11C-Methionine positron emission tomography delineates non-contrast enhancing tumor regions at high risk for recurrence in pediatric high-grade glioma

John T. Lucas, Nick Serrano, Hyun Kim, Xingyu Li, Scott E. Snyder, Scott Hwang, Yimei Li, Chia Ho Hua, Alberto Broniscer, Thomas E. Merchant, Barry L. Shulkin

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9 Scopus citations

Abstract

We assessed the prognostic utility of 11C-Methionine positron emission tomography (MET-PET) in pediatric high-grade glioma (HGG). Thirty-one children had 62 MET-PET studies. Segmented tumor volumes from co-registered magnetic resonance studies were assessed for concordance with MET-PET uptake using Boolean operations. The tumor volume at diagnosis and treatment failure was assessed relative to MET-PET avid volume. The prognostic impact of MET-PET—delineated non-contrast enhancing tumor (NCET) was assessed. NCET was defined as the region of tumor defined by defined by FLAIR which did not enhance but showed MET-PET avidity. MET-PET concordance varied according to magnetic resonance sequence. MET-PET rarely added to the tumor volume in most cases. The volume of MET-PET with standardized uptake value >3.0 was differentially distributed at diagnosis, post treatment, and at recurrence. The initial MET-PET region overlapped with recurrent tumor in 90% of the cases. When the proportion of tumor which was NCET was >10%, an earlier time to progression (5.8 months; 95% CI, 1–8.2 vs. 10.5 months; 95% CI, 0.9–NR; p = 0.035) was noted. MET-PET delineates regions at increased risk for recurrence and may improve the definition of failure, prognostic assessment, and target definition for radiotherapy.

Original languageEnglish
Pages (from-to)163-170
Number of pages8
JournalJournal of Neuro-Oncology
Volume132
Issue number1
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

Keywords

  • High-grade glioma
  • MET-PET
  • Pediatric

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    Lucas, J. T., Serrano, N., Kim, H., Li, X., Snyder, S. E., Hwang, S., Li, Y., Hua, C. H., Broniscer, A., Merchant, T. E., & Shulkin, B. L. (2017). 11C-Methionine positron emission tomography delineates non-contrast enhancing tumor regions at high risk for recurrence in pediatric high-grade glioma. Journal of Neuro-Oncology, 132(1), 163-170. https://doi.org/10.1007/s11060-016-2354-z