FDG PET/CT Assessment of the Biological Behavior of Meningiomas.

Park, Yong Sook; Jeon, Byung Chan; Oh, Hyung Suk; Lee, Seok Mo; Chun, Bong Kwon; Chang, Hee Kyung

Original Article

Journal of Korean Neurosurgical Society 2006;40(6): 428-433.

Yong Sook Park, Byung Chan Jeon, Hyung Suk Oh, Seok Mo Lee, Bong Kwon Chun, Hee Kyung Chang

¹Departments of Neurosurgery, College of Medicine, Kosin University Gospel Hospital, Busan, Korea. jbcstar@kosinmed.or.kr
²Departments of Nuclear Medicine, College of Medicine, Kosin University Gospel Hospital, Busan, Korea.
³Departments of Pathology, College of Medicine, Kosin University Gospel Hospital, Busan, Korea.

ABSTRACT

OBJECTIVE
We investigated the pattern of glucose uptake in meningiomas using (18)F-fluoro-2-deoxy-D-glucose(FDG) PET/CT. It was hypothesized that the degree of glucose uptake in each tumor could predict the histologic grade.
METHODS
In 19 patients with meningiomas, the Ki-67 proliferative index, standardized uptake values(SUV) of FDG uptake, tumor to contralateral gray matter ratio(TGR) of SUV, tumor size, edema grade, vascular endothelial growth factor(VEGF) expression, histopathologic grade and the blood supply pattern were assessed.
RESULTS
Of the 19 meningiomas, 8 were meningothelial, 1 fibrous, 2 transitional, 1 psammomatous, 2 angiomatous, and 5 atypical. The tumor proliferative index of Ki-67, tumor size, and peritumoral edema were larger in the histopathologic grade-2 meninigiomas than in the grade-1 meningioma group. There were no significant differences in SUV and TGR between two groups. Tumor size and peritumoral edema were significantly larger in VEGF-positive tumors than in negative tumors. Conventional angiography was performed in 12 patients. Dural supply was noted predominantly in 2 patients. Four patients had mainly pial cortical supply patterns. In tumors with more pial supply, VEGF was more frequently positive. There was a significant relation between SUV and Ki-67 and between SUV and peritumoral edema.
CONCLUSION
We found FDG uptake in meningiomas is associated with proliferative potential, however, no clear limits of SUV and TGR can be set to distinguish between grade-1 and grade-2 meningiomas, which makes the assessment of malignancy grade using PET scan metabolic imaging difficult in individual cases.

Key Words: Positron emission tomography; 2-[(18)F] fluoro-2-deoxy-D-glucose; Meningiomas; Proliferation; Ki-67