Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 7/2017

01-07-2017 | Original Article

Prognostic value of molecular and imaging biomarkers in patients with supratentorial glioma

Authors: Egesta Lopci, Marco Riva, Laura Olivari, Fabio Raneri, Riccardo Soffietti, Arnoldo Piccardo, Alberto Bizzi, Pierina Navarria, Anna Maria Ascolese, Roberta Rudà, Bethania Fernandes, Federico Pessina, Marco Grimaldi, Matteo Simonelli, Marco Rossi, Tommaso Alfieri, Paolo Andrea Zucali, Marta Scorsetti, Lorenzo Bello, Arturo Chiti

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2017

Login to get access

Abstract

Purpose

We evaluated the relationship between 11C-methionine PET (11C-METH PET) findings and molecular biomarkers in patients with supratentorial glioma who underwent surgery.

Methods

A consecutive series of 109 patients with pathologically proven glioma (64 men, 45 women; median age 43 years) referred to our Institution from March 2012 to January 2015 for tumour resection and who underwent preoperative 11C-METH PET were analysed. Semiquantitative evaluation of the 11C-METH PET images included SUVmax, region of interest-to-normal brain SUV ratio (SUVratio) and metabolic tumour volume (MTV). Imaging findings were correlated with disease outcome in terms of progression-free survival (PFS), and compared with other clinical biological data, including IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation. The patients were monitored for a mean period of 16.7 months (median 13 months).

Results

In all patients, the tumour was identified on 11C-METH PET. Significant differences in SUVmax, SUVratio and MTV were observed in relation to tumour grade (p < 0.001). IDH1 mutation was found in 49 patients, 1p/19q codeletion in 58 patients and MGMT promoter methylation in 74 patients. SUVmax and SUVratio were significantly inversely correlated with the presence of IDH1 mutation (p < 0.001). Using the 2016 WHO classification, SUVmax and SUVratio were significantly higher in patients with primary glioblastoma (IDH1-negative) than in those with other diffuse gliomas (p < 0.001). Relapse or progression was documented in 48 patients (median PFS 8.7 months). Cox regression analysis showed that SUVmax and SUVratio, tumour grade, tumour type on 2016 WHO classification, IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation were significantly associated with PFS. None of these factors was found to be an independent prognostic factor in multivariate analysis.

