18F-Fluorocholine PET/CT in the Prediction of Molecular Subtypes and Prognosis for Gliomas

Clinical Nuclear Medicine - Tập 44 Số 10 - Trang e548-e558 - 2019
Ana María García Vicente1, Julián Pérez-Beteta2, Mariano Amo‐Salas3, Francisco José Pena Pardo1, Maikal Villena Martín4, Hernán Sandoval Valencia5, Manuela Mollejo Villanueva6, Rosa Barbella1, Christoph José Klein Zampaña5, José María Borrás Moreno4, Á.M. Soriano Castrejón1, Vı́ctor M. Pérez-Garcı́a2
1Nuclear Medicine Department, University General Hospital, Ciudad Real
2Mathematical Oncology Laboratory (MôLAB), Castilla La Mancha University, Ciudad Real
3Department of Mathematics, Castilla La Mancha University, Ciudad Real
4Neurosurgery Department. University General Hospital, Ciudad Real
5Neurosurgery Department, University General Hospital, Albacete
6Pathology Department, Complejo Hospitalario de Toledo, Toledo

Tóm tắt

Aim

To study the association of metabolic features of 18F-fluorocholine in gliomas with histopathological and molecular parameters, progression-free survival (PFS) and overall survival (OS).

Methods

Prospective multicenter and nonrandomized study (Functional and Metabolic Glioma Analysis). Patients underwent a basal 18F-fluorocholine PET/CT and were included after histological confirmation of glioma. Histological and molecular profile was assessed: grade, Ki-67, isocitrate dehydrogenase status and 1p/19q codeletion. Patients underwent standard treatment after surgery or biopsy, depending on their clinical situation. Overall survival and PFS were obtained after follow-up. After tumor segmentation of PET images, SUV and volume-based variables, sphericity, surface, coefficient of variation, and multilesionality were obtained. Relations of metabolic variables with histological, molecular profile and prognosis were evaluated using Pearson χ2 and t test. Receiver operator caracteristic curves were used to obtain the cutoff of PET variables. Survival analysis was performed using Kaplan-Meier and Cox regression analysis.

Results

Forty-five patients were assessed; 38 were diagnosed as having high-grade gliomas. Significant differences of SUV-based variables with isocitrate dehydrogenase status, tumor grade, and Ki-67 were found. Tumor grade, Ki-67, SUVmax, and SUVmean were related to progression. Kaplan-Meier analysis revealed significant associations of SUVmax, SUVmean, and multilesionaly with OS and PFS. SUVmean, sphericity, and multilesionality were independent predictors of OS and PFS in Cox regression analysis.

Conclusions

Metabolic information obtained from 18F-fluorocholine PET of patients with glioma may be useful in the prediction of tumor biology and patient prognosis.

Từ khóa


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