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Purpose <p>To investigate the clinical utility of <sup>18</sup>F-NOTA-NFB PET/MRI relative to <sup>11</sup>C-methionine (<sup>11</sup>C-MET) PET/MRI and contrast-enhanced MRI (CE-MRI) for glioma recurrence detection.</p> Methods <p>Patients with suspected recurrence of glioma were prospectively enrolled. All patients underwent paired <sup>18</sup>F-NOTA-NFB and <sup>11</sup>C-MET PET/MRI. Diagnostic efficiency of glioma recurrence detection by different imaging methods were assessed and compared. The suspected lesions showed via <sup>18</sup>F-NOTA-NFB and <sup>11</sup>C-MET PET/MRI were compared by SUVmax and tumor-to-background ratio (TBR). The diagnostic performance of <sup>18</sup>F-NOTA-NFB and <sup>11</sup>C-MET SUVmax/TBR was tested by receiver operating characteristic curve.</p> Results <p>Thirty-eight patients with suspected recurrent glioma were included, with 28 positive for recurrent gliomas and 10 negative for recurrence which were confirmed by the pathology or clinical follow-up. For visual assessment, the accuracy and specificity of <sup>18</sup>F-NOTA-NFB PET were equivalent to <sup>11</sup>C-MET PET (accuracy: 92.11% vs. 94.74%, <i>P</i> = 1.00; specificity: 70.00% vs. 80.00%, <i>P</i> = 1.00) and higher than CE-MRI (accuracy: 92.11% vs. 76.32%, <i>P</i> = 0.031; specificity: 70.00% vs. 10.00%, <i>P</i> = 0.031). For quantitative analysis, in recurrent gliomas, <sup>18</sup>F-NOTA-NFB PET revealed higher SUVmax (<i>P</i> = 0.007) and TBR (<i>P =</i> 0.002) than treatment-related effects, with higher TBR for recurrence than that of <sup>11</sup>C-MET (<i>P</i> &lt; 0.001). Although <sup>11</sup>C-MET SUVmax had the highest AUC of 0.911 for detecting glioma recurrence, but with no significant difference relative to <sup>11</sup>C-MET TBR (AUC = 0.889, <i>P</i> = 0.75), <sup>18</sup>F-NOTA-NFB SUVmax (AUC = 0.793, <i>P</i> = 0.32), and <sup>18</sup>F-NOTA-NFB TBR (AUC = 0.829, <i>P</i> = 0.42).</p> Conclusion <p>The diagnostic efficacy of <sup>18</sup>F-NOTA-NFB PET or PET/MRI performed equivalent to <sup>11</sup>C-MET PET or PET/MRI, and better than CE-MRI for diagnosis of recurrent gliomas. Compared to <sup>11</sup>C-MET, <sup>18</sup>F-NOTA-NFB PET/MRI exhibited higher TBR, giving advantages in glioma delineation that might provide valuable information for making treatment strategy.</p>

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18F-NOTA-NFB PET/MRI in glioma recurrence: comparison with 11C-methionine PET/MRI and contrast-enhanced MRI

  • 期刊论文

  • 发表日期：

    2025年7月21日

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  • Zhenwei Du,
  • Yi Luo,
  • Jinju Sun,
  • He Long,
  • Jianping You,
  • Xin Li,
  • Lunshan Xu,
  • Weiguo