Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Minokamo, Gifu, Japan.
Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.
Brain Behav. 2023 Dec;13(12):e3291. doi: 10.1002/brb3.3291. Epub 2023 Oct 16.
The volume of excised tumor in contrast-enhanced areas evaluated via magnetic resonance imaging is known to have a strong influence on the survival of patients with glioblastoma (GBM). In this study, we investigated the effect of tumor resection on the survival of patients with GBM in the C-methionine (MET) accumulation area using MET-positron emission tomography (MET-PET).
A total of 26 patients (median age, 69 years; 15 males) who had undergone tumor resection and MET-PET before and after surgery, after being newly diagnosed with GBM, were included in the study. MET-PET before and after tumor resection were compared. The association between the decrease in the maximum standardized uptake value (SUV) of the tumor divided by the normal cortical mean SUV (%; ΔT/N), the MET extent of resection (MET-EOR) from the % reduction in the MET accumulation area (%), and residual MET accumulation area (in cm ; MET-residual tumor volume [RTV]), as well as the survival time of patients with GBM, were evaluated via univariate analysis.
ΔT/N were positively associated with survival (hazard ratio [HR], 0.98 [95% confidence interval (CI), 0.97-0.99], p = .02). MET-RTV revealed a negative association with survival (HR, 1.02 [95% CI, 1.01-1.04], p = .04). Additionally, MET-EOR showed a strong trend with survival (HR, 0.99 [95% CI, 0.97-1.01], p = .06).
Surgical resection of MET-accumulated areas in GBM significantly prolongs the survival of patients with GBM. However, a prospective large-scale multicenter study is needed to confirm our findings.
磁共振成像（MRI）增强区域内切除的肿瘤体积对胶质母细胞瘤（GBM）患者的生存有很大影响。本研究使用 C-蛋氨酸（MET）正电子发射断层扫描（MET-PET）来研究 MET 摄取区域肿瘤切除对 GBM 患者生存的影响。
本研究共纳入 26 例新诊断为 GBM 并在手术前和手术后进行了肿瘤切除和 MET-PET 的患者（中位年龄 69 岁；15 例男性）。比较了肿瘤切除前后的 MET-PET。通过单因素分析评估了肿瘤最大标准化摄取值（SUV）除以正常皮质平均 SUV 的下降（%）（ΔT/N）、肿瘤 MET 切除程度（MET-EOR）与 MET 摄取面积（%）减少的关系（%）以及残留的 MET 摄取区域（cm；MET 残留肿瘤体积 [RTV]）与 GBM 患者生存时间之间的相关性。
ΔT/N 与生存呈正相关（危险比 [HR]，0.98 [95%置信区间 [CI]，0.97-0.99]，p=0.02）。MET-RTV 与生存呈负相关（HR，1.02 [95% CI，1.01-1.04]，p=0.04）。此外，MET-EOR 与生存呈强趋势相关（HR，0.99 [95% CI，0.97-1.01]，p=0.06）。
GBM 中 MET 积累区域的手术切除显著延长了 GBM 患者的生存时间。然而，需要进行前瞻性大规模多中心研究来证实我们的发现。
