Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Combination of Magnetic Resonance Spectroscopy and 11C-Methionine Positron Emission Tomography for the Accurate Diagnosis of Non-Enhancing Supratentorial Glioma

  • Nijiati Kudulaiti (Department of Neurologic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University) ;
  • Tianming Qiu (Department of Neurologic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University) ;
  • Junfeng Lu (Department of Neurologic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University) ;
  • Huiwei Zhang (PET Center, Huashan Hospital, Shanghai Medical College, Fudan University) ;
  • Zhengwei Zhang (PET Center, Huashan Hospital, Shanghai Medical College, Fudan University) ;
  • Yihui Guan (PET Center, Huashan Hospital, Shanghai Medical College, Fudan University) ;
  • Dongxiao Zhuang (Department of Neurologic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University) ;
  • Jinsong Wu (Department of Neurologic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University)
  • Received : 2018.10.05
  • Accepted : 2019.01.28
  • Published : 2019.06.01
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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.

Keywords

Acknowledgement

This study was supported by the National Natural Science Foundation of China (Nos.81672476 and 81701289), Shanghai Sailing Program (No.16YF1415400).

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