Comparison of L-Methyl-11C-Methionine PET With Magnetic Resonance Spectroscopy in Detecting Newly Diagnosed Glioma.

Abstract

AIMS:

Amino acid PET and magnetic resonance spectroscopy (MRS) are at the forefront of noninvasive imaging techniques used for detection and subtyping of glioma-suspicious lesions. In this pilot study, we compare L-methyl-C-methionine PET and MRS for their ability to predict glioma subtypes.

METHODS:

Nineteen patients with histologically, confirmed newly diagnosed glioma underwent preoperative L-methyl-C-methionine PET and MRS in 1 diagnostic session. According to the molecular portfolio and histopathologic diagnosis, patients were subdivided in isocitrate dehydrogenase (IDH) wild-type glioblastoma, IDH wild-type grade II/III glioma, IDH-mutant grade II/III glioma without 1p/19q codeletion, and with 1p/19q codeletion subgroups. Maximum tumor-to-brain ratio (TBRmax), creatine, choline, and N-acetyl aspartate peaks were correlated with postoperative histopathologic tumor diagnoses.

RESULTS:

Maximum tumor-to-brain ratio was highest in glioblastoma patients (4.18) followed by patients with IDH wild-type grade II and III glioma (3.41). The latter TBRmax values were higher compared with those in patients with IDH-mutant grade II/III glioma without 1p/19q codeletion (1.95) and in patients with IDH-mutant 1p/19q codeleted grade II and III glioma (2.79). Magnetic resonance spectroscopy marker distribution showed no clear trend. Receiver operating characteristic analysis revealed TBRmax to be the best performing parameter in identifying IDH status (area under the curve, 0.67) and all spectroscopy markers combined in identifying glioma subgroups (area under the curve, 0.68), respectively.

CONCLUSIONS:

L-Methyl-C-methionine PET and MRS bear limited potential in glioma subgrouping. L-Methyl-C-methionine PET appears to be superior in differentiating IDH status, whereas MRS is more helpful in glioma subgrouping.

• Authors: Sied Kebir, Lazaros Lazaridis, Manuel Weber, Cornelius Deuschl, Ann-Kathrin Stoppek, Teresa Schmidt, Christoph Mönninghoff, Tobias Blau, Kathy Keyvani, Lale Umutlu, Daniela Pierscianek, Michael Forsting, Martin Stuschke, Gerald Antoch, Ulrich Sure, Christoph Kleinschnitz, Björn Scheffler, Patrick M Colletti, Domenico Rubello, Ken Herrmann, Martin Glas
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 44 Issue 6 Pg. e375-e381 (Jun 2019) ISSN: 1536-0229 [Electronic] United States
• PMID: 30985412 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Methionine
• methionine methyl ester
• Isocitrate Dehydrogenase

Topics

• Adult
• Brain Neoplasms (diagnostic imaging, genetics, pathology)
• Female
• Glioma (diagnostic imaging, genetics, pathology)
• Humans
• Isocitrate Dehydrogenase (genetics)
• Magnetic Resonance Imaging
• Male
• Methionine (analogs & derivatives)
• Mutation
• Pilot Projects
• Positron-Emission Tomography