S-Space College of Medicine/School of Medicine (의과대학/대학원) Pathology (병리학전공) Journal Papers (저널논문_병리학전공)
(18)F-FDG PET in the assessment of tumor grade and prediction of tumor recurrence in intracranial meningioma
- Lee, Jeong Won; Kang, Keon Wook; Park, Sung-Hye; Lee, Sang Mi; Chung, June-Key; Lee, Dong Soo; Lee, Myung Chul; Paeng, Jin Chul
- Issue Date
- EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING; Vol.36 10; 1574-1582
- Meningioma; Positron emission tomography (PET); (18)F-fluorodeoxyglucose (FDG); Prognosis; Recurrence
- Purpose The purpose of this study was to investigate the role of (18)F-fluorodeoxyglucose (FDG) PET in detecting high-grade meningioma and predicting the recurrence in patients with meningioma after surgical resection. Methods Fifty-nine patients (27 men and 32 women) with intracranial meningioma who underwent preoperative FDG PET and subsequent surgical resection were enrolled. All patients underwent clinical follow-up for tumor recurrence with a mean duration of 34 +/- 20 months. The tumor to gray matter ratio (TGR) of FDG uptake was calculated and a receiver-operating characteristic (ROC) curve of the TGR was drawn to determine the cutoff value of the TGR for detection of high-grade meningioma. Further, univariate analysis with the log-rank test was performed to assess the predictive factors of meningioma recurrence. Results The TGR in high-grade meningioma (WHO grade II and III) was significantly higher than that in low-grade ones (WHO grade I) (p = 0.002) and significantly correlated with the MIB-1 labeling index (r = 0.338, p = 0.009) and mitotic count of the tumor (r = 0.284, p = 0.03). The ROC analysis revealed that the TGR of 1.0 was the best cutoff value for detecting high-grade meningioma with a sensitivity of 43%, specificity of 95%, and accuracy of 81%. Of 59 patients, 5 (9%) had a recurrent event. In the log-rank test, the TGR, MIB-1 labeling index, presence of brain invasion, and WHO grade were significantly associated with tumor recurrence. The cumulative recurrence-free survival rate of patients with a TGR of 1.0 or less was significantly higher than that of patients with a TGR of more than 1.0 (p = 0.0003) Conclusion FDG uptake in meningioma was the significant predictive factor of tumor recurrence and significantly correlated with the proliferative potential of the tumor.
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