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Independent prognostic value of pre-treatment 18-FDG-PET in high-grade gliomas

  • Clinical Study - Patient Study
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Abstract

The prognostic value of PET with (18F)-fluoro-2-deoxy-d-glucose (FDG) has been shown in high-grade gliomas (HGG), but not compared with consensual prognostic factors. We sought to evaluate the independent predictive value of pre-treatment FDG-PET on overall (OS) and event-free survival (EFS). We retrospectively analyzed 41 patients with histologically-confirmed HGG (31 glioblastomas and 10 anaplastic gliomas). The pre-treatment uptake of FDG was assessed qualitatively by five-step visual metabolic grading, and quantitatively by the ratio between the tumor and contralateral maximal standardized uptake value (T/CL). EFS and OS following PET were compared with FDG uptake by univariate analysis, and by two multivariate analyses: one including main consensual prognostic factors (age, KPS, extent of surgery and histological grade), and the other including the classification system of the Radiation Therapy Oncology Group (Recursive Partitioning Analysis, RPA). Median OS and EFS were 13.8 and 7.4 months, respectively, for glioblastomas, and over 25.8 and 12 months, respectively, for anaplastic gliomas (P = 0.040 and P = 0.027). The T/CL ratio predicted OS in the entire group [P = 0.003; Hazard Ratio (HR) = 2.3] and in the glioblastoma subgroup (P = 0.018; HR = 2), independently of age, Karnofsky performance status, histological grade, and surgery, and independently of RPA classification. T/CL ratio tended to predict EFS in the whole group (P = 0.052). The prognostic value of visual metabolic grade on OS was less significant than T/CL ratio, both in the entire group and in the glioblastoma subgroup (P = 0.077 and P = 0.059). Quantitative evaluation of the ratio between the maximal tumor and contralateral uptake in pre-treatment FDG-PET provides significant additional prognostic information in newly-diagnosed HGG, independently of consensual prognostic factors.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. APHM, Hôpital de la Timone, Service Central de Biophysique et Médecine Nucléaire, 13005, Marseille, France

    Cécile Colavolpe, Olivier Mundler & Eric Guedj

  2. Aix-Marseille Université, CERIMED, 13005, Marseille, France

    Cécile Colavolpe, Olivier Mundler & Eric Guedj

  3. APHM, Hôpital de la Timone, Service de Santé Publique et d’Information Médicale, 13005, Marseille, France

    Julien Mancini

  4. APHM, Hôpital de la Timone, Service de Neurochirurgie, 13005, Marseille, France

    Philippe Metellus

  5. Aix-Marseille Université, UMR 911 Inserm, 13005, Marseille, France

    Philippe Metellus, Dominique Figarella-Branger & Olivier Chinot

  6. APHM, Hôpital de la Timone, Unité de Neuro-Oncologie, 13005, Marseille, France

    Maryline Barrie, Céline Béquet-Boucard & Olivier Chinot

  7. APHM, Hôpital de la Timone, Service d’Anatomie Pathologique et de Neuropathologie, 13005, Marseille, France

    Dominique Figarella-Branger

  8. Service Central de Biophysique et Médecine Nucléaire, CHU Timone 264 rue Saint-Pierre, 13385, Marseille, Cedex 5, France

    Eric Guedj

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  1. Cécile Colavolpe
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Correspondence to Eric Guedj.

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Colavolpe, C., Metellus, P., Mancini, J. et al. Independent prognostic value of pre-treatment 18-FDG-PET in high-grade gliomas. J Neurooncol 107, 527–535 (2012). https://doi.org/10.1007/s11060-011-0771-6

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  • DOI: https://doi.org/10.1007/s11060-011-0771-6

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