| 11C-MET PET/CT筛查幕上较低级别胶质瘤IDH和1p/19q分子分型的应用价值 |
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| 引用本文： | C-MET PET/CT筛查幕上较低级别胶质瘤IDH和p/q分子分型的应用价值.11C-MET PET/CT筛查幕上较低级别胶质瘤IDH和1p/19q分子分型的应用价值[J].首都医学院学报,2022,43(6):826-833. |
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| 作者姓名： | C-MET PET/CT筛查幕上较低级别胶质瘤IDH和p/q分子分型的应用价值 |
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| 作者单位： | 首都医科大学附属北京天坛医院核医学科,北京 100054 |
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| 基金项目： | 国家自然科学基金面上项目(7192054)。 |
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| 摘 要： | 目的 评估11C-蛋氨酸(11C-methionine,11C-MET)正电子发射型计算机断层显像／电子计算机断层显像(positron emission tomography/computed tomography, PET/CT) 半定量参数在筛查幕上较低级别胶质瘤(lower-grade glioma, LrGG)异柠檬酸脱氢酶(isocitric dehydrogenase, IDH)突变以及1p/19q共缺失状态的应用价值。 方法 分析37例幕上较低级别胶质瘤患者术前11C-MET PET/CT图像以及病理学资料。测量11C-MET PET/CT图像上病灶最大肿瘤／正常组织摄取比值(maximum tumor/normal tissue uptake ratio, TNRmax)、平均肿瘤／正常组织摄取比值(mean TNR, TNRmean)以及肿瘤／正常组织摄取比值峰值(peak TNR, TNRpeak)。根据IDH基因突变以及1p/19q共缺失状态,将患者分为3组:IDH野生型(IDHwt),IDH突变-1p/19q共缺失型(IDHmut1p/19qdel)以及IDH突变-1p/19q非共缺失型(IDHmut1p/19qint)。比较不同分子分型的LrGG间的TNRmax、TNRmean以及TNRpeak。使用受试者工作特征(receiver operating characteristic,ROC)曲线分析单参数对于IDH突变和1p/19q共缺失状态的筛查效能。采用Logistic回归建立联合诊断模型,对预测概率进行ROC分析,评估多参数联合筛查效能。 结果 TNRmax、TNRmean、TNRpeak在3组LrGG间的差异有统计学意义(P<0.05)。IDHwt组TNRmax、TNRmean、TNRpeak最高,其次为IDHmut1p/19qdel组,IDHmut1p/19qint组最低。IDHwt LrGG的TNRmax、TNRmean、TNRpeak均高于IDHmut LrGG组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示, TNRmax、TNRmean、TNRpeak筛查LrGG IDH突变的曲线下面积( area under the curve, AUC)分别为0.827、0.847、0.807,以3.09、1.84和2.58为阈值,准确率分别为70.3%、75.7%和75.7%,采用Logistic回归分析构建的筛查模型能提高诊断准确率, AUC值为0.943,灵敏度、特异度和准确率分别为100%、83.3%和94.6%。TNRmax、TNRmean、TNRpeak筛查LrGG 1p/19q共缺失的AUC分别为0.766、0.792、0.812,以3.35、1.44和2.02为阈值,准确率分别为76.0%、80.0%和80.0%。Logistic筛查模型不能提高诊断效能。 结论 11C-MET PET/CT有助于筛查幕上较低级别胶质瘤IDH突变以及1p/19q共缺失状态。多参数联合能够提高对于IDH基因突变的筛查效能。
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| 关 键 词： | 较低级别胶质瘤 11C-蛋氨酸 正电子发射型计算机断层显像 异柠檬酸脱氢酶 1p/19q |
| 收稿时间： | 2022-09-30 |
Application of 11C-MET PET/CT in screening isocitric dehydrogenase and 1p/19q status in supratentorial lower-grade gliomas |
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| Zhang Shu,Wang Kai,Yang Zihao,Qiao Zhen,Li Xiaotong,Yuan Leilei,Ai Lin.Application of 11C-MET PET/CT in screening isocitric dehydrogenase and 1p/19q status in supratentorial lower-grade gliomas[J].Journal of Capital University of Medical Sciences,2022,43(6):826-833. |
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| Authors: | Zhang Shu Wang Kai Yang Zihao Qiao Zhen Li Xiaotong Yuan Leilei Ai Lin |
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| Affiliation: | Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100054, China |
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| Abstract: | Objective To evaluate the value of 11C-methionine (11C-MET ) positron emission tomography/computed tomography (PET/CT) in screeningisocitric dehydrogenase (IDH) mutation and 1p/19q co-deletion status in supratentorial lower-grade glioma (LrGG). Methods The preoperative 11C-MET PET/CT images and pathological data of 37 patients with lower-grade supratentorial glioma were retrospectively analyzed. The maximum tumor/normal tissue ratio (TNRmax), mean tumor/normal tissue ratio (TNRmean) and peak tumor/normal tissue ratio (TNRpeak) of lesions on were measured. According to IDH gene mutation and 1p/19q co-deletion status, patients were divided into three groups: IDH wild type (IDHwt); IDH mutation-1p/19q co-deletion type (IDHmut1p/19qdel) and IDH mutation-1p/19q intact type (IDHmut1p/19qint). TNR values of different molecular subtypes of LrGG were compared with each other. The differential diagnostic efficacy of semi-quantitative parameters for different molecular subtypes of LrGG was analyzed using receiver operating characteristic (ROC)curve. Logistic regression was used to establish a joint diagnostic model, and the ROC analysis was conducted to evaluate the predictive efficiency of joint diagnostic model. Results There were significant differences in TNRmax, TNRmean and TNRpeak among the three groups of LrGG (P<0.05). TNRmax, TNRmean and TNRpeak were the highest in the IDHwt group, followed by the IDHmut1p/19qdel group. Semiquantitative values were the lowest in the IDHmut1p/19qint group. The TNRmax, TNRmean and TNRpeak of IDHwt LrGG were higher than those of IDHmut LrGG, and the difference was statistically significant(P<0.05). The results of ROC analysis showed that the area under the curves (AUCs) of TNRmax, TNRmean, and TNRpeak for screening IDH mutations were 0.827, 0.847, and 0.807, with thresholds of 3.09, 1.84, and 2.58, respectively, and the accuracy rates were 70.3%、75.7% and 75.7%, respectively. The screening model based on Logistic regression analysis can improve diagnostic accuracy, with an AUC value of 0.943, sensitivity, specificity, and accuracy of 100%, 83.3%, and 94.6%, respectively. The TNRmax, TNRmean and TNRpeak of IDHmut1p/19qdel LrGG were significantly higher than those of IDHmut1p/19qint LrGG (P<0.05). The AUCs of TNRmax, TNRmean, and TNRpeak for predicting 1p/19q co-deletion of IDHmut LrGG were 0.766, 0.792, and 0.812, with thresholds of 3.35, 1.44, and 2.02, respectively, and the accuracies were 76.0%, 80.0%, and 80.0%, respectively. Joint diagnostic model cannot improve diagnostic efficiency. Conclusion 11C-MET PET/CT is helpful for screening IDH mutation and 1p/19q co-deletion status in supratentorial lower-grade gliomas. The combination of multiple parameters can improve the efficiency of screening IDH gene mutation. |
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| Keywords: | lower-grade glioma 11C-methionine positron-emission tomography isocitric dehydrogenase 1p/19q |
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