11C-Methionine PET to predict survival of glioma patients treated by radiotherapy

Abstract

1523 Background: The early prediction of glioma prognosis is very important. Amino acid metabolism of glioma is associated with numerous catabolic processes favoring tumor growth. As an essential amino acid, L-methionine plays a central role in the altered metabolism of cancer cells. The aim of this study was to evaluate the prognostic value of PET imaging using 11C-methionine (MET) in patients with gliomas treated by radiotherapy. Methods: MET PET was prospectively performed in 36 patients with gliomas before and within one month after radiotherapy. Tumor MET uptake was measured with the semiquantitative tumor-to-nontumor ratio (T/N ratio). The MET uptake in the tumor and relevant clinical parameters were entered into univariate and multivariate survival analysis. Results: All tumors were identified in the baseline MET PET study. Patients with a baseline T/N ratio of < 4.0 had a significant better survival than patients with a baseline T/N ratio > 4.0 (2-year survival rate: 50.8% versus 0%, P=0.026). Patients with a post radiotherapy ratio of <4.0 had a better survival than that with a post radiotherapy ratio > 4.0 (2-year survival rate: 50.4% versus 0%, P=0.0012). The univariate analysis showed that both baseline and postradiotherapy T/N ratio were statistically significant predictors of patient survival, and postradiotherapy T/N ratio was a significant independent survival predictor in multivariate analysis. Tumors with larger T/N ratio had a significantly poorer prognosis. Conclusions: Baseline MET uptake was a potential survival indicator and postradiotherapy MET uptake was a significant independent predicator in glioma patients treated by radiotherapy. MET PET is a valuable tool in the predication of survival in patients with gliomas treated by radiotherapy. No significant financial relationships to disclose.