11C-Methionine PET for Grading and Prognostication in Gliomas: A Comparison Study with 18F-FDG PET and Contrast Enhancement on MRI
11C-Methionine PET for Grading and Prognostication in Gliomas: A Comparison Study with 18F-FDG PET and Contrast Enhancement on MRI
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DOI：
10.2967/jnumed.111.102533
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发表时间：
2012-11-01
影响因子：
9.3
通讯作者：
Mantil, Joseph C.
中科院分区：
文献类型：
--
作者：
Singhal, Tarun;Narayanan, Tanjore K.;Mantil, Joseph C.
本研究的目的是比较 F-18-FDG PET 和对比增强 MRI 的 L-[甲基-C-11]-蛋氨酸 (C-11-MET) PET 对胶质瘤患者的分级和预后价值。方法：经组织病理学证实的神经胶质瘤患者 (n = 102) 在 PET 后平均随访 34.6 +/- 3.8 个月。高级别胶质瘤组的中位生存期为 18 +/- 4.7 个月，低级别胶质瘤组的中位生存期为 58 +/- 27 个月。患者在诊断和术前阶段接受了 F-18-FDG PET、C-11-MET PET 和 MRI。计算肿瘤中的平均标准化摄取值与对侧正常皮质中的平均标准化摄取值的比率（T/N比率）。进行了 Kaplan-Meier 生存分析和方差分析。结果：高级别胶质瘤中 C-11-MET PET 和 F-18-FDG PET 的 T/N 比值显着高于低级别胶质瘤（2.15 +/- 0.77 与 1.56 +/- 0.74，P < 0.001，0.85 +/- 0.61 与 0.63 +/- 0.37，P < 0.01）。 C-11-MET PET 的 TIN 比率大于 1.51 的患者的中位生存期为 19 ± 5.4 个月，TIN 比率小于 1.51 的患者的中位生存期为 58 ± 26.7 个月 (P = 0.03)。在 LGG 中，C-11-MET PET 平均 TIN 比率大于 1.51 的患者（16 +/- 10 个月；95% 置信区间，1-36 个月）的中位生存期低于 TIN 比率小于 1.51 的患者（P = 0.04）。基于 F-18-FDG 摄取和 MRI 对比增强，LGG 的生存率没有显着差异。结论：C-11-MET PET 可以预测胶质瘤的预后，并且在预测 LGG 的生存方面优于 F-18-FDG PET 和 MRI。
The aim of this study was to compare the grading and prognostic value of L-[methyl-C-11]-methionine (C-11-MET) PET in glioma patients with F-18-FDG PET and contrast-enhanced MRI. Methods: Patients (n = 102) with histopathologically confirmed gliomas were followed up for an average of 34.6 +/- 3.8 mo after PET. The median survival was 18 +/- 4.7 mo in the high-grade glioma group and 58 +/- 27 mo in the low-grade glioma group. Patients underwent F-18-FDG PET, C-11-MET PET, and MRI in the diagnostic and preoperative stage. The ratio of the mean standardized uptake value in the tumor to mean standardized uptake value in contralateral normal cortex (T/N ratio) was calculated. Kaplan-Meier survival analysis and ANOVA were performed. Results: T/N ratios for C-11-MET PET and F-18-FDG PET were significantly higher in high-grade gliomas than in low-grade gliomas (2.15 +/- 0.77 vs. 1.56 +/- 0.74, P < 0.001, and 0.85 +/- 0.61 vs. 0.63 +/- 0.37, P < 0.01, respectively). Median survival was 19 5.4 mo in patients with a TIN ratio greater than 1.51 for C-11-MET PET and 58 +/- 26.7 mo in those with a TIN ratio less than 1.51 (P = 0.03). Among the LGGs, median survival was lower in patients with a mean TIN ratio greater than 1.51 for C-11-MET PET (16 +/- 10 mo; 95% confidence interval, 1-36 mo) than in those with a TIN ratio less than 1.51 (P = 0.04). No significant difference in survival in LGGs was based on F-18-FDG uptake and MRI contrast enhancement. Conclusion: C-11-MET PET can predict prognosis in gliomas and is better than F-18-FDG PET and MRI in predicting survival in LGGs.