title: 11C-Methionine positron emission tomography delineates non-contrast enhancing tumor regions at high risk for recurrence in pediatric high-grade glioma.
abstract: We assessed the prognostic utility of11C-Methionine positron emission tomography (MET-PET) in pediatric high-grade glioma (HGG). Thirty-one children had 62 MET-PET studies. Segmented tumor volumes from co-registered magnetic resonance studies were assessed for concordance with MET-PET uptake using Boolean operations. The tumor volume at diagnosis and treatment failure was assessed relative to MET-PET avid volume. The prognostic impact of MET-PET-delineated non-contrast enhancing tumor (NCET) was assessed. NCET was defined as the region of tumor defined by defined by FLAIR which did not enhance but showed MET-PET avidity. MET-PET concordance varied according to magnetic resonance sequence. MET-PET rarely added to the tumor volume in most cases. The volume of MET-PET with standardized uptake value >3.0 was differentially distributed at diagnosis, post treatment, and at recurrence. The initial MET-PET region overlapped with recurrent tumor in 90% of the cases. When the proportion of tumor which was NCET was >10%, an earlier time to progression (5.8 months; 95% CI, 1-8.2 vs. 10.5 months; 95% CI, 0.9-NR; p = 0.035) was noted. MET-PET delineates regions at increased risk for recurrence and may improve the definition of failure, prognostic assessment, and target definition for radiotherapy.
authors.affiliation: Department of Radiation Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 210, Memphis, TN, 38106-3678, USA. john.lucas@stjude.org.
authors.forename: John T
authors.initials: JT
authors.lastname: Lucas
authors.affiliation: Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Nick
authors.initials: N
authors.lastname: Serrano
authors.affiliation: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Xingyu
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Snyder
authors.affiliation: Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Hwang
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Yimei
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 210, Memphis, TN, 38106-3678, USA.
authors.forename: Chia-Ho
authors.initials: CH
authors.lastname: Hua
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.|Department of Pediatrics, University of Tennessee Health Services Center, Memphis, TN, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Broniscer
authors.affiliation: Department of Radiation Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 210, Memphis, TN, 38106-3678, USA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Merchant
authors.affiliation: Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Barry L
authors.initials: BL
authors.lastname: Shulkin
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002250:Carbon Radioisotopes; D002648:Child; D002675:Child, Preschool; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008715:Methionine; D060787:Neoplasm Grading; D049268:Positron-Emission Tomography / Q000379:methods*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D002250:Carbon Radioisotopes; D008715:Methionine
keywords: High-grade glioma; MET-PET; Pediatric