Predicting Glioma Recurrence Using 18F-FDG PET/CT, MRI, and Tumor Markers: A Combined Approach.

OBJECTIVE

To evaluate the combined predictive value of 18F-FDG PET/CT, MRI, and tumor markers for glioma recurrence.

METHODS

A retrospective analysis was conducted on the clinical data of 82 glioma patients treated at our hospital from January 2023 to April 2024. Patients were divided into Group A (n = 19, recurrence) and Group B (n = 63, no recurrence) based on whether recurrence occurred. All patients underwent 18F-FDG PET/CT to obtain maximum standardized uptake value (SUVmax) and lesion-to-normal tissue ratio (L/N). MRI was performed to measure the apparent diffusion coefficient (ADC) of the tumor parenchyma and cerebral blood flow (CBF). Serum samples were collected from all patients, and tumor markers, including monocyte-to-lymphocyte ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR), were measured using an automated blood analyzer. Differences in SUVmax, L/N, ADC, CBF, MLR, and NLR levels between Groups A and B were compared. Spearman correlation analysis was used to assess the relationships between SUVmax, L/N, ADC, CBF, MLR, NLR, and glioma recurrence. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic value of each parameter for glioma recurrence.

RESULTS

Recurrent patients demonstrated significantly higher SUVmax, L/N, NLR, and MLR, alongside lower ADC and CBF (all P < 0.05). These parameters correlated with recurrence (SUVmax, L/N, NLR, MLR positively; ADC and CBF negatively; all P < 0.05). ROC analysis highlighted the superiority of combined modalities, achieving an AUC of 0.856, with higher sensitivity and specificity than individual markers.

CONCLUSION

SUVmax, L/N, ADC, CBF, MLR, and NLR are correlated with glioma recurrence. The combined use of SUVmax, L/N, ADC, CBF, MLR, and NLR provides higher diagnostic value for glioma recurrence.