Lower grade gliomas: relationships between metabolic and structural imaging with grading and molecular factors.

Lower grade gliomas: relationships between metabolic and structural imaging with grading and molecular factors.

World Neurosurg. 2019 Feb 21;:

Authors: Riva M, Lopci E, Castellano A, Olivari L, Gallucci M, Pessina F, Fernandes B, Simonelli M, Navarria P, Grimaldi M, Rudà R, Castello A, Rossi M, Alfiero T, Soffietti R, Chiti A, Bello L

Abstract
BACKGROUND: positron emission tomography (PET) is a valuable tool for the characterization of brain tumors in vivo. However, few studies investigated the correlation between 11C-METH PET metrics and the clinico-radiological, histological and molecular features in patients affected by lower grade gliomas (LGGs). This observational study aimed at evaluating the relationships between carbon-11-methionine PET (11C-METH PET) metrics and structural MRI imaging with histo-molecular biomarkers in patients with LGGs candidate to surgery.
METHODS: 96 patients with pathologically proven LGGs (51 males, 45 females; age 44.1±13.7 years; 45 grade II, 51 grade III), referred from March 2012 to January 2015 for tumor resection and submitted to pre-operative 11C-METH PET, were enrolled. Semi-quantitative metrics for 11C-METH PET included Standard Uptake Value (SUV) max, SUV ratio to normal brain and metabolic tumor burden (MTB). PET semiquantitative metrics were analyzed and compared to MRI features, histological diagnosis, IDH-1/2 status and 1p/19q co-deletion.
RESULTS: Histological grade was associated with SUV Max (p=0.002), SUV ratio (p=0.011) and MTB (p.=0.001), with grade III lesions showing higher metrics. Among nonenhancing lesions on MRI, SUVmax (p=0.001), SUVratio (p=0.003) and MTB (p<0.001) were statistically different in grade II versus grade III. MRI lesion volume poorly correlated with MTB (r2=0.13). SUVmax and the SUVratio were higher (p<0.05) in IDH-1/2 wild-type lesions, while SUVratio was associated with the presence of the 1p19q codeletion.
CONCLUSIONS: 11C-METH PET metrics significantly correlated with histological grade and molecular profile. PET semiquantitative metrics can improve pre-surgical evaluation of LGGs and thus support the clinical decision-making.

PMID: 30797926 [PubMed - as supplied by publisher]

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