Purpose: The prognostic evaluation of glioma recurrence patients is important in the therapeutic management. We investigated the prognostic value of C-methionine PET-CT (MET-PET) dynamic and semiquantitative parameters in patients with suspected glioma recurrence.
Methods: Sixty-seven consecutive patients who underwent MET-PET for suspected glioma recurrence at MR were retrospectively included. Twenty-one patients underwent static MET-PET; 46/67 underwent dynamic MET-PET. In all patients, SUVmax, SUVmean and tumour-to-background ratio (T/B) were calculated. From dynamic acquisition, the shape and slope of time-activity curves, time-to-peak and its SUVmax (SUVmax) were extrapolated. The prognostic value of PET parameters on progression-free (PFS) and overall survival (OS) was evaluated using Kaplan-Meier survival estimates and Cox regression.
Results: The overall median follow-up was 19 months from MET-PET. Recurrence patients (38/67) had higher SUVmax ( = 0.001), SUVmean ( = 0.002) and T/B ( < 0.001); deceased patients (16/67) showed higher SUVmax ( = 0.03), SUVmean ( = 0.03) and T/B ( = 0.006). All static parameters were associated with PFS (all < 0.001); T/B was associated with OS ( = 0.031). Regarding kinetic analyses, recurrence (27/46) and deceased (14/46) patients had higher SUVmax ( = 0.02, = 0.01, respectively). SUVmax was the only dynamic parameter associated with PFS ( = 0.02) and OS ( = 0.006). At univariate analysis, SUVmax, SUVmean, T/B and SUVmax were predictive for PFS (all < 0.05); SUVmax was predictive for OS ( = 0.02). At multivariate analysis, SUVmax remained significant for PFS ( = 0.03).
Conclusion: Semiquantitative parameters and SUVmax were associated with clinical outcomes in patients with suspected glioma recurrence. Dynamic PET-CT acquisition, with static and kinetic parameters, can be a valuable non-invasive prognostic marker, identifying patients with worse prognosis who require personalised therapy.
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| http://dx.doi.org/10.3390/cancers13194777 | DOI Listing |
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