Abstract：
To clarify the relationships between 11C-methionine (MET) positron emission tomography (PET) metrics and the histology, genetics, and prognosis of adult-type diffuse glioma (ADG) based on the World Health Organization (WHO) 2021 classification.
A total of 125 newly diagnosed patients with ADG were enrolled. We compared the maximum standardized uptake value (SUVmax), tumor-to-normal background ratio (TNR), metabolic tumor volume (MTV), and total lesion methionine uptake (TLMU) to the histology and genetics of the patients with ADG. We also evaluated the prognoses of the 93 surgically treated patients.
The patients with isocitrate dehydrogenase wild ADG showed significantly higher MET-PET metrics (P < 0.05 for all parameters), significantly shorter overall survival and progression-free survival (P < 0.0001 for both) than those of the patients with isocitrate dehydrogenase mutant (IDHm) ADG. In the IDHm ADG group, the SUVmax, MTV, and TLMU values were significantly higher in patients with IDHm grade (G) 4 astrocytoma than patients with IDHm G2/3 astrocytoma (P < 0.05 for all), but not than patients with G2-3 oligodendroglioma. The progression-free survival was significantly shorter in the patients with G4 astrocytoma versus the patients with G2/3 astrocytoma and G3 oligodendroglioma (P < 0.05 for both). The SUVmax and TNR values were significantly higher in recurrent patients than nonrecurrent patients (P < 0.01 for both), but no significant differences were found in MTV or TLMU values.
MET-PET metrics well reflect the histological subtype, WHO grade and prognosis of ADG based on the 2021 WHO classification, with the exception of oligodendroglial tumors. Volumetric parameters were not significantly associated with recurrence, unlike the SUVmax and TNR.
A total of 125 newly diagnosed patients with ADG were enrolled. We compared the maximum standardized uptake value (SUVmax), tumor-to-normal background ratio (TNR), metabolic tumor volume (MTV), and total lesion methionine uptake (TLMU) to the histology and genetics of the patients with ADG. We also evaluated the prognoses of the 93 surgically treated patients.
The patients with isocitrate dehydrogenase wild ADG showed significantly higher MET-PET metrics (P < 0.05 for all parameters), significantly shorter overall survival and progression-free survival (P < 0.0001 for both) than those of the patients with isocitrate dehydrogenase mutant (IDHm) ADG. In the IDHm ADG group, the SUVmax, MTV, and TLMU values were significantly higher in patients with IDHm grade (G) 4 astrocytoma than patients with IDHm G2/3 astrocytoma (P < 0.05 for all), but not than patients with G2-3 oligodendroglioma. The progression-free survival was significantly shorter in the patients with G4 astrocytoma versus the patients with G2/3 astrocytoma and G3 oligodendroglioma (P < 0.05 for both). The SUVmax and TNR values were significantly higher in recurrent patients than nonrecurrent patients (P < 0.01 for both), but no significant differences were found in MTV or TLMU values.
MET-PET metrics well reflect the histological subtype, WHO grade and prognosis of ADG based on the 2021 WHO classification, with the exception of oligodendroglial tumors. Volumetric parameters were not significantly associated with recurrence, unlike the SUVmax and TNR.
摘要：
目的：阐明11C-蛋氨酸（MET）正电子发射断层扫描（PET）指标与组织学之间的关系，遗传学,根据世界卫生组织（WHO）2021分类，成人型弥漫性胶质瘤（ADG）的预后。
方法：共纳入125例新诊断的ADG患者。我们比较了最大标准化摄取值(SUVmax)，肿瘤与正常比率（TNR），代谢性肿瘤体积（MTV），和总病变蛋氨酸摄取（TLMU）对ADG患者的组织学和遗传学。我们还评估了93例经手术治疗的患者的预后。
结果：异柠檬酸脱氢酶（IDH）野生（w）ADG患者显示出明显较高的MET-PET指标（所有参数p<0.05），与IDH突变(m)ADG患者相比,总生存期(OS)和无进展生存期(PFS)显著缩短(两者p<0.0001).在IDHmADG组中，SUVmax,MTV,IDHm(G)4级星形细胞瘤患者的TLMU值显著高于IDHmG2/3级星形细胞瘤患者(P<0.05),但不超过G2-3少突胶质细胞瘤患者。与G2/3星形细胞瘤和G3少突胶质细胞瘤患者相比，G4星形细胞瘤患者的PFS明显更短（两者均p<0.05）。复发患者的SUVmax和TNR值显著高于非复发患者(两者均p<0.01),但MTV或TLMU值无显著差异。
结论：MET-PET指标很好地反映了组织学亚型，基于2021年WHO分类的ADG的WHO等级和预后，少突胶质肿瘤除外。体积参数与复发无显著相关,与SUVmax和TNR不同。
方法：共纳入125例新诊断的ADG患者。我们比较了最大标准化摄取值(SUVmax)，肿瘤与正常比率（TNR），代谢性肿瘤体积（MTV），和总病变蛋氨酸摄取（TLMU）对ADG患者的组织学和遗传学。我们还评估了93例经手术治疗的患者的预后。
结果：异柠檬酸脱氢酶（IDH）野生（w）ADG患者显示出明显较高的MET-PET指标（所有参数p<0.05），与IDH突变(m)ADG患者相比,总生存期(OS)和无进展生存期(PFS)显著缩短(两者p<0.0001).在IDHmADG组中，SUVmax,MTV,IDHm(G)4级星形细胞瘤患者的TLMU值显著高于IDHmG2/3级星形细胞瘤患者(P<0.05),但不超过G2-3少突胶质细胞瘤患者。与G2/3星形细胞瘤和G3少突胶质细胞瘤患者相比，G4星形细胞瘤患者的PFS明显更短（两者均p<0.05）。复发患者的SUVmax和TNR值显著高于非复发患者(两者均p<0.01),但MTV或TLMU值无显著差异。
结论：MET-PET指标很好地反映了组织学亚型，基于2021年WHO分类的ADG的WHO等级和预后，少突胶质肿瘤除外。体积参数与复发无显著相关,与SUVmax和TNR不同。
