registered with ClinicalTrials.gov (registration: NCT02518061).

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Author information

Authors and Affiliations

  1. Nuclear Medicine, Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy

    Egesta Lopci & Arturo Chiti

  2. Neurosurgery, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy

    Marco Riva, Fabio Raneri, Federico Pessina & Lorenzo Bello

  3. Università degli Studi di Milano, Milan, Italy

    Laura Olivari, Marco Rossi, Tommaso Alfieri & Lorenzo Bello

  4. Neuro-Oncology, University & City of Health and Science Hospital, Turin, Italy

    Riccardo Soffietti & Roberta Rudà

  5. Nuclear Medicine, Galliera Hospital, Genova, Italy

    Arnoldo Piccardo

  6. Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Alberto Bizzi

  7. Radiosurgery and Radiotherapy, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy

    Pierina Navarria & Anna Maria Ascolese

  8. Pathology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy

    Bethania Fernandes & Marta Scorsetti

  9. Medical Oncology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy

    Marco Grimaldi

  10. Radiology Department, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy

    Matteo Simonelli & Paolo Andrea Zucali

  11. Humanitas University, Rozzano, Milan, Italy

    Marta Scorsetti & Arturo Chiti

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  1. Egesta Lopci
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  2. Marco Riva
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  3. Laura Olivari
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  15. Marco Rossi
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  19. Lorenzo Bello
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Corresponding author

Correspondence to Egesta Lopci.

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Funding

None.

Conflicts of interest

None.

Ethical approval

The study presented here was approved by the local review board and performed in accordance with the principles of good clinical practice, with the principles of the Declaration of Helsinki, and with national regulations regarding clinical trials. Informed consent has been obtained for patients, or their legal guardians, and patient assent was obtained whenever appropriate.

Additional information

E. Lopci and M. Riva contributed equally to this work.

L. Bello and A. Chiti can be considered joint last authors.

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Lopci, E., Riva, M., Olivari, L. et al. Prognostic value of molecular and imaging biomarkers in patients with supratentorial glioma. Eur J Nucl Med Mol Imaging 44, 1155–1164 (2017). https://doi.org/10.1007/s00259-017-3618-3

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  • DOI: https://doi.org/10.1007/s00259-017-3618-3

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