Background: PET with radiolabelled amino acids is used in the preoperative evaluation of patients with glial neoplasms. This study aimed to assess the role of [ 11C]methionine (MET) PET in assessing molecular features, tumour extent, and prognosis in newly-diagnosed lower-grade gliomas (LGGs) surgically treated. Methods: 153 patients with a new diagnosis of grade 2/3 glioma who underwent surgery at our Institution and were imaged preoperatively using [ 11C]MET PET/CT were retrospectively included. [ 11C]MET PET images were qualitatively and semiquantitatively analyzed using tumour-to-background ratio (TBR). Progression-free survival (PFS) rates were estimated using the Kaplan-Meier method and Cox proportional-hazards regression was used to test the association of clinicopathological and imaging data to PFS. Results: Overall, 111 lesions (73%) were positive, while thirty-two (21%) and ten (6%) were isometabolic and hypometabolic at [ 11C]MET PET, respectively. [ 11C]MET uptake was more common in oligodendrogliomas than IDH-mutant astrocytomas (87% vs 50% of cases, respectively). Among [ 11C]MET-positive gliomas, grade 3 oligodendrogliomas had the highest median TBRmax (3.22). In 25% of patients, PET helped to better delineate tumour margins compared to MRI only. In IDH-mutant astrocytomas, higher TBRmax values at [ 11C]MET PET were independent predictors of shorter PFS. Conclusions: This work highlights the role of preoperative [ 11C]MET PET in estimating the type, assessing tumour extent, and predicting biological behaviour and prognosis of LGGs. Our findings support the implementation of [ 11C]MET PET in routine clinical practice to better manage these neoplasms.

Preoperative [11C]methionine PET to personalize treatment decisions in patients with lower-grade gliomas / Ninatti, Gaia; Sollini, Martina; Bono, Beatrice; Gozzi, Noemi; Fedorov, Daniil; Antunovic, Lidija; Gelardi, Fabrizia; Navarria, Pierina; Politi, Letterio S; Pessina, Federico; Chiti, Arturo. - In: NEURO-ONCOLOGY. - ISSN 1523-5866. - 24:9(2022), pp. 1546-1556. [10.1093/neuonc/noac040]

Preoperative [11C]methionine PET to personalize treatment decisions in patients with lower-grade gliomas

Sollini, Martina;Chiti, Arturo
Ultimo
2022-01-01

Abstract

Background: PET with radiolabelled amino acids is used in the preoperative evaluation of patients with glial neoplasms. This study aimed to assess the role of [ 11C]methionine (MET) PET in assessing molecular features, tumour extent, and prognosis in newly-diagnosed lower-grade gliomas (LGGs) surgically treated. Methods: 153 patients with a new diagnosis of grade 2/3 glioma who underwent surgery at our Institution and were imaged preoperatively using [ 11C]MET PET/CT were retrospectively included. [ 11C]MET PET images were qualitatively and semiquantitatively analyzed using tumour-to-background ratio (TBR). Progression-free survival (PFS) rates were estimated using the Kaplan-Meier method and Cox proportional-hazards regression was used to test the association of clinicopathological and imaging data to PFS. Results: Overall, 111 lesions (73%) were positive, while thirty-two (21%) and ten (6%) were isometabolic and hypometabolic at [ 11C]MET PET, respectively. [ 11C]MET uptake was more common in oligodendrogliomas than IDH-mutant astrocytomas (87% vs 50% of cases, respectively). Among [ 11C]MET-positive gliomas, grade 3 oligodendrogliomas had the highest median TBRmax (3.22). In 25% of patients, PET helped to better delineate tumour margins compared to MRI only. In IDH-mutant astrocytomas, higher TBRmax values at [ 11C]MET PET were independent predictors of shorter PFS. Conclusions: This work highlights the role of preoperative [ 11C]MET PET in estimating the type, assessing tumour extent, and predicting biological behaviour and prognosis of LGGs. Our findings support the implementation of [ 11C]MET PET in routine clinical practice to better manage these neoplasms.
2022
[11C]methionine PET
brain tumours
lower-grade gliomas
prognosis
surgery
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/140705
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