Adding 11C-methionine PET to the EORTC prognostic factors in grade 2 gliomas

Abstract

Our findings further strengthen the role of MET PET as an important prognostic tool in the management of this group of patients.

Analysis of11C-methionine Uptake in Low-Grade Gliomas and Correlation with Proliferative Activity

“…The MET uptake was the most important prognostic factor in DA, and the presence of contrast enhancement on CT or MR imaging did not influence survival in both groups. 19 These findings demonstrate that DA with higher MET uptake may be more likely to undergo malignant transformation. On conventional MR imaging, local enhancement or peripheral edema suggests malignant transformation; however, these changes may not always be evident in the biologic history of a grade II glioma.…”

“…[10][11][12][13][14][15] In grade II glioma (DA, 33; OD, 39; OA, 17), tumor resection had a clear effect in patients with high MET uptake; however, no effect from surgery was found in the group of patients with low MET uptake. 17 Smits et al 19 analyzed DAs and oligodendrocytic tumors (OD and OA) separately in the reevaluation of the prognostic impact of the European Organisation for Research and Treatment of Cancer (EORTC) factors after adding the MET uptake as an extra prognostic factor. The MET uptake was the most important prognostic factor in DA, and the presence of contrast enhancement on CT or MR imaging did not influence survival in both groups.…”

“…It is generally believed that for most patients with grade II gliomas, the tumor will at some point transform into a more malignant form. 19 We hypothesized that MET uptake correlates significantly with proliferative activity and may thus be a predictor of malignant transformation in low-grade gliomas. We therefore compared MET uptake in DAs, ODs, and oligoastrocytomas (OAs) and investigated correlation with proliferative activity, as measured by Mib-1 LI.…”

Dynamic 18F-FET PET in Newly Diagnosed Astrocytic Low-Grade Glioma Identifies High-Risk Patients

“…The prognostic significance of amino acid uptake intensity in low-grade glioma still remains unclear. Even when comparing the results of the research group of Ribom et al, who investigated the impact of 11 C-methionine uptake in low-grade glioma, one can find controversial results: although one study reported low 11 Cmethionine uptake to be an independent prognostically favorable factor in low-grade glioma along with oligodendroglial histology (32), a later study showed an impact of 11 C-methionine uptake intensity on untreated oligodendroglial low-grade glioma but not on astrocytic low-grade glioma (33), and the latest study, in which 11 C-methionine uptake was added as a prognostic factor to the European Organisation for Research and Treatment of Cancer criteria, an impact was found for the small group of "high-risk" patients only, and a similar trend was found for the "low-risk" patients with oligodendroglial tumors (34). For a better understanding of the prognostic impact of amino acid uptake, larger studies with clearly homogeneous patient groups stratified by histologic subtype and with similar patient management (e.g., all patients untreated or all with surgical resection) would be extremely helpful.…”

PET imaging of gliomas using novel tracers: a sleeping beauty waiting to be kissed

“…Whereas some studies only see a limited value [37] others propose a high value, particularly for grade II gliomas [38][39][40]. Furthermore, recently published data showed a potential correlation of dynamic 18 F-FET-PET imaging and clinical outcome of the patients [41].…”