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11C-Methionine positron emission tomography delineates non-contrast enhancing tumor regions at high risk for recurrence in pediatric high-grade glioma

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Abstract

We assessed the prognostic utility of 11C-Methionine positron emission tomography (MET-PET) in pediatric high-grade glioma (HGG). Thirty-one children had 62 MET-PET studies. Segmented tumor volumes from co-registered magnetic resonance studies were assessed for concordance with MET-PET uptake using Boolean operations. The tumor volume at diagnosis and treatment failure was assessed relative to MET-PET avid volume. The prognostic impact of MET-PET—delineated non-contrast enhancing tumor (NCET) was assessed. NCET was defined as the region of tumor defined by defined by FLAIR which did not enhance but showed MET-PET avidity. MET-PET concordance varied according to magnetic resonance sequence. MET-PET rarely added to the tumor volume in most cases. The volume of MET-PET with standardized uptake value >3.0 was differentially distributed at diagnosis, post treatment, and at recurrence. The initial MET-PET region overlapped with recurrent tumor in 90% of the cases. When the proportion of tumor which was NCET was >10%, an earlier time to progression (5.8 months; 95% CI, 1–8.2 vs. 10.5 months; 95% CI, 0.9–NR; p = 0.035) was noted. MET-PET delineates regions at increased risk for recurrence and may improve the definition of failure, prognostic assessment, and target definition for radiotherapy.

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Acknowledgements

The authors thank Tina Davis and Roletta Ammons for their help with manuscript preparation, Cherise Guess for her help with manuscript review and Beth Lovorn for her assistance with protocol management and trial enrollment, accrual, and administration.

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Authors and Affiliations

  1. Department of Radiation Oncology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, MS 210, Memphis, TN, 38106-3678, USA

    John T. Lucas Jr., Chia-Ho Hua & Thomas E. Merchant

  2. Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Xingyu Li & Yimei Li

  3. Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Alberto Broniscer

  4. Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Scott E. Snyder, Scott Hwang & Barry L. Shulkin

  5. Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA, USA

    Nick Serrano

  6. Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, USA

    Hyun Kim

  7. Department of Pediatrics, University of Tennessee Health Services Center, Memphis, TN, USA

    Alberto Broniscer

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  1. John T. Lucas Jr.
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  2. Nick Serrano
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  3. Hyun Kim
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  4. Xingyu Li
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  5. Scott E. Snyder
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  6. Scott Hwang
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  7. Yimei Li
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  8. Chia-Ho Hua
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  9. Alberto Broniscer
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  10. Thomas E. Merchant
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  11. Barry L. Shulkin
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Correspondence to John T. Lucas Jr..

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lucas, J.T., Serrano, N., Kim, H. et al. 11C-Methionine positron emission tomography delineates non-contrast enhancing tumor regions at high risk for recurrence in pediatric high-grade glioma. J Neurooncol 132, 163–170 (2017). https://doi.org/10.1007/s11060-016-2354-z

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  • DOI: https://doi.org/10.1007/s11060-016-2354-z

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