Prognostic value of 11C-methionine volume-based PET parameters in IDH wild type glioblastoma.

van Dijken, Bart R. J.; Ankrah, Alfred O.; Stormezand, Gilles N.; Dierckx, Rudi A. J. O.; Jan van Laar, Peter; van der Hoorn, Anouk

Purpose: 11C-Methionine (11C-MET) PET prognostication of isocitrate dehydrogenase (IDH) wild type glioblastomas is inadequate as conventional parameters such as standardized uptake value (SUV) do not adequately reflect tumor heterogeneity. We retrospectively evaluated whether volume-based parameters such as metabolic tumor volume (MTV) and total lesion methionine metabolism (TLMM) outperformed SUV for survival correlation in patients with IDH wild type glioblastomas. Methods: Thirteen IDH wild type glioblastoma patients underwent preoperative 11C-MET PET. Both SUV-based parameters and volume-based parameters were calculated for each lesion. Kaplan-Meier curves with log-rank testing and Cox regression analysis were used for correlation between PET parameters and overall survival. Results: Median overall survival for the entire cohort was 393 days. MTV (HR 1.136, p = 0.007) and TLMM (HR 1.022, p = 0.030) were inversely correlated with overall survival. SUV-based 11C-MET PET parameters did not show a correlation with survival. In a paired analysis with other clinical parameters including age and radiotherapy dose, MTV and TLMM were found to be independent factors. Conclusions: MTV and TLMM, and not SUV, significantly correlate with overall survival in patients with IDH wild type glioblastomas. The incorporation of volume-based 11C-MET PET parameters may lead to a better outcome prediction for this heterogeneous patient population.

PROGNOSIS; GLIOBLASTOMA multiforme; ISOCITRATE dehydrogenase; METHIONINE; METHIONINE metabolism; REGRESSION analysis; POLYETHYLENE terephthalate; LOG-rank test

PLoS ONE, 2022, Vol 18, Issue 2, p1

1932-6203

Academic Journal

10.1371/journal.pone.0264387