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11C-methionine PET imaging characteristics in children with diffuse intrinsic pontine gliomas and relationship to survival and H3 K27M mutation status

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Abstract

Purpose

This study aimed to describe 11C-methionine (11C-MET) PET imaging characteristics in patients with paediatric diffuse intrinsic pontine glioma (DIPG) and correlate them with survival and H3 K27M mutation status.

Methods

We retrospectively analysed 98 children newly diagnosed with DIPG who underwent 11C-MET PET. PET imaging characteristics evaluated included uptake intensity, uniformity, metabolic tumour volume (MTV), and total lesion methionine uptake (TLMU). The maximum, mean, and peak of the tumour-to-background ratio (TBR), calculated as the corresponding standardised uptake values (SUV) divided by the mean reference value, were also recorded. The associations between the PET imaging characteristics and clinical outcomes in terms of progression-free survival (PFS) and overall survival (OS) and H3 K27M mutation status were assessed, respectively.

Results

In univariate analysis, imaging characteristics significantly associated with shorter PFS and OS included a higher uniformity grade, higher TBRs, larger MTV, and higher TLMU. In multivariate analysis, larger MTV at diagnosis, shorter symptom duration, and no treatment were significantly correlated with shorter PFS and OS. The PET imaging features were not correlated with H3 K27M mutation status.

Conclusion

Although several imaging features were significantly associated with PFS and OS, only MTV, indicating the size of the active tumour, was identified as a strong independent prognostic factor.

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Data Availability

The data that support the findings of this study are available from the corresponding author (L.A.), upon reasonable request.

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Acknowledgements

The authors thank Yongzhong Zhang and Di Fan for their efforts in radiopharmaceuticals synthesis; Wei Zhang, Qingsong Long, and Tong Wu for the image data acquisition; and Jian Pan for his assistance in picture modification and edition.

Funding

This work was supported by funds from the National Natural Science Foundation of China (81527805, 81971668), the National Natural Science Foundation of China (2018YFC1315201), and the Beijing Natural Science Foundation (81771143).

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Author notes

  1. Xiaobin Zhao and Deling Li contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Nan Si Huan Xi Lu 119, Fengtai District, Beijing, 100070, People’s Republic of China

    Xiaobin Zhao, Zhen Qiao, Kai Wang, Qian Chen & Lin Ai

  2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Nan Si Huan Xi Lu 119, Fengtai District, Beijing, 100070, People’s Republic of China

    Deling Li, Changcun Pan & Liwei Zhang

  3. China National Clinical Research Center for Neurological Diseases, Beijing, 100070, People’s Republic of China

    Deling Li, Dan Xiao, Tianshu Xi & Liwei Zhang

  4. Department of Emergency Neurosurgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, 264000, People’s Republic of China

    Yuliang Wu

  5. Beijing Key Laboratory of Brain Tumor, Beijing, 100070, People’s Republic of China

    Liwei Zhang

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  1. Xiaobin Zhao
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Correspondence to Liwei Zhang or Lin Ai.

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For this retrospective analysis, ethical approval was obtained, and the informed consent requirement was waived by the Institutional Reviewing Board of Beijing Tiantan Hospital, Capital Medical University.

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Zhao, X., Li, D., Qiao, Z. et al. 11C-methionine PET imaging characteristics in children with diffuse intrinsic pontine gliomas and relationship to survival and H3 K27M mutation status. Eur J Nucl Med Mol Imaging 50, 1709–1719 (2023). https://doi.org/10.1007/s00259-022-06105-z

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