Korean J Radiol.  2019 Jun;20(6):967-975. 10.3348/kjr.2018.0690.

Combination of Magnetic Resonance Spectroscopy and ¹¹C-Methionine Positron Emission Tomography for the Accurate Diagnosis of Non-Enhancing Supratentorial Glioma

Affiliations
  • 1Department of Neurologic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. ernestzdx@163.com
  • 2PET Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.

Abstract


OBJECTIVE
To evaluate whether the combination of magnetic resonance spectroscopy (MRS) and 11C-methionine positron emission tomography (11C-MET PET) could increase accurate diagnostic sensitivity for non-enhancing supratentorial gliomas.
MATERIALS AND METHODS
Between February 2012 and December 2017, 109 patients with non-enhanced supratentorial lesions on contrast-enhanced MRI were enrolled. Each patient underwent MRS and 11C-MET PET before treatment. A lesion was considered to be a glioma when either the MRS or 11C-MET PET results reached the diagnostic threshold. The radiological diagnosis was compared with the pathological diagnosis or medical diagnostic criteria.
RESULTS
The sensitivity and specificity were 60.0% and 50.0% for MRS and 75.8% and 50.0% for 11C-MET PET, respectively. Upon combining the two modalities, the sensitivity and specificity of the imaging-based diagnosis prior to surgery reached 89.5% and 42.9%, respectively. Statistically significant differences in the sensitivities were observed between the combined and individual approaches (MRS alone, 89.5% vs. 60.0%, p < 0.001; 11C-MET PET alone, 89.5% vs. 75.8%, p = 0.001). However, no significant differences in specificity were observed between the combined and individual modalities.
CONCLUSION
The combination of MRS and 11C-MET PET findings significantly increases accurate diagnostic sensitivity for non-enhancing supratentorial gliomas without significantly lowering the specificity. This finding suggests the potential of the combined MRS and 11C-MET PET approach in clinical applications.

Keyword

Glioma; Magnetic resonance spectroscopy; Methionine; PET

MeSH Terms

Diagnosis*
Electrons*
Glioma*
Humans
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy*
Methionine
Positron-Emission Tomography*
Sensitivity and Specificity
Methionine
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