Correlation of 18 F-FDG and 11 C-methionine uptake on PET/CT with Ki-67 immunohistochemistry in newly diagnosed intracranial meningiomas

Abstract

Objective

We evaluated the uptake of 2-deoxy-2-¹⁸F-fluoro-d-glucose (FDG) and l-[methyl-¹¹C]-methionine (MET) in patients with newly diagnosed intracranial meningiomas and correlated the results with tumor proliferation.

Methods

Data from 22 patients with newly diagnosed intracranial meningioma (12 grade I and 10 grade II) who underwent both FDG and MET brain PET/CT studies were retrospectively analyzed. The PET images were evaluated by a qualitative method and semiquantitative analysis using standardized uptake value (SUV) (SUV_max and SUV_peak) and tumor-to-reference tissue ratio (T_max/N ratio and T_peak/N ratio). Proliferative activity as indicated by the Ki-67 index was estimated in tissue specimens.

Results

MET PET/CT showed a higher detection rate of meningioma than did FDG PET/CT (100 vs. 46%, respectively). The T_max/N ratio and T_peak/N ratio on MET PET/CT were significantly higher than those on FDG PET/CT (p < 0.001 and p < 0.001, respectively). There was a significant difference between grades I and II with respect to FDG SUVmax (p = 0.003), FDG SUV_peak (p = 0.003), FDG T_max/N ratio (p = 0.02), FDG T_peak/N ratio (p = 0.006), MET SUV_max (p = 0.002), MET SUV_peak (p = 0.002), MET T_max/N ratio (p = 0.002), and MET T_peak/N ratio (p = 0.002). There was a significant correlation between Ki-67 index and FDG PET/CT for SUV_max (p = 0.02), SUV_peak (p = 0.005), and T_peak/N ratio (p = 0.05) and between Ki-67 index and MET PET/CT for SUV_max (p = 0.004), SUV_peak (p = 0.007), T_max/N ratio (p = 0.002), and T_peak/N ratio (p = 0.004).

Conclusion

MET PET/CT showed a high sensitivity compared with FDG PET/CT for detection of newly diagnosed WHO grades I and II intracranial meningiomas. Both FDG and MET uptake were found to be useful for evaluating tumor proliferation in meningiomas.