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Isocric acid dehydrogenase (IDH) mutation is an important indicator of glioma molecular diagnosis and has been included in the 2016 WHO Central Nervous System Tumor Classification.
electron emission fault scanning (PET) is a commonly used imaging examination method to determine the grading and proliferation activity of gliomas.
3'-deoxygenation-3'-18F fluorothyridine (FLT) and L-methyl-11C-methionine (MET) are two commonly used spectroscopic agents in PET examination.
Tonoya Ogawa of Neurosurgery at The General Rehabilitation Hospital of Ikawa Prefecture, Japan, compared the diagnostic value of PET-CT to IDH1 mutant glioma with MET and FLT as a development agent, and the results were published online May 2020 in EJNMMI Research.
Study Methodology The authors reviewed 81 cases of glioma from April 2009 to March 2019;
the molecular and tissue pathology of surgical specimens in accordance with the 2016 WHO Central Nervous System Tumor Classification.
All patients were preoperatively examined with MET and FLT as the development agents, and the ratio of the maximum tumor intake (SUV) to the corresponding cortital average SUV value (T/N ratio) of the two PET-CT tests was calculated, respectively.
results showed that the average T/N ratio of MET-PET/CT and FLT-PET/CT for IDH1 wild gliomas was significantly higher than that of IDH1 mutant gliomas (P 0.001 and P 0.001).
ROC curve analysis of the diagnostic IDH1 mutant model shows that the area (0.911) under the FLT-PET/CT T/N ratio corresponding to the AAUC curve is significantly larger than the T/N ratio (0.727) ;(P0.01) of the MET-PET/CT.
the average T/N ratio of IDH1 wild glioma FLT-PET/CT was significantly higher than that of IDH1 mutant glioma (P-0.005), but the met-PET/CT test results were not so.
, met-PET/CT and FLT-PET/CT were able to distinguish between WHO Level II and Level III IDH1 mutant gliomas (P 0.002 and P.001, respectively), but only FLT-PET/CT was able to distinguish between WHO Level III and Level IV IDH1 wild gliomas (P=0.029).
the authors concluded that FLT-PET/CT was more accurate in diagnosing IDH1 mutant gliomas and graded gliomas than MET-PET/CT.
authors point out that the use of PET-CT diagnostic imaging of tumors without reinforcement must be careful, and that the results need to be further expanded to verify the sample size.
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