Prognostic Value of Molecular and Imaging Biomarkers in Patients with Supratentorial Glioma

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2017 Jan 23

PMID 28110346

Citations 40

Authors

Egesta Lopci

Marco Riva

Laura Olivari

Fabio Raneri

Riccardo Soffietti

Arnoldo Piccardo

Alberto Bizzi

Pierina Navarria

Anna Maria Ascolese

Roberta Ruda

Bethania Fernandes

Federico Pessina

Marco Grimaldi

Matteo Simonelli

Marco Rossi

Tommaso Alfieri

Paolo Andrea Zucali

Marta Scorsetti

Lorenzo Bello

Arturo Chiti

Affiliations

Soon will be listed here.

Abstract

Purpose: We evaluated the relationship between C-methionine PET (C-METH PET) findings and molecular biomarkers in patients with supratentorial glioma who underwent surgery.

Methods: A consecutive series of 109 patients with pathologically proven glioma (64 men, 45 women; median age 43 years) referred to our Institution from March 2012 to January 2015 for tumour resection and who underwent preoperative C-METH PET were analysed. Semiquantitative evaluation of the C-METH PET images included SUVmax, region of interest-to-normal brain SUV ratio (SUVratio) and metabolic tumour volume (MTV). Imaging findings were correlated with disease outcome in terms of progression-free survival (PFS), and compared with other clinical biological data, including IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation. The patients were monitored for a mean period of 16.7 months (median 13 months).

Results: In all patients, the tumour was identified on C-METH PET. Significant differences in SUVmax, SUVratio and MTV were observed in relation to tumour grade (p < 0.001). IDH1 mutation was found in 49 patients, 1p/19q codeletion in 58 patients and MGMT promoter methylation in 74 patients. SUVmax and SUVratio were significantly inversely correlated with the presence of IDH1 mutation (p < 0.001). Using the 2016 WHO classification, SUVmax and SUVratio were significantly higher in patients with primary glioblastoma (IDH1-negative) than in those with other diffuse gliomas (p < 0.001). Relapse or progression was documented in 48 patients (median PFS 8.7 months). Cox regression analysis showed that SUVmax and SUVratio, tumour grade, tumour type on 2016 WHO classification, IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation were significantly associated with PFS. None of these factors was found to be an independent prognostic factor in multivariate analysis.

Conclusion: C-METH PET parameters are significantly correlated with histological grade and IDH1 mutation status in patients with glioma. Grade, pathological classification, molecular biomarkers, SUVmax and SUVratio were prognostic factors for PFS in this cohort of patients. The trial was registered with ClinicalTrials.gov (registration: NCT02518061).

Citing Articles

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Predictive IDH Genotyping Based on the Evaluation of Spatial Metabolic Heterogeneity by Compartmental Uptake Characteristics in Preoperative Glioma Using F-FET PET.

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Yano H, Miwa K, Nakayama N, Maruyama T, Ohe N, Ikuta S World Neurosurg X. 2023; 19:100193.

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References

Shinozaki N, Uchino Y, Yoshikawa K, Matsutani T, Hasegawa A, Saeki N . Discrimination between low-grade oligodendrogliomas and diffuse astrocytoma with the aid of 11C-methionine positron emission tomography. J Neurosurg. 2011; 114(6):1640-7. DOI: 10.3171/2010.11.JNS10553. View

Louis D, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee W . The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016; 131(6):803-20. DOI: 10.1007/s00401-016-1545-1. View

Glaudemans A, Enting R, Heesters M, Dierckx R, van Rheenen R, Walenkamp A . Value of 11C-methionine PET in imaging brain tumours and metastases. Eur J Nucl Med Mol Imaging. 2012; 40(4):615-35. DOI: 10.1007/s00259-012-2295-5. View

Galldiks N, Kracht L, Berthold F, Miletic H, Klein J, Herholz K . [11C]-L-methionine positron emission tomography in the management of children and young adults with brain tumors. J Neurooncol. 2009; 96(2):231-9. PMC: 2808525. DOI: 10.1007/s11060-009-9953-x. View

Bello L, Gambini A, Castellano A, Carrabba G, Acerbi F, Fava E . Motor and language DTI Fiber Tracking combined with intraoperative subcortical mapping for surgical removal of gliomas. Neuroimage. 2007; 39(1):369-82. DOI: 10.1016/j.neuroimage.2007.08.031. View

Kim S, Chung J, Im S, Jeong J, Lee D, Kim D . 11C-methionine PET as a prognostic marker in patients with glioma: comparison with 18F-FDG PET. Eur J Nucl Med Mol Imaging. 2004; 32(1):52-9. DOI: 10.1007/s00259-004-1598-6. View

Kato T, Shinoda J, Oka N, Miwa K, Nakayama N, Yano H . Analysis of 11C-methionine uptake in low-grade gliomas and correlation with proliferative activity. AJNR Am J Neuroradiol. 2008; 29(10):1867-71. PMC: 8118949. DOI: 10.3174/ajnr.A1242. View

Roelcke U, Wyss M, Nowosielski M, Ruda R, Roth P, Hofer S . Amino acid positron emission tomography to monitor chemotherapy response and predict seizure control and progression-free survival in WHO grade II gliomas. Neuro Oncol. 2015; 18(5):744-51. PMC: 4827046. DOI: 10.1093/neuonc/nov282. View

Yoo M, Paeng J, Cheon G, Lee D, Chung J, Edmund Kim E . Prognostic Value of Metabolic Tumor Volume on (11)C-Methionine PET in Predicting Progression-Free Survival in High-Grade Glioma. Nucl Med Mol Imaging. 2015; 49(4):291-7. PMC: 4630329. DOI: 10.1007/s13139-015-0362-0. View

10.

Nihashi T, Dahabreh I, Terasawa T . PET in the clinical management of glioma: evidence map. AJR Am J Roentgenol. 2013; 200(6):W654-60. DOI: 10.2214/AJR.12.9168. View

11.

Saito T, Maruyama T, Muragaki Y, Tanaka M, Nitta M, Shinoda J . 11C-methionine uptake correlates with combined 1p and 19q loss of heterozygosity in oligodendroglial tumors. AJNR Am J Neuroradiol. 2012; 34(1):85-91. PMC: 7966311. DOI: 10.3174/ajnr.A3173. View

12.

Jalbert L, Neill E, Phillips J, Lupo J, Olson M, Molinaro A . Magnetic resonance analysis of malignant transformation in recurrent glioma. Neuro Oncol. 2016; 18(8):1169-79. PMC: 4933480. DOI: 10.1093/neuonc/now008. View

13.

Nariai T, Tanaka Y, Wakimoto H, Aoyagi M, Tamaki M, Ishiwata K . Usefulness of L-[methyl-11C] methionine-positron emission tomography as a biological monitoring tool in the treatment of glioma. J Neurosurg. 2005; 103(3):498-507. DOI: 10.3171/jns.2005.103.3.0498. View

14.

Ribom D, Schoenmaekers M, Engler H, Smits A . Evaluation of 11C-methionine PET as a surrogate endpoint after treatment of grade 2 gliomas. J Neurooncol. 2005; 71(3):325-32. DOI: 10.1007/s11060-004-2031-5. View

15.

Louis D, Ohgaki H, Wiestler O, Cavenee W, Burger P, Jouvet A . The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007; 114(2):97-109. PMC: 1929165. DOI: 10.1007/s00401-007-0243-4. View

16.

Lopci E, Franzese C, Grimaldi M, Zucali P, Navarria P, Simonelli M . Imaging biomarkers in primary brain tumours. Eur J Nucl Med Mol Imaging. 2014; 42(4):597-612. DOI: 10.1007/s00259-014-2971-8. View

17.

Albert N, Weller M, Suchorska B, Galldiks N, Soffietti R, Kim M . Response Assessment in Neuro-Oncology working group and European Association for Neuro-Oncology recommendations for the clinical use of PET imaging in gliomas. Neuro Oncol. 2016; 18(9):1199-208. PMC: 4999003. DOI: 10.1093/neuonc/now058. View

18.

Smits A, Westerberg E, Ribom D . Adding 11C-methionine PET to the EORTC prognostic factors in grade 2 gliomas. Eur J Nucl Med Mol Imaging. 2007; 35(1):65-71. DOI: 10.1007/s00259-007-0531-1. View

19.

Mitterhauser M, Wadsak W, Krcal A, Schmaljohann J, Eidherr H, Schmid A . New aspects on the preparation of [11C]Methionine--a simple and fast online approach without preparative HPLC. Appl Radiat Isot. 2004; 62(3):441-5. DOI: 10.1016/j.apradiso.2004.07.006. View

20.

Herholz K, Holzer T, Bauer B, Schroder R, Voges J, Ernestus R . 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology. 1998; 50(5):1316-22. DOI: 10.1212/wnl.50.5.1316. View