The roles of 11C-acetate PET/CT in predicting tumor differentiation and survival in patients with cerebral glioma

Soyoung Kim, Dongwoo Kim, Se Hoon Kim, Mi ae Park, Jong Hee Chang, Mijin Yun

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: This prospective study aimed to evaluate the clinical values of 11C–acetate positron emission tomography/computed tomography (PET/CT) in predicting histologic grades and survival in patients with cerebral glioma. Methods: Seventy-three patients with surgically confirmed cerebral gliomas (19 grade II, 21 grade III, and 33 grade IV) who underwent 11C–acetate PET/CT before surgery were included. Tumor-to-choroid plexus ratio (TCR), which was defined as the maximum standardized uptake value (SUV) of tumors to the mean SUV of choroid plexus, was compared between three World Health Organization (WHO) grade groups. Moreover, metabolic tumor volumes (MTV) were calculated. Progression-free survival (PFS) and overall survival (OS) curves were plotted using the Kaplan–Meier method, and differences in survival between groups were assessed using the log-rank test. Results: Median TCR was 1.20 (interquartile range [IQR], 1.14 to 1.4) in grade II, 1.65 (IQR, 1.26 to 1.79) in grade III, and 2.53 (IQR, 1.93 to 3.30) in grade IV gliomas. Significant differences in TCR were seen among the three WHO grade groups (P < 0.001). In Cox regression analysis including TCR, MTV, molecular markers, and other clinical factors, TCR was prognostic for PFS (P = 0.016) and TCR and MTV were prognostic for OS (P = 0.024 [TCR], P = 0.030 [MTV]). PFS and OS were significantly shorter in patients with a TCR ≥ 1.6 than in those with a TCR < 1.6. OS were significantly shorter in patients with a MTV ≥ 1 than in those with a TCR < 1. Conclusions: TCR on 11C–acetate PET/CT significantly differed between low- and high-grade cerebral gliomas, and it showed the capability to further differentiate grade III from grade IV tumors. TCR and MTV were independent prognostic factors and predicted survival better than did the WHO grade.

Original languageEnglish
Pages (from-to)1012-1020
Number of pages9
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume45
Issue number6
DOIs
Publication statusPublished - 2018 Jun 1

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Choroid Plexus
Glioma
Survival
Tumor Burden
Neoplasms
Disease-Free Survival
carbon-11 acetate
Positron Emission Tomography Computed Tomography
Choroid Plexus Neoplasms
Biomarkers
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "The roles of 11C-acetate PET/CT in predicting tumor differentiation and survival in patients with cerebral glioma",
abstract = "Purpose: This prospective study aimed to evaluate the clinical values of 11C–acetate positron emission tomography/computed tomography (PET/CT) in predicting histologic grades and survival in patients with cerebral glioma. Methods: Seventy-three patients with surgically confirmed cerebral gliomas (19 grade II, 21 grade III, and 33 grade IV) who underwent 11C–acetate PET/CT before surgery were included. Tumor-to-choroid plexus ratio (TCR), which was defined as the maximum standardized uptake value (SUV) of tumors to the mean SUV of choroid plexus, was compared between three World Health Organization (WHO) grade groups. Moreover, metabolic tumor volumes (MTV) were calculated. Progression-free survival (PFS) and overall survival (OS) curves were plotted using the Kaplan–Meier method, and differences in survival between groups were assessed using the log-rank test. Results: Median TCR was 1.20 (interquartile range [IQR], 1.14 to 1.4) in grade II, 1.65 (IQR, 1.26 to 1.79) in grade III, and 2.53 (IQR, 1.93 to 3.30) in grade IV gliomas. Significant differences in TCR were seen among the three WHO grade groups (P < 0.001). In Cox regression analysis including TCR, MTV, molecular markers, and other clinical factors, TCR was prognostic for PFS (P = 0.016) and TCR and MTV were prognostic for OS (P = 0.024 [TCR], P = 0.030 [MTV]). PFS and OS were significantly shorter in patients with a TCR ≥ 1.6 than in those with a TCR < 1.6. OS were significantly shorter in patients with a MTV ≥ 1 than in those with a TCR < 1. Conclusions: TCR on 11C–acetate PET/CT significantly differed between low- and high-grade cerebral gliomas, and it showed the capability to further differentiate grade III from grade IV tumors. TCR and MTV were independent prognostic factors and predicted survival better than did the WHO grade.",
author = "Soyoung Kim and Dongwoo Kim and Kim, {Se Hoon} and Park, {Mi ae} and Chang, {Jong Hee} and Mijin Yun",
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The roles of 11C-acetate PET/CT in predicting tumor differentiation and survival in patients with cerebral glioma. / Kim, Soyoung; Kim, Dongwoo; Kim, Se Hoon; Park, Mi ae; Chang, Jong Hee; Yun, Mijin.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 45, No. 6, 01.06.2018, p. 1012-1020.

Research output: Contribution to journalArticle

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N2 - Purpose: This prospective study aimed to evaluate the clinical values of 11C–acetate positron emission tomography/computed tomography (PET/CT) in predicting histologic grades and survival in patients with cerebral glioma. Methods: Seventy-three patients with surgically confirmed cerebral gliomas (19 grade II, 21 grade III, and 33 grade IV) who underwent 11C–acetate PET/CT before surgery were included. Tumor-to-choroid plexus ratio (TCR), which was defined as the maximum standardized uptake value (SUV) of tumors to the mean SUV of choroid plexus, was compared between three World Health Organization (WHO) grade groups. Moreover, metabolic tumor volumes (MTV) were calculated. Progression-free survival (PFS) and overall survival (OS) curves were plotted using the Kaplan–Meier method, and differences in survival between groups were assessed using the log-rank test. Results: Median TCR was 1.20 (interquartile range [IQR], 1.14 to 1.4) in grade II, 1.65 (IQR, 1.26 to 1.79) in grade III, and 2.53 (IQR, 1.93 to 3.30) in grade IV gliomas. Significant differences in TCR were seen among the three WHO grade groups (P < 0.001). In Cox regression analysis including TCR, MTV, molecular markers, and other clinical factors, TCR was prognostic for PFS (P = 0.016) and TCR and MTV were prognostic for OS (P = 0.024 [TCR], P = 0.030 [MTV]). PFS and OS were significantly shorter in patients with a TCR ≥ 1.6 than in those with a TCR < 1.6. OS were significantly shorter in patients with a MTV ≥ 1 than in those with a TCR < 1. Conclusions: TCR on 11C–acetate PET/CT significantly differed between low- and high-grade cerebral gliomas, and it showed the capability to further differentiate grade III from grade IV tumors. TCR and MTV were independent prognostic factors and predicted survival better than did the WHO grade.

AB - Purpose: This prospective study aimed to evaluate the clinical values of 11C–acetate positron emission tomography/computed tomography (PET/CT) in predicting histologic grades and survival in patients with cerebral glioma. Methods: Seventy-three patients with surgically confirmed cerebral gliomas (19 grade II, 21 grade III, and 33 grade IV) who underwent 11C–acetate PET/CT before surgery were included. Tumor-to-choroid plexus ratio (TCR), which was defined as the maximum standardized uptake value (SUV) of tumors to the mean SUV of choroid plexus, was compared between three World Health Organization (WHO) grade groups. Moreover, metabolic tumor volumes (MTV) were calculated. Progression-free survival (PFS) and overall survival (OS) curves were plotted using the Kaplan–Meier method, and differences in survival between groups were assessed using the log-rank test. Results: Median TCR was 1.20 (interquartile range [IQR], 1.14 to 1.4) in grade II, 1.65 (IQR, 1.26 to 1.79) in grade III, and 2.53 (IQR, 1.93 to 3.30) in grade IV gliomas. Significant differences in TCR were seen among the three WHO grade groups (P < 0.001). In Cox regression analysis including TCR, MTV, molecular markers, and other clinical factors, TCR was prognostic for PFS (P = 0.016) and TCR and MTV were prognostic for OS (P = 0.024 [TCR], P = 0.030 [MTV]). PFS and OS were significantly shorter in patients with a TCR ≥ 1.6 than in those with a TCR < 1.6. OS were significantly shorter in patients with a MTV ≥ 1 than in those with a TCR < 1. Conclusions: TCR on 11C–acetate PET/CT significantly differed between low- and high-grade cerebral gliomas, and it showed the capability to further differentiate grade III from grade IV tumors. TCR and MTV were independent prognostic factors and predicted survival better than did the WHO grade.

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