11C-methionine PET as a prognostic marker in patients with glioma: comparison with 18F-FDG PET

Purpose The purpose of this study was to compare the prognostic value of ¹¹C-methionine (MET) and ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in glioma patients.Methods The study population comprised 47 patients with gliomas (19 glioblastoma, 28 others). Pretreatment magnetic resonance imaging, MET PET and FDG PET were performed within a time interval of 2 weeks in all patients. The uptake ratio and standard uptake values were calculated. Univariate and multivariate analyses were done to determine significant prognostic factors. Ki-67 index was measured by immunohistochemical staining, and compared with FDG and MET uptake in glioma.Results Among the several clinicopathological prognostic factors, tumour pathology (glioblastoma or not), age (60 or <60 years), Karnofsky performance status (KPS) (70 or <70) and MET PET (higher uptake or not compared with normal cortex) were found to be significant predictors by univariate analysis. In multivariate analysis, tumour pathology, KPS and MET PET were identified as significant independent predictors. The Ki-67 proliferation index was significantly correlated with MET uptake (r=0.64), but not with FDG uptake.Conclusion Compared with FDG PET in glioma, MET PET was an independent significant prognostic factor and MET uptake was correlated with cellular proliferation. MET PET may be a useful biological prognostic marker in glioma patients.