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FDG-PET as a prognostic factor in high-grade astrocytoma
O De Witte1, F Lefranc, M Levivier
1Department of Neurosurgery, H pital Erasme, Université Libre de Bruxelles, Brussels, Belgium. odewitte@ulb.ac.be
Journal of Neuro-Oncology
|February 24, 2001
Summary
Positron emission tomography with [18F]-fluoro-deoxy-D-glucose (FDG-PET) metabolic grading shows prognostic value in glioblastoma, but not superior to pathological grading for malignant gliomas overall. FDG-PET is valuable for glioblastoma prognosis.
Area of Science:
- Neuro-oncology
- Medical imaging
- Nuclear medicine
Background:
- The prognostic significance of [18F]-fluoro-deoxy-D-glucose (FDG-PET) metabolic status in cerebral gliomas is established for mixed-grade populations.
- Its prognostic value remains uncertain for high-grade gliomas (grades 3 and 4) alone.
Purpose of the Study:
- To evaluate the prognostic value of FDG-PET metabolic grading in malignant gliomas (grades 3 and 4).
- To compare FDG-PET metabolic grading with pathological grading for survival prediction in these tumors.
Main Methods:
- FDG-PET was performed on 30 patients with anaplastic astrocytoma (grade III) and 61 with glioblastoma (grade 4).
- Patients were classified into metabolic grades 1, 2, and 3 based on FDG uptake relative to white matter and cortex.
- Survival analysis was conducted using Kaplan-Meier curves and multivariate analysis.
Main Results:
- Metabolic grade 3 showed significantly worse survival (p = 0.007) compared to grades 1 and 2.
- Metabolic grade was not an independent prognostic factor in multivariate analysis when considering all malignant gliomas.
- Metabolic grade demonstrated predictive value only when applied separately to glioblastomas.
Conclusions:
- FDG-PET metabolic grading is not superior to pathological grading for predicting survival in malignant gliomas overall.
- However, FDG-PET metabolic grading retains prognostic value specifically for glioblastomas.