11 C-Methionine PET for Identification of Pediatric High-Grade Glioma Recurrence.

Autor:	Bag AK; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee; asim.bag@stjude.org., Wing MN; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee., Sabin ND; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee., Hwang SN; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee., Armstrong GT; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee., Han Y; Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee., Li Y; Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee., Snyder SE; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee., Robinson GW; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee., Qaddoumi I; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee; and., Broniscer A; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee., Lucas JT; Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee., Shulkin BL; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee.
Jazyk:	angličtina
Zdroj:	Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2022 May; Vol. 63 (5), pp. 664-671. Date of Electronic Publication: 2021 Aug 26.
DOI:	10.2967/jnumed.120.261891
Abstrakt:	Differentiating tumor recurrence or progression from pseudoprogression during surveillance of pediatric high-grade gliomas (PHGGs) using MRI, the primary imaging modality for evaluation of brain tumors, can be challenging. The aim of this study was to evaluate whether 11 C-methionine PET, a molecular imaging technique that detects functionally active tumors, is useful for further evaluating MRI changes concerning for tumor recurrence during routine surveillance. Methods : Using 11 C-methionine PET during follow-up visits, we evaluated 27 lesions in 26 patients with new or worsening MRI abnormalities for whom tumor recurrence was of concern. We performed quantitative and qualitative assessments of both 11 C-methionine PET and MRI data to predict the presence of tumor recurrence. Further, to assess for an association with overall survival (OS), we plotted the time from development of the imaging changes against survival. Results: Qualitative evaluation of 11 C-methionine PET achieved 100% sensitivity, 60% specificity, and 93% accuracy to correctly predict the presence of tumors in 27 new or worsening MRI abnormalities. Qualitative MRI evaluation achieved sensitivity ranging from 86% to 95%, specificity ranging from 40% to 60%, and accuracy ranging from 85% to 89%. The interobserver agreement for 11 C-methionine PET assessment was 100%, whereas the interobserver agreement was only 50% for MRI ( P < 0.01). Quantitative MRI and 11 C-methionine PET evaluation using receiver-operating characteristics demonstrated higher specificity (80%) than did qualitative evaluations (40%-60%). Postcontrast enhancement volume, metabolic tumor volume, tumor-to-brain ratio, and presence of tumor as determined by consensus MRI assessment were inversely associated with OS. Conclusion: 11 C-methionine PET has slightly higher sensitivity and accuracy for correctly predicting tumor recurrence, with excellent interobserver agreement, than does MRI. Quantitative 11 C-methionine PET can also predict OS. These findings suggest that 11 C-methionine PET can be useful for further evaluation of MRI changes during surveillance of previously treated PHGGs. (© 2022 by the Society of Nuclear Medicine and Molecular Imaging.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu