Journal de radiologie OMICS

Abstrait

Predictive Value of 1 Month Postoperative MRSI and FDG-PET Evaluations of Glioblastomas

Dorra Ben Sellem, Waisse Waissi, Mojdeh Dormishian, Caroline Bund, Jean-Louis Dietemann, Marie-Pierrette Chenard, Georges Noël and Izzie- Jacques Namer*

Aim: The purpose of this study was to investigate prospectively the predictive value of positron emission tomography with proton magnetic resonance spectroscopic imaging (MRSI) and 18F-fluorodeoxyglucose (FDG-PET) performed the 1st month after surgery and before radio- chemotherapy in 43 patients with glioblastoma (GBM).

Patients and methods: Metabolite concentrations were quantified using LCModel. Overall survival (OS) and progression free survival (PFS) were calculated including all 43 patients using Kaplan-Meier curves, and the Cox proportional hazard model was used to calculate the predictor of survival.

Results: At the end of the follow-up period, all patients died within a period of 1–70.2 months. In 32 patients (74.4%), increased FDG-uptake was seen around the resection cavity and abnormal metabolic profiles on MRSI, indicative of residual disease, were present in all patients. There was no significant difference between the median OS in patients with hypometabolic FDG lesions compared to patients with hypermetabolic FDG lesions. On univariate analysis, normalized choline-containing compounds/creatine (nCho/Cr) and normalized lactate/creatine (nLac/Cr) were significantly predictive of OS and nLac/Cr and normalized N-Acetylaspartylglutamate and NAcetylaspartate/ creatine (NAA/Cr) were significantly predictive of PFS.

Conclusions: nCho/Cr and nLac/Cr ratio after surgery and before radio-chemotherapy were independent metabolic predictive factors of OS times in newly diagnosed patients with GBM.