Cancer Management and Research (Oct 2019)
The Diagnostic Value Of Using 18F-Fluorodeoxyglucose Positron Emission Tomography To Differentiate Between Low- And High-Grade Meningioma
Abstract
Lingyang Hua,1 Fengchun Hua,2 Hongda Zhu,1 Jiaojiao Deng,1 Daijun Wang,1 Shihai Luan,1 Hailiang Tang,1 Yihui Guan,2 Qing Xie,1 Ye Gong1,3 1Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, People’s Republic of China; 2Department of Nuclear Medicine and PET Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, People’s Republic of China; 3Department of Critical Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, People’s Republic of ChinaCorrespondence: Ye GongDepartment of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai 200040, People’s Republic of ChinaTel +86 138 1793 9896Email [email protected] Qing XieDepartment of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai 200040, People’s Republic of ChinaTel +86 21 5288 7030Fax +86 21 5288 7218Email [email protected]: This study aims to evaluate the potential role of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in detecting high-grade meningiomas and predicting the prognosis of patients after meningioma surgery.Patients and methods: A total of 124 patients met the final inclusion criterion. Tumor to gray ratio (TGR) was compared with Ki-67 labeling index, and its correlations with pre-operative neurological function and treatment status were also evaluated. Receiver-operating characteristic (ROC) curve was drawn to determine a cut-off value which could discriminate meningioma of different grades. Prognostic factors including TGR were analyzed using Kaplan-Meier survival curve and cox proportional model.Results: The TGR of higher World Health Organization (WHO) grade meningioma was significantly higher than that in lower grade (p < 0.001), and it was correlated with the Ki-67 labeling index (p < 0.001, r = 0.1545). The TGR of 1.30 was the best cutoff value for the detection of high grade (WHO grade II&III) meningioma from low grade (WHO grade I) according to ROC analysis, with a sensitivity of 61.5%, the specificity of 86.7%, and accuracy of 81.5%. The TGR (p < 0.001), treatment status (p = 0.035), tumor grade (p < 0.001) and Ki-67 labeling index (p < 0.001) were significantly associated with progression-free survival (PFS). Cox proportional hazards model demonstrated that TGR (p = 0.013) was an independent prognostic factor for PFS.Conclusion: A high uptake of FDG was correlated with a more proliferative biological behavior and is a risk factor for tumor recurrence.Keywords: meningioma, 18F-FDG PET, molecular imaging, clinical characteristic, prognosis
