Study on the correlation between IDH gene mutation status in gliomas and metabolic parameters in 18F-FDG PET/CT

To explore the correlation between isocitrate dehydrogenase (IDH) mutation status and 18F-deoxyglucose (18F-FDG) PET/computed tomography (CT) metabolic parameters in gliomas, and screen imaging biomarkers for preoperative prediction of IDH genotype.

Clinical and preoperative PET/CT data of 85 pathologically confirmed glioma patients were retrospectively analyzed, including 34 IDH-mutant and 51 IDH-wild-type cases. Lesion maximum standard uptake value (SUVmax), SUVmax T/C (lesion-to-contralateral cortex) and SUVmax T/W (lesion-to-contralateral white matter) were measured. Intergroup differences were compared via one-way analysis of variance, and receiver operating characteristic curves were applied to assess the predictive efficacy of significant parameters.

All three metabolic indices were markedly elevated in IDH-wild-type tumors: SUVmax (11.77 ± 5.94 vs. 9.46 ± 3.30; P = 0.042), SUVmax T/C (1.63 ± 0.67 vs. 1.34 ± 0.40; P = 0.028), SUVmax T/W (2.80 ± 1.19 vs. 2.31 ± 0.63; P = 0.024). SUVmax T/C [area under the curve (AUC) = 0.671] and SUVmax T/W (AUC = 0.668) showed moderate predictive value, whereas SUVmax had poor performance (AUC = 0.339). Patients with IDH mutation were significantly younger.

IDH-wild-type gliomas present stronger glycolytic metabolism. 18F-FDG PET/CT-derived SUVmax, SUVmax T/C, and SUVmax T/W allow noninvasive preoperative evaluation of IDH status, with normalized ratio parameters demonstrating better diagnostic stability. Higher metabolic heterogeneity exists in IDH-wild-type gliomas.