Conclusion

11C-METH PET parameters are significantly correlated with histological grade and IDH1 mutation status in patients with glioma. Grade, pathological classification, molecular biomarkers, SUVmax and SUVratio were prognostic factors for PFS in this cohort of patients.
The trial was registered with ClinicalTrials.gov (registration: NCT02518061).
Literature
1.
Ostrom QT, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. Neuro Oncol. 2014;16 Suppl 4:iv1–iv63.CrossRefPubMedPubMedCentral
2.
Weller M, Pfister SM, Hegi ME, Reifenberger G, Stupp R. Molecular neuro-oncology in clinical practice: a new horizon. Lancet Oncol. 2013;14:e370–e379.CrossRefPubMed
3.
Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 WHO Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131:803–820.CrossRefPubMed
4.
Nihashi T, Dahabreh IJ, Terasawa T. PET in the clinical management of glioma: evidence map. AJR Am J Roentgenol. 2013;200:654–660.CrossRef
5.
Lopci E, Franzese C, Grimaldi M, Zucali PA, Navarria P, Simonelli M, et al. Imaging biomarkers in primary brain tumors. Eur J Nucl Med Mol Imaging. 2015;42:597–612.CrossRefPubMed
6.
Schinkelshoek M, Lopci E, Clerici E, Alongi F, Mancosu P, Rodari M, et al. Impact of 11C-methionine positron emission tomography/computed tomography on radiation therapy planning and prognosis in patients with primary brain tumors. Tumori. 2014;100:636–644.PubMed
7.
Roelcke U, Wyss MT, Nowosielski M, Rudà R, Roth P, Hofer S, et al. Amino acid positron emission tomography to monitor chemotherapy response and predict seizure control and progression-free survival in WHO grade II gliomas. Neuro Oncol. 2016;18:744–751.CrossRefPubMed
8.
Albert NL, Weller M, Suchorska B, Galldiks N, Soffietti R, Kim MM, et al. Response Assessment in Neuro-Oncology working group and European Association for Neuro-Oncology recommendations for the clinical use of PET imaging in gliomas. Neuro Oncol. 2016;18:1199–1208.CrossRefPubMed
9.
Mitterhauser M, Wadsak W, Krcal A, Schmaljohann J, Eidherr H, Schmid A, et al. New aspects on the preparation of [11C]methionine. A simple and fast online approach without preparative HPLC. Appl Radiat Isot. 2005;62:441–445.CrossRefPubMed
10.
Glaudemans AW, Enting RH, Heesters MA, Dierckx RA, van Rheenen RW, Walenkamp AM, et al. Value of 11C-methionine PET in imaging brain tumours and metastases. Eur J Nucl Med Mol Imaging. 2013;40:615–635.CrossRefPubMed
11.
Galldiks N, Kracht LW, Berthold F, Miletic H, Klein JC, Herholz K, et al. [11C]-L-methionine positron emission tomography in the management of children and young adults with brain tumors. J Neurooncol. 2010;96:231–239.CrossRefPubMed
12.
Bello L, Gambini A, Castellano A, Carrabba G, Acerbi F, Fava E, et al. Motor and language DTI fiber tracking combined with intraoperative subcortical mapping for surgical removal of gliomas. Neuroimage. 2008;39:369–382.CrossRefPubMed
13.
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO Classification of Tumors of the Central Nervous System. Acta Neuropathol. 2007;114:97–109.CrossRefPubMedPubMedCentral
14.
van den Bent MJ, Carpentier AF, Brandes AA, Sanson M, Taphoorn MJ, Bernsen HJ, et al. Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial. J Clin Oncol. 2006;24:2715–2722.CrossRefPubMed
15.
Singhal T, Narayanan TK, Jacobs MP, Bal C, Mantil JC. 11C-methionine PET for grading and prognostication in gliomas: a comparison study with 18F-FDG PET and contrast enhancement on MRI. J Nucl Med. 2012;53:1709–1715.CrossRefPubMed
16.
Law M, Yang S, Wang H, Babb JS, Johnson G, Cha S, et al. Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol. 2003;24:1989–1998.PubMed
17.
Haegler K, Wiesmann M, Böhm C, Freiherr J, Schnell O, Brückmann H, et al. New similarity search based glioma grading. Neuroradiology. 2012;54:829–837.CrossRefPubMed
18.
Jalbert LE, Neill E, Phillips JJ, Lupo JM, Olson MP, Molinaro AM, et al. Magnetic resonance analysis of malignant transformation in recurrent glioma. Neuro Oncol. 2016;18:1169–1179.CrossRefPubMedPubMedCentral
19.
Nariai T, Tanaka Y, Wakimoto H, Aoyagi M, Tamaki M, Ishiwata K, et al. Usefulness of L-[methyl-11C]methionine-positron emission tomography as a biological monitoring tool in the treatment of glioma. J Neurosurg. 2005;103:498–507.CrossRefPubMed
20.
Sato N, Suzuki M, Kuwata N, Kuroda K, Wada T, Beppu T, et al. Evaluation of the malignancy of glioma using 11C-methionine positron emission tomography and proliferating cell nuclear antigen staining. Neurosurg Rev. 1999;22:210–214.CrossRefPubMed
21.
Shinozaki N, Uchino Y, Yoshikawa K, Matsutani T, Hasegawa A, Saeki N, et al. Discrimination between low-grade oligodendrogliomas and diffuse astrocytoma with the aid of 11C-methionine positron emission tomography. J Neurosurg. 2011;114:1640–1647.CrossRefPubMed
22.
Kato T, Shinoda J, Oka N, Miwa K, Nakayama N, Yano H, et al. Analysis of 11C-methionine uptake in low-grade gliomas and correlation with proliferative activity. AJNR Am J Neuroradiol. 2008;29:1867–1871.CrossRefPubMed
23.
Metellus P, Colin C, Taieb D, Guedj E, Nanni-Metellus I, de Paula AM, et al. IDH mutation status impact on in vivo hypoxia biomarkers expression: new insights from a clinical, nuclear imaging and immunohistochemical study in 33 glioma patients. J Neurooncol. 2011;105:591–600.CrossRefPubMed
24.
Saito T, Maruyama T, Muragaki Y, Tanaka M, Nitta M, Shinoda J, et al. 11C-methionine uptake correlates with combined 1p and 19q loss of heterozygosity in oligodendroglial tumors. AJNR Am J Neuroradiol. 2013;34:85–91.CrossRefPubMed
25.
Okita Y, Nonaka M, Shofuda T, Kanematsu D, Yoshioka E, Kodama Y, et al. 11C-methionine uptake correlates with MGMT promoter methylation in nonenhancing gliomas. Clin Neurol Neurosurg. 2014;125:212–216.CrossRefPubMed
26.
Choi H, Bang JI, Cheon GJ, Kim YH, Park CK, Park SH, et al. 18F-fluorodeoxyglucose and 11C-methionine positron emission tomography in relation to methyl-guanine methyltransferase promoter methylation in high-grade gliomas. Nucl Med Commun. 2015;36:211–218.CrossRefPubMed
27.
Ribom D, Schoenmaekers M, Engler H, Smits A. Evaluation of 11C-methionine PET as a surrogate endpoint after treatment of grade 2 gliomas. J Neurooncol. 2005;71:325–332.CrossRefPubMed
28.
Kim S, Chung JK, Im SH, Jeong JM, Lee DS, Kim DG, et al. 11C-methionine PET as a prognostic marker in patients with glioma: comparison with 18F-FDG PET. Eur J Nucl Med Mol Imaging. 2005;32:52–9.CrossRefPubMed
29.
Yoo MY, Paeng JC, Cheon GJ, Lee DS, Chung JK, Kim EE, et al. Prognostic value of metabolic tumor volume on (11)C-methionine PET in predicting progression-free survival in high-grade glioma. Nucl Med Mol Imaging. 2015;49:291–7.CrossRefPubMedPubMedCentral
30.
Smits A, Westerberg E, Ribom D. Adding 11C-methionine PET to the EORTC prognostic factors in grade 2 gliomas. Eur J Nucl Med Mol Imaging. 2008;35:65–71.CrossRefPubMed
31.
Herholz K, Holzer T, Bauer B, Schröder R, Voges J, Ernestus RI, et al. 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology. 1998;50:1316–1322.CrossRefPubMed
Metadata
Title
Prognostic value of molecular and imaging biomarkers in patients with supratentorial glioma
Authors
Egesta Lopci
Marco Riva
Laura Olivari
Fabio Raneri
Riccardo Soffietti
Arnoldo Piccardo
Alberto Bizzi
Pierina Navarria
Anna Maria Ascolese
Roberta Rudà
Bethania Fernandes
Federico Pessina
Marco Grimaldi
Matteo Simonelli
Marco Rossi
Tommaso Alfieri
Paolo Andrea Zucali
Marta Scorsetti
Lorenzo Bello
Arturo Chiti
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2017
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-017-3618-3

Other articles of this Issue 7/2017

European Journal of Nuclear Medicine and Molecular Imaging 7/2017 Go to the issue

Original Article

18F-FDG PET as novel imaging biomarker for disease progression after ablation therapy in colorectal liver metastases

Image of the Month

18F-FDG PET/CT in Erdheim–Chester disease

Original Article

Investigating the role of SPECT/CT in dynamic sentinel lymph node biopsy for penile cancers

Original Article

Clinical evaluation of TOF versus non-TOF on PET artifacts in simultaneous PET/MR: a dual centre experience

Original Article

Correlation between tumour characteristics, SUV measurements, metabolic tumour volume, TLG and textural features assessed with 18F-FDG PET in a large cohort of oestrogen receptor-positive breast cancer patients

Original Article

Feasibility of in vivo 18F-florbetaben PET/MR imaging of human carotid amyloid-β