Pessina Federico, Navarria Pierina, Clerici Elena, Bellu Luisa, Franzini Andrea, Milani Davide, Simonelli Matteo, Persico Pasquale, Politi Letterio S, Casarotti Alessandra, Fernandes Bethania, Olei Simone, Sollini Martina, Chiti Arturo, Scorsetti Marta
Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy.
J Clin Med. 2021 May 25;10(11):2313. doi: 10.3390/jcm10112313.
(1) Background: We investigated the role of [11C]-methionine PET in a cohort of newly diagnosed glioblastoma multiforme (GBM) patients to evaluate whether it could modify the extent of surgical resection and improve radiation therapy volume delineation. (2) Methods: Newly diagnosed GBM patients, ages 18-70, with a Karnofsky performance scale (KPS) ≥ 70 with available MRI and [11C]-methionine PET were included. Patients were treated with different amounts of surgical resection followed by radio-chemotherapy. The role of [11C]-methionine PET in surgical and RT planning was analyzed. A threshold of SUVmax was searched. (3) Results: From August 2013 to April 2016, 93 patients were treated and included in this analysis. Residual tumor volume was detected in 63 cases on MRI and in 78 on [11C]-methionine PET, including 15 receiving gross total resection. The location of uptake was mainly observed in FLAIR abnormalities. [11C]-methionine uptake changed RT volume in 11% of patients. The presence of [11C]-methionine uptake in patients receiving GTR proved to influence survival ( = 0.029). The threshold of the SUVmax conditioning outcome was five. (4) Conclusions: [11C]-methionine PET allowed to detect areas at higher risk of recurrence located in FLAIR abnormalities in patients affected by GBM. A challenging issue is represented by integrating morphological and functional imaging to better define the extent of surgical resection to perform.
(1) 背景：我们在一组新诊断的多形性胶质母细胞瘤（GBM）患者中研究了[11C] - 蛋氨酸PET的作用，以评估其是否能改变手术切除范围并改善放射治疗靶区勾画。(2) 方法：纳入年龄在18 - 70岁、卡氏评分（KPS）≥70、有可用MRI和[11C] - 蛋氨酸PET的新诊断GBM患者。患者接受不同程度的手术切除，随后进行放化疗。分析了[11C] - 蛋氨酸PET在手术和放疗计划中的作用。寻找SUVmax的阈值。(3) 结果：2013年8月至2016年4月，93例患者接受治疗并纳入本分析。MRI检测到63例有残留肿瘤体积，[11C] - 蛋氨酸PET检测到78例，其中15例接受了全切除。摄取部位主要在FLAIR异常区域观察到。[11C] - 蛋氨酸摄取改变了11%患者的放疗靶区。接受全切除的患者中[11C] - 蛋氨酸摄取的存在被证明会影响生存（P = 0.029）。影响结果的SUVmax阈值为5。(4) 结论：[11C] - 蛋氨酸PET能够检测出GBM患者FLAIR异常区域中复发风险较高的区域。将形态学和功能成像相结合以更好地确定手术切除范围是一个具有挑战性的问题。
