Combination of Magnetic Resonance Spectroscopy and ¹¹C-Methionine Positron Emission Tomography for the Accurate Diagnosis of Non-Enhancing Supratentorial Glioma

Abstract

Objective To evaluate whether the combination of magnetic resonance spectroscopy (MRS) and 11 C-methionine positron emission tomography ( 11 C-MET PET) could increase accurate diagnostic sensitivity for non-enhancing supratentorial gliomas. Materials and Methods Between February 2012 and December 2017, 109 patients with non-enhanced supratentorial lesions on contrast-enhanced MRI were enrolled. Each patient underwent MRS and 11 C-MET PET before treatment. A lesion was considered to be a glioma when either the MRS or 11 C-MET PET results reached the diagnostic threshold. The radiological diagnosis was compared with the pathological diagnosis or medical diagnostic criteria. Results The sensitivity and specificity were 60.0% and 50.0% for MRS and 75.8% and 50.0% for 11 C-MET PET, respectively. Upon combining the two modalities, the sensitivity and specificity of the imaging-based diagnosis prior to surgery reached 89.5% and 42.9%, respectively. Statistically significant differences in the sensitivities were observed between the combined and individual approaches (MRS alone, 89.5% vs. 60.0%, p < 0.001; 11 C-MET PET alone, 89.5% vs. 75.8%, p = 0.001). However, no significant differences in specificity were observed between the combined and individual modalities. Conclusion The combination of MRS and 11 C-MET PET findings significantly increases accurate diagnostic sensitivity for non-enhancing supratentorial gliomas without significantly lowering the specificity. This finding suggests the potential of the combined MRS and 11 C-MET PET approach in clinical applications.

Comparison of Amino Acid PET to Advanced and Emerging MRI Techniques for Neurooncology Imaging: A Systematic Review of the Recent Studies

“…Amino Acid PET and MR Spectroscopy (Table 3) 3.3.1. MET PET with MRS. Two recent studies compared MET PET with MRS. Kudulaiti et al retrospectively reviewed the scans of 109 nonenhancing supratentorial lesions with MET PET and MRS prior to treatment, and compared their ability to differentiate glioma from nonglioma lesions [63]. The Cho/NAA index (CNI) for each voxel was used as the MRS parameter.…”