Kim Dongwoo, Cho Arthur, Hwang Sang Hyun, Jo KwanHyeong, Chang Jong Hee, Yun Mijin
Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752 South Korea.
Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Nucl Med Mol Imaging. 2020 Dec;54(6):274-280. doi: 10.1007/s13139-020-00672-5. Epub 2020 Nov 16.
We aimed to compare different reference regions and select one with the most clinical relevance on C11-acetate (ACE) positron emission tomography/computed tomography (PET/CT) in patients with cerebral glioma.
We retrospectively reviewed 51 patients with cerebral glioma who underwent baseline ACE PET/CT at diagnosis. Other than the standardized uptake value (SUV) of the primary tumor, SUVs of the reference regions including the normal gray matter, white matter, choroid plexus, and cerebellum were measured. Then, the SUV ratio (SUV = tumor SUV/reference region SUV) was calculated. The effect of patient age on the SUV of each reference was examined and the SUV of each reference region were compared between grades. age, sex, tumor size, histological grades, SUV, and the presence of isocitrate dehydrogenase (IDH) mutation were included for survival analyses.
Except for the cerebellum showing a mild negative correlation, we found no correlations between age and SUV using the gray matter, white matter, and choroid plexus ( = - 0.280, = 0.047). Only the SUV-choroid plexus was able to differentiate between the WHO grades (Grade II vs. III, = 0.035; grade III vs. IV, < 0.001; grade II vs. IV, < 0.001). Multivariate Cox proportional hazards models found that the SUVR-choroid plexus and IDH mutation were statistically significant for predicting OS.
Of the different reference regions used for grading cerebral gliomas, the choroid plexus was found to be the most optimal. In addition, the SUV ratio is useful to predict the overall survival in the model with the choroid plexus as a reference region.
我们旨在比较不同的参考区域，并在脑胶质瘤患者的C11-乙酸盐（ACE）正电子发射断层扫描/计算机断层扫描（PET/CT）中选择一个具有最大临床相关性的区域。
我们回顾性分析了51例在诊断时接受基线ACE PET/CT检查的脑胶质瘤患者。除了测量原发肿瘤的标准化摄取值（SUV）外，还测量了包括正常灰质、白质、脉络丛和小脑在内的参考区域的SUV。然后，计算SUV比值（SUV = 肿瘤SUV/参考区域SUV）。研究了患者年龄对每个参考区域SUV的影响，并比较了不同分级之间每个参考区域的SUV。纳入年龄、性别、肿瘤大小、组织学分级、SUV以及异柠檬酸脱氢酶（IDH）突变情况进行生存分析。
除小脑显示出轻度负相关外，我们发现年龄与使用灰质、白质和脉络丛的SUV之间无相关性（r = -0.280，r = 0.047）。只有SUV-脉络丛能够区分世界卫生组织分级（II级与III级，P = 0.035；III级与IV级，P < 0.001；II级与IV级，P < 0.001）。多变量Cox比例风险模型发现，SUVR-脉络丛和IDH突变对预测总生存期具有统计学意义。
在用于脑胶质瘤分级的不同参考区域中，脉络丛被发现是最理想的。此外，SUV比值有助于以脉络丛为参考区域的模型中预测总生存期。
