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The Diagnostic Value Of Using 18F-Fluorodeoxyglucose Positron Emission Tomography To Differentiate Between Low- And High-Grade Meningioma

Authors Hua L, Hua F, Zhu H, Deng J, Wang D, Luan S, Tang H, Guan Y, Xie Q, Gong Y

Received 21 August 2019

Accepted for publication 14 October 2019

Published 25 October 2019 Volume 2019:11 Pages 9185—9193

DOI https://doi.org/10.2147/CMAR.S228129

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Nicola Ludin

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


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 China

Correspondence: Ye Gong
Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai 200040, People’s Republic of China
Tel +86 138 1793 9896
Email drgongye@163.com
 
Qing Xie
Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai 200040, People’s Republic of China
Tel +86 21 5288 7030
Fax +86 21 5288 7218
Email neurosurgeon.qing@gmail.com

Objective: 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


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