18F-FLT PET ococytosis predicts the progression of meningococ

Meningoma is a common primary intracranial tumor in adults, in recent years, with the popular application of imaging examination, asymptomatic meningoma detection rate is increasing, but there is no accurate way to predict the progress of asymptomatic meningioma.
Studies such as Asma Bashir of the Centre for Clinical Physiology, Nuclear Medicine and PET at the University Hospital of Copenhagen, Denmark, found that 18F-FLT PET could be used as an invasive imaging technique to assess the proliferation of meningoencephaloma cells to predict the progression of asymptomatic meningoma, an article published in the December 2020 issue of Brain.
study included 43 asymptomatic meningoma patients, of whom 30 were women and 13 were men;
a total of 82 MRI imaging follow-up visits were conducted, 1-3 times per follow-up, an average of 2 times, and the last imaging follow-up was on April 14, 2020.
18F-FLT PET post-imaging follow-up was 5-33.5 months, with a medium of 18 months, of which 31 follow-up periods exceeded 12 months (72.1%) (Table 1).
1. Demographic and imaging data from 43 patients were found by MRI-T1 weighted imaging that the tumors of 46 meningomas had a maximum diameter of 9-55mm and a medium of <21mm;
researchers used tumor volume and 2D-RANO to assess tumor progress.
2D-RANO standard detected more accurate tumor progress (91%) than the 10 tumor volume standards.
2D-RANO standard was used to assess tumor progressity follow-up, 2D-RANO standard line MRI examination showed that 11 patients (25.6%) tumor progress, of which 2 (18.2%) performed surgery and radiation therapy respectively, and the remaining 81.8% continued to receive rigorous imaging follow-up.
18F-FLT intake in patients with tumor progression increased significantly compared to patients with tumor stability, and the maximum tumor/blood ratio (TBRmax) was 5.5±1.3:3.6±1.1 (P< <0.0001); Average tumor/blood ratio (TBRmean) 3.5±0.8: 2.4±0.7 (P<0.0001).
ROC curve analysis shows that the optimal threshold for identifying tumor progress and stability is 4.4 (sensitivity 82%, specificity 77%, accuracy 78% and AUC 0.871; P<0 .0001); the best threshold for TBRmean is 2.8 (sensitivity 82%, specificity 77%, accuracy 78% and AUC 0.848; P<0.001).
patients with stable tumors and 12 months of follow-up found that TBRmax remained unchanged at 4.4 (sensitivity 82%, specificity 79%, accuracy 80% and AAUC 0.869; P=0.001 The optimal threshold for TBRmean also remained unchanged at 2.8 (sensitivity 82%, specificity 75%, accuracy 77%, and AUC 0.850; P=0.001) (Table 2, Figure 1).
these thresholds, 18 F-FLT PET tests false positive 8 times (18.6%), false negative 2 times (4.7%).
Table 2. ROC Curve Analysis Figure 1. 18F-FLT intake in a typical case.
A.1 case of 50-year-old female, pineal meningioma, size 33×39mm.
-celiac semen semen to reduce hydrocephaly on the screen; PET visible found that TBRmax was 4.8 and TBRmean was 3.3.
21 months, the tumor increased by 26.5% and there was mild edema around the tumor.
B.1 cases of 66-year-old females with a right front bed sudden meninges, size 27×22mm, accompanied by edema around the tumor; PET visible, TBRmax 3.4 and TBRmean 2.3.
no progress in tumor volume or edema around the tumor after 16 months.
47-year-old female with a left-hand top lob brain penicour tumor size of 20×20mm, PET visible found that TBRmax was 5.5 and TBRmean was 3.7.
follow-up MRI showed tumor progressity of 20.0%, according to RANO standard for tumor stability, close imaging follow-up.
the use of volume standards to assess tumor progressity follow-up, the use of volume standard line MRI examination showed that 10 patients (23.3%) tumor progress.
tumor growth rate (TGR) absolute value 0-38.4cm3/year, median 0.1cm3/year, relative value 0-209.8%, median 7.1%.
TGR absolute value of patients with tumor progression was 0.3-38.4cm3/year, median 2.6cm 3/year, and patients with stable tumor tumours had an absolute value of 0-11.5cm3/year, median 0.06cm3/year (P<0.0001).
TGR relative value of 19.4-209.8%, median 34.4%, tumor stable patients TGR relative value of 0-40.6%, median 2.6% (P<0.0001).
positive correlation between TGRs and 18F-FLT intake (r<0.513; P<0.015).
ROC curve analysis showed that the optimal threshold for identifying tumor progress and stability was 4.4 and the optimal threshold for TBRmean was 2.8 (sensitivity 80%, specificity 75%, accuracy 76%, and AAC 0.838 and 0.810; P<0.003).
used these thresholds, 18 F-FLT PET tested false positive 9 times (20.9%) and false negative 2 times (4.7%).
single-factor regression analysis of tumor progression showed that TBRmax (HR=1.715; 95% CI, 1.187-2.479; P=0.004) and tumor surrounding edema (HR= 6.561;95% CI, 1.093-39.371; P-0.040) is an important predictor of tumor progression, while age, sex, tumor baseline size, tumor location, and tumor residue have no significant effect.
multi-factor analysis shows that TBRmax (HR-1.703; 95% CI, 1.156-2.509; P-0.007) is still tumor progress the best predictor, while edema around the tumor shows only progress trends (HR s 4.875; 95% CI, 0.809-29.386; P s 0.084).
When assessing tumor progression using volumetric criteria, TBRmax remains the best predictor of tumor progression (HR=1.626; 95% CI, 1.008-2.623; P=0.046) (Figure 2).
Figure 2. Kaplan-Meier of TBRmax.
Kaplan-Meier curve, which showed the progress of 46 asymptomatic meningomas, was strated with TBRmax with a threshold of 4.4.
the results show that 18F-FLT PET occlusion predicts the progression of asymptomatic meningoma, which has broad application prospects.
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