Increased tryptophan uptake on PET has strong independent prognostic value in patients with a previously treated high-grade glioma

摘要: Background. Previously, we demonstrated the high accuracy of alpha-[ 11 C]methyl-L-tryptophan (AMT) PET for differentiating recurrent gliomas from radiation injury. The present study evaluated prognostic value increased AMT uptake in patients with previously treated high-grade glioma. Methods. AMT-PET was performed 39 suspected recurrence World Health Organization grades III– IV glioma following surgical resection, radiation, and chemotherapy. Mean maximum standardized values (SUVs) unidirectional (K) were measured brain regions suspicious tumor compared contralateral cortex (ie, background). Optimal cutoff thresholds 1-year survival prediction determined each parameter used calculating (above threshold) versus low (below post-PET overall (OS). Results. In univariate analyses, strongly associated 3 parameters (SUVmax, SUVmean, tumor-to-background K-ratio; odds ratios: 21.3 – 25.6; P ≤ .001) recent change MRI contrast enhancement (odds ratio: 14.7; ¼ .02). Median OS 876 days low- 177 high-AMT groups (log-rank , .001). multivariate all remained strong predictors survival: unfavorable (binary regression .003) shorter whole group (Cox hazard 5.3 –10.0) on as well (hazard 7.0–9.3; Conclusion. Increased is highly survival, independent other factors a