Abstract
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Background: L-[S-methyl- 11C]methionine (MET) PET is a highly sensitive and established method for glioma imaging. However, little is known about gender specific aspects of glioma with respect to imaging characteristics. Aim: To evaluate gender specific differences in distribution, localization as well as in diagnosis by using MET PET of newly diagnosed gliomas prior to any therapy.
Methods: Data of 160 glioma patients (45% female, mean age: 45, range 18 - 84 yrs.) were retrospectively analyzed. We assessed gender specific differences regarding clinical presentation at the time of the diagnosis, visual and semi-quantitative evaluation by means of tumor to background (T/N) ratio in pre-surgical MET PET, the isocitrate dehydrogenase 1-R132H mutational status (IDH1-R132H), and survival using Kaplan-Meier estimates and a Cox proportional hazard model in all patients. Results: At the time of diagnosis there were no significant differences in clinical symptoms, tumor size, histology, and IDH1-R132H mutations between male and female patients. Nevertheless, we have observed statistically significant differences for the surgical approach (tumor resection, open biopsy and stereotactic biopsy) as well as for visual PET analysis (focal, focal-areal, multifocal-areal, areal, and negative) between male and female studied patients (P< 0.01). The T/N ratio was significantly higher in male than in female patients (3.0 ± 1.5 vs. 2.5 ± 1.3, P= 0.03). Furthermore, male patients showed a higher number of occipital tumors (P= 0.02) and a significantly lower median overall survival rate (76 vs. 112 months, P= 0.02) in comparison to female patients.
Conclusions: There are differences concerning localization of the tumor, MET PET analysis as well as surgical approaches and survival rate between male and female patients with gliomas. Therefore, gender of patient has to be taken into account during management of gliomas.