Abstract
Purpose
We aimed to compare different reference regions and select one with the most clinical relevance on C11-acetate (ACE) positron emission tomography/computed tomography (PET/CT) in patients with cerebral glioma.
Methods
We retrospectively reviewed 51 patients with cerebral glioma who underwent baseline ACE PET/CT at diagnosis. Other than the standardized uptake value (SUV) of the primary tumor, SUVs of the reference regions including the normal gray matter, white matter, choroid plexus, and cerebellum were measured. Then, the SUV ratio (SUVR = tumor SUVmax/reference region SUVmean) was calculated. The effect of patient age on the SUVmean of each reference was examined and the SUVRs of each reference region were compared between grades. age, sex, tumor size, histological grades, SUVR, and the presence of isocitrate dehydrogenase (IDH) mutation were included for survival analyses.
Results
Except for the cerebellum showing a mild negative correlation, we found no correlations between age and SUVmean using the gray matter, white matter, and choroid plexus (r = − 0.280, P = 0.047). Only the SUVR-choroid plexus was able to differentiate between the WHO grades (Grade II vs. III, P = 0.035; grade III vs. IV, P < 0.001; grade II vs. IV, P < 0.001). Multivariate Cox proportional hazards models found that the SUVR-choroid plexus and IDH mutation were statistically significant for predicting OS.
Conclusion
Of the different reference regions used for grading cerebral gliomas, the choroid plexus was found to be the most optimal. In addition, the SUV ratio is useful to predict the overall survival in the model with the choroid plexus as a reference region.
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Dongwoo Kim, Arthur Cho, Sang Hyun Hwang, KwanHyeong Jo, and Jong Hee Chang, Mijin Yun declare that they have no conflict of interest. This research was supported by the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (NRF-2016R1E1A1A01943303). The funders of the study were not involved in the study design, data collection, data interpretation, writing of the report, or the decision to submit the paper for publication. The authors report no other potential conflict of interest relevant to this article.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki declaration as revised in 2013 and its later amendments or comparable ethical standards.
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The institutional review board of our institute approved this retrospective study, and the requirement to obtain informed consent was waived.
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Kim, D., Cho, A., Hwang, S.H. et al. Choroid Plexus as the Best Reference Region for Standardized Uptake Value Analysis on C11-Acetate PET/CT for Grading and Predicting Prognosis in Patients with Cerebral Gliomas. Nucl Med Mol Imaging 54, 274–280 (2020). https://doi.org/10.1007/s13139-020-00672-5
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DOI: https://doi.org/10.1007/s13139-020-00672-5