PT  - JOURNAL ARTICLE
AU  - Bart Van Dijken
AU  - Alfred Ankrah
AU  - Gilles Stormezand
AU  - Peter Jan van Laar
AU  - Rudi Dierckx
AU  - Anouk van der Hoorn
TI  - Prognostic value of 11C-methionine PET in patients with IDH wild-type glioma<strong/>
DP  - 2019 May 01
TA  - Journal of Nuclear Medicine
PG  - 1501--1501
VI  - 60
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/60/supplement_1/1501.short
4100  - http://jnm.snmjournals.org/content/60/supplement_1/1501.full
SO  - J Nucl Med2019 May 01; 60
AB  - 1501Purpose: Isocitrate dehydrogenase (IDH) wild-type gliomas are a heterogeneous subgroup with poor prognosis. To improve outcome prediction for IDH wild-type glioma, 11C-methionine PET (MET-PET) may complement MRI. However, conventional MET-PET parameters such as standardized uptake value (SUV) do not adequately reflect the tumor heterogeneity. Volume-based parameters such as metabolic tumor volume (MTV) and the novel parameter total lesion methionine metabolism (TLMM), combine metabolic and anatomical information and possibly overcome the limitations of SUV. In this study, we retrospectively evaluated the prognostic value of both conventional metabolic and volume-based MET-PET parameters for survival correlation in patients with IDH wild-type glioma. Methods: Fifteen treatment-naïve patients with histopathologically proven IDH wild-type glioma (8 males; mean age 54 years) underwent preoperative MET-PET. Images were acquired 20 minutes after injection of 200 MBq methionine. Tumors were automatically delineated using a threshold of 40% of SUVmax. Extracted parameters included SUVmax, SUVmean, SUVpeak, MTV, and TLMM, which was calculated by the product of SUVmean and MTV. The data was dichotomized based on median cut-offs. Then, Kaplan-Meier curves with log-rank testing and Cox regression analysis were used for correlation between PET parameters and survival. Results: All tumors showed positive uptake on MET-PET. Patients with high MTV (≥14, median) had significantly lower survival than patients with low MTV (294 vs. 793 days, p=0.014) (Figure 1A). Comparable results were obtained for TLMM as patients with high TLMM (≥51) did worse than patients with low TLMM (335 vs. 828 days, p=0.041) (Figure 1B). Cox regression analysis confirmed a significant correlation of MTV (HR 1.047, p=0.032) and TLMM (HR 1.026, p=0.015) with survival, independent of histological grade. Other MET-PET parameters did not show a correlation with survival. Conclusions: MTV and TLMM significantly correlate with overall survival in patients with IDH wild-type gliomas. The incorporation of volume-based MET-PET parameters may lead to a better outcome prediction for this heterogeneous patient population.