Diagnostic Performance of [11C]Methionine Positron Emission Tomography in Newly Diagnosed and Untreated Glioma Based on the Revised World Health Organization 2016 Classification

Maximum Lesion-to-contralateral Normal Brain Tissue Ration of 11C-methionine PET as a Prognostic Imaging Biomarker for Newly Diagnosed and Untreated Astrocytic Glioma

“…From July 2011 to March 2018, there were 66 adult patients and two patients under 18 years old with newly diagnosed and untreated WHO grade -glioma who underwent surgical tumor resection and preoperative 11C-methionine PET examination, as previously reported. [5] From this previous cohort, we included adult astrocytic glioma patients with IDH mutated-TERT promoter wild-type, or those with IDH wild-type in the present study. Finally, a total of 56 patients with astrocytic tumor were included in the present cohort.…”

“…An Eminence B PET scanner (Shimadzu, Kyoto, Japan) or Biograph-16 PET scanner (Siemens, Bon, Germany) was used for 11Cmethionine PET, according to previously reported procedures. [5,7] Mean and maximum lesion-to-contralateral normal brain tissue (L/N) ratios were determined by dividing the tumor standardized uptake value by the mean standardized uptake value of the normal contralateral region of the brain, as previously reported. [5] Genetic Analysis Genetic analysis was performed as previously described.…”

“…[5,7] Mean and maximum lesion-to-contralateral normal brain tissue (L/N) ratios were determined by dividing the tumor standardized uptake value by the mean standardized uptake value of the normal contralateral region of the brain, as previously reported. [5] Genetic Analysis Genetic analysis was performed as previously described. [5] Genomic DNA was extracted from surgically resected tumor specimens using the DNeasy Blood & Tissue Kit (Qiagen, Valencia, CA, USA) or NucleoSpin Tissue (Machery-Nagel, Duren, Germany).…”

“…[5] Genetic Analysis Genetic analysis was performed as previously described. [5] Genomic DNA was extracted from surgically resected tumor specimens using the DNeasy Blood & Tissue Kit (Qiagen, Valencia, CA, USA) or NucleoSpin Tissue (Machery-Nagel, Duren, Germany). Hotspot mutations of IDH1/2 (codon 132 of IDH1 and codon 172 of IDH2) and TERT promoter (termed C228 and C250) were examined using Sanger sequencing with a 3130xLGenetic Analyzer (Thermo Fisher Scienti c, Waltham, MA, USA) and Big-Dye® Terminator v1.1 Cycle Sequencing Kit (Thermo Fisher Scienti c, Waltham, MA, USA).…”

“…[3,4] We have previously reported a positive correlation between WHO grade and accumulation of 11C-methionine among astrocytomas, but that study did no analyze the relationship with prognosis. [5] Additional analysis was thus performed in the current study. Moreover, the clinical studies investigating the relationship between molecular analysis and uptake of amino acid PET in glioma patients are sparse, and detailed prognostic analyses of associations with molecular pro les and 11C-methionine PET uptake in glioma patients have not been fully completed.…”