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11.09.2023 | Case Study

The prognostic power of [¹¹C]methionine PET in IDH-wildtype diffuse gliomas with lower-grade histological features: venturing beyond WHO classification

verfasst von: Gaia Ninatti, Cristiano Pini, Beatrice Claudia Bono, Fabrizia Gelardi, Lidija Antunovic, Bethania Fernandes, Martina Sollini, Claudio Landoni, Arturo Chiti, Federico Pessina

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2023

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Abstract

Purpose

IDH-wildtype (IDH-wt) diffuse gliomas with histological features of lower-grade gliomas (LGGs) are rare and heterogeneous primary brain tumours. [¹¹C]Methionine (MET) positron emission tomography (PET) is commonly used to evaluate glial neoplasms at diagnosis. The present study aimed to assess the prognostic value of MET PET in newly diagnosed, treatment naïve IDH-wt gliomas with histological features of LGGs.

Methods

Patients with a histological diagnosis of IDH-wt LGG who underwent preoperative (< 100 days) MET PET/CT and surgery were retrospectively included. Qualitative and semi-quantitative analyses of MET PET images were performed. Progression-free survival (PFS) and overall survival (OS) were analysed by Kaplan–Meier curves. Cox proportional-hazards regression was used to test the association of imaging and clinical data to PFS and OS.

Results

We included 48 patients (M:F = 25:23; median age 55). 39 lesions were positive and 9 negative at MET PET. Positive MET PET was significantly associated with shorter median PFS (15.7 months vs. not reached, p = 0.0146) and OS time (32.6 months vs. not reached, p = 0.0253). Incomplete surgical resection and higher TBR_mean values were independent predictors of shorter PFS on multivariate analysis (p < 0.001 for both). Higher tumour grade and incomplete surgical resection were independent predictors of OS at multivariate analysis (p = 0.027 and p = 0.01, respectively).

Conclusion

MET PET is useful for the prognostic stratification of patients with IDH-wt glial neoplasms with histological LGGs features. Considering their huge biological heterogeneity, the combination of MET PET and molecular analyses may help to improve the prognostic accuracy in these diffuse gliomas subset and influence therapeutic choices accordingly.

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Titel: The prognostic power of [11C]methionine PET in IDH-wildtype diffuse gliomas with lower-grade histological features: venturing beyond WHO classification
verfasst von: Gaia Ninatti
Cristiano Pini
Beatrice Claudia Bono
Fabrizia Gelardi
Lidija Antunovic
Bethania Fernandes
Martina Sollini
Claudio Landoni
Arturo Chiti
Federico Pessina
Publikationsdatum: 11.09.2023
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 2/2023
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-023-04438-9

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