Impact of [C]methionine PET with Bayesian Penalized Likelihood Reconstruction on Glioma Grades Based on New WHO 2021 Classification

Overview

Journal Ann Nucl Med

Date 2024 Mar 11

PMID 38466549

Authors

Kei Wagatsuma

Kensuke Ikemoto

Motoki Inaji

Yuto Kamitaka

Shoko Hara

Kaoru Tamura

Kenta Miwa

Kaede Tsuzura

Taisei Tsuruki

Noriaki Miyaji

Kenji Ishibashi

Kenji Ishii

Affiliations

Soon will be listed here.

Abstract

Objective: The uptake of [C]methionine in positron emission tomography (PET) imaging overlapped in earlier images of tumors. Bayesian penalized likelihood (BPL) reconstruction increases the quantitative values of tumors compared with conventional ordered subset-expectation maximization (OSEM). The present study aimed to grade glioma malignancy based on the new WHO 2021 classification using [C]methionine PET images reconstructed using BPL.

Methods: We categorized 32 gliomas in 28 patients as grades 2/3 (n = 15) and 4 (n = 17) based on the WHO 2021 classification. All [C]methionine images were reconstructed using OSEM + time-of-flight (TOF) and BPL + TOF (β = 200). Maximum standardized uptake value (SUV) and tumor-to-normal tissue ratio (T/N) were measured at each lesion.

Results: The mean SUV was 4.65 and 4.93 in grade 2/3 and 6.38 and 7.11 in grade 4, and the mean T/N was 7.08 and 7.22 in grade 2/3 and 9.30 and 10.19 in grade 4 for OSEM and BPL, respectively. The BPL significantly increased these values in grade 4 gliomas. The area under the receiver operator characteristic (ROC) curve (AUC) for SUV was the highest (0.792) using BPL.

Conclusions: The BPL increased mean SUV and mean T/N in lesions with higher contrast such as grade 4 glioma. The discrimination power between grades 2/3 and 4 in SUV was also increased using [C]methionine PET images reconstructed with BPL.

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