Diagnostic value of volumetric parameters of 11C methionine PETCT combined with molecular biomarkers for suspected glioma

Purpose: We aimed to investigate the diagnostic value of volume based parameters of 11C methionine (11C MET) PETCT for clinically suspected glioma and explore the potential association between the uptake parameters, glioma grading, and molecular biomarkers.Method: A total of 135 patients with clinical suspected glioma by magnetic resonance imaging (MRI) and 11C MET PETCT were enrolled retrospectively. Diagnostic value of 11C MET PETCT for differentiating neoplastic lesions (NLs) from non neoplastic lesions (NNLs) and differentiating high grade gliomas (HGGs) from low grade gliomas (LGGs) were assessed by receiver operating characteristic (ROC) curve. Relationship between glioma grading, 11C MET parameters, and molecular markers was evaluated by spearman correlation analysis, chi-squared test and Tukey Kramer

Methods: Result: Total lesion methionine uptake (TLMU) and metabolic tumor volume (MTV) of NLs were larger than NNLs. The optimal thresholds of TLMU, MTV, and LNR_max for differentiating NLs from NNLs were 12.7 (PPV = 95.6%, NPV = 48.5%), 7.0 (PPV = 92.3%, NPV = 43.5%), and 1.6 (PPV = 93.8%, NPV = 70.5%), respectively. The cutoff value of LNR_max for differentiating HGGs from LGGs was 2.6 (PPV = 82.4%, NPV = 67.9%). The IDH1 mutation showed a significant correlation with tumor grade, MR enhancement, and oligodendroglia component (p = 0.002, p = 0.001, p = 0.017, respectively).Conclusion: TLMU, MTV, and LNR_max derived from 11C-MET PET could potentially differentiate NLs from NNLs. In addition, a higher LNR_max may indicate the high grade glioma.Keywords: 11C MET, PETCT, glioma, MTV, TLMU, molecular biomarker.

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