Lower Grade Gliomas: Relationships Between Metabolic and Structural Imaging with Grading and Molecular Factors
Lower Grade Gliomas: Relationships Between Metabolic and Structural Imaging with Grading and Molecular Factors
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DOI：
10.1016/j.wneu.2019.02.031
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发表时间：
2019-06-01
影响因子：
2
通讯作者：
Bello, Lorenzo
中科院分区：
文献类型：
--
作者：
Riva, Marco;Lopci, Egesta;Bello, Lorenzo
背景：正电子发射断层扫描（PET）是一种有价值的工具，在体内脑肿瘤的特点。然而，很少有研究调查碳-11-甲硫氨酸（11 C-METH）PET指标与低级别胶质瘤（LGG）患者的临床、放射学、组织学和分子特征之间的相关性。本观察性研究评估了11 C-METH PET指标与结构磁共振成像（MRI）结果之间的关系，这些结果与LGG患者的组织分子生物标志物之间的关系，这些患者是手术的候选人。（51例男性，45例女性;年龄44.1 ± 13.7岁; 45例为II级，51例为III级），他们于2012年3月至2015年1月接受肿瘤切除术，并接受了术前11 C-METH PET。11 C-METH PET的半定量指标包括最大标准化摄取值（SUVmax）、与正常脑的SUV比值和代谢性肿瘤负荷（MTB）。PET半定量指标进行了分析，并与MRI特征，组织学诊断，异柠檬酸脱氢酶-1/2状态，和1 p/19 q codeletion.RESULTS：组织学分级与SUVmax（P = 0.002），SUV比（P = 0.011），MTB（P = 0.001），与III级病变显示更高的价值。在MRI上无强化的病灶中，SUVmax（P = 0.001）、SUV比值（P = 0.003）和MTB（P < 0.001）在II级与III级之间有显著性差异。MRI病灶体积与MTB相关性较差（r（2）= 0.13）。在异柠檬酸脱氢酶-1/2野生型病变中，SUVmax和SUV比更大（P < 0.05），SUV比与1 p19 q共缺失的存在相关。结论：11 C-METH PET指标与组织学分级和分子特征显著相关。半定量PET指标可以改善LGG的术前评估，从而支持临床决策。
BACKGROUND: Positron emission tomography (PET) is a valuable tool for the characterization of brain tumors in vivo. However, few studies have investigated the correlation between carbon-11-methionine (11C-METH) PET metrics and the clinical, radiological, histological, and molecular features of patients affected by lower grade gliomas (LGGs). The present observational study evaluated the relationships between 11C-METH PET metrics and structural magnetic resonance imaging (MRI) findings with the histomolecular biomarkers in patients with LGGs who were candidates for surgery.METHODS: We enrolled 96 patients with pathologically proven LGG (51 men, 45 women; age 44.1 +/- 13.7 years; 45 with grade II, 51 with grade III), who had been referred from March 2012 to January 2015 for tumor resection and had undergone preoperative 11C-METH PET. The semiquantitative metrics for 11C-METH PET included maximum standardized uptake value (SUVmax), SUV ratio to normal brain, and metabolic tumor burden (MTB). The PET semiquantitative metrics were analyzed and compared with the MRI features, histological diagnosis, isocitrate dehydrogenase-1/2 status, and 1p/19q codeletion.RESULTS: Histological grade was associated with SUVmax (P = 0.002), SUV ratio (P = 0.011), and MTB (P = 0.001), with grade III lesions showing higher values. Among the nonenhancing lesions on MRI, SUVmax (P = 0.001), SUV ratio (P = 0.003) and MTB (P < 0.001) were significantly different statistically for grade II versus grade III. The MRI lesion volume correlated poorly with MTB (r(2) = 0.13). The SUVmax and SUV ratio were greater (P < 0.05) in isocitrate dehydrogenase-1/2 wild-type lesions, and the SUV ratio was associated with the presence of the 1p19q codeletion.CONCLUSIONS: The 11C-METH PET metrics correlated significantly with histological grade and the molecular profile. Semiquantitative PET metrics can improve the preoperative evaluation of LGGs and thus support clinical decision-making.