Usefulness of positron emission tomography for differentiating gliomas according to the 2016 World Health Organization classification of tumors of the central nervous system

被引：24

作者：

Takei, Hiroaki ^{[1
,2
,4
]}

Shinoda, Jun ^{[1
,2
,3
]}

Ikuta, Soko ^{[5
]}

Maruyama, Takashi ^{[5
]}

Muragaki, Yoshihiro ^{[5
]}

Kawasaki, Tomohiro ^{[1
,2
,4
]}

Ikegame, Yuka ^{[1
,2
,3
]}

Okada, Makoto ^{[1
,2
]}

Ito, Takeshi ^{[1
,2
]}

Asano, Yoshitaka ^{[1
,2
,3
]}

Yokoyama, Kazutoshi ^{[1
,2
]}

Nakayama, Noriyuki ^{[4
]}

Yano, Hirohito ^{[4
]}

Iwama, Toru ^{[4
]}

机构：

[1] Kizawa Mem Hosp, Dept Neurosurg, Minokamo, Gifu, Japan

[2] Kizawa Mem Hosp, Chubu Med Ctr Prolonged Traumat Brain Dysfunct, Minokamo, Gifu, Japan

[3] Gifu Univ, Grad Sch Med, Dept Clin Brain Sci, Gifu, Japan

[4] Gifu Univ, Grad Sch Med, Dept Neurosurg, Gifu, Japan

[5] Tokyo Womens Med Univ, Dept Neurosurg, Tokyo, Japan

来源：

JOURNAL OF NEUROSURGERY | 2020年 / 133卷 / 04期

基金：

日本学术振兴会;

关键词：

C-11-methionine; C-11-choline; F-18-fluorodeoxyglucose; positron emission tomography; glioma; isocitrate dehydrogenase mutation; oncology; C-11-METHIONINE PET; C-11; METHIONINE; IDH2; MUTATIONS; BRAIN-TUMORS; F-18-FDG PET; SURVIVAL; C-11-CHOLINE; DIAGNOSIS; NECROSIS; CHOLINE;

D O I：

10.3171/2019.5.JNS19780

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE: Positron emission tomography (PET) is important in the noninvasive diagnostic imaging of gliomas. There are many PET studies on glioma diagnosis based on the 2007 WHO classification; however, there are no studies on glioma diagnosis using the new classification (the 2016 WHO classification). Here, the authors investigated the relationship between uptake of 11C-methionine (MET), 11C-choline (CHO), and 18F-fluorodeoxyglucose (FDG) on PET imaging and isocitrate dehydrogenase (IDH) status (wild-type [IDH-wt] or mutant [IDH-mut]) in astrocytic and oligodendroglial tumors according to the 2016 WHO classification. METHODS: In total, 105 patients with newly diagnosed cerebral gliomas (6 diffuse astrocytomas [DAs] with IDH-wt, 6 DAs with IDH-mut, 7 anaplastic astrocytomas [AAs] with IDH-wt, 24 AAs with IDH-mut, 26 glioblastomas [GBMs] with IDH-wt, 5 GBMs with IDH-mut, 19 oligodendrogliomas [ODs], and 12 anaplastic oligodendrogliomas [AOs]) were included. All OD and AO patients had both IDH-mut and 1p/19q codeletion. The maximum standardized uptake value (SUV) of the tumor/mean SUV of normal cortex (T/N) ratios for MET, CHO, and FDG were calculated, and the mean T/N ratios of DA, AA, and GBM with IDH-wt and IDH-mut were compared. The diagnostic accuracy for distinguishing gliomas with IDH-wt from those with IDH-mut was assessed using receiver operating characteristic (ROC) curve analysis of the mean T/N ratios for the 3 PET tracers. RESULTS: There were significant differences in the mean T/N ratios for all 3 PET tracers between the IDH-wt and IDH-mut groups of all histological classifications (p < 0.001). Among the 27 gliomas with mean T/N ratios higher than the cutoff values for all 3 PET tracers, 23 (85.2%) were classified into the IDH-wt group using ROC analysis. In DA, there were no significant differences in the T/N ratios for MET, CHO, and FDG between the IDH-wt and IDH-mut groups. In AA, the mean T/N ratios of all 3 PET tracers in the IDH-wt group were significantly higher than those in the IDH-mut group (p < 0.01). In GBM, the mean T/N ratio in the IDH-wt group was significantly higher than that in the IDH-mut group for both MET (p = 0.034) and CHO (p = 0.01). However, there was no significant difference in the ratio for FDG. CONCLUSIONS: PET imaging using MET, CHO, and FDG was suggested to be informative for preoperatively differentiating gliomas according to the 2016 WHO classification, particularly for differentiating IDH-wt and IDH-mut tumors.

引用

页码：1010 / 1019

页数：10