The prognostic power of [11C]methionine PET in IDH-wildtype diffuse gliomas with lower-grade histological features : venturing beyond WHO classification

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..

PURPOSE: IDH-wildtype (IDH-wt) diffuse gliomas with histological features of lower-grade gliomas (LGGs) are rare and heterogeneous primary brain tumours. [11C]Methionine (MET) positron emission tomography (PET) is commonly used to evaluate glial neoplasms at diagnosis. The present study aimed to assess the prognostic value of MET PET in newly diagnosed, treatment naïve IDH-wt gliomas with histological features of LGGs.

METHODS: Patients with a histological diagnosis of IDH-wt LGG who underwent preoperative (< 100 days) MET PET/CT and surgery were retrospectively included. Qualitative and semi-quantitative analyses of MET PET images were performed. Progression-free survival (PFS) and overall survival (OS) were analysed by Kaplan-Meier curves. Cox proportional-hazards regression was used to test the association of imaging and clinical data to PFS and OS.

RESULTS: We included 48 patients (M:F = 25:23; median age 55). 39 lesions were positive and 9 negative at MET PET. Positive MET PET was significantly associated with shorter median PFS (15.7 months vs. not reached, p = 0.0146) and OS time (32.6 months vs. not reached, p = 0.0253). Incomplete surgical resection and higher TBRmean values were independent predictors of shorter PFS on multivariate analysis (p < 0.001 for both). Higher tumour grade and incomplete surgical resection were independent predictors of OS at multivariate analysis (p = 0.027 and p = 0.01, respectively).

CONCLUSION: MET PET is useful for the prognostic stratification of patients with IDH-wt glial neoplasms with histological LGGs features. Considering their huge biological heterogeneity, the combination of MET PET and molecular analyses may help to improve the prognostic accuracy in these diffuse gliomas subset and influence therapeutic choices accordingly.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:164

Enthalten in:

Journal of neuro-oncology - 164(2023), 2 vom: 11. Sept., Seite 473-481

Sprache:

Englisch

Beteiligte Personen:

Ninatti, Gaia [VerfasserIn]
Pini, Cristiano [VerfasserIn]
Bono, Beatrice Claudia [VerfasserIn]
Gelardi, Fabrizia [VerfasserIn]
Antunovic, Lidija [VerfasserIn]
Fernandes, Bethania [VerfasserIn]
Sollini, Martina [VerfasserIn]
Landoni, Claudio [VerfasserIn]
Chiti, Arturo [VerfasserIn]
Pessina, Federico [VerfasserIn]

Links:

Volltext

Themen:

[11C]methionine
Brain tumours
IDH-wildtype gliomas
Journal Article
Lower-grade gliomas
PET
Prognosis

Anmerkungen:

Date Revised 26.09.2023

published: Print-Electronic

Citation Status Publisher

doi:

10.1007/s11060-023-04438-9

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM361929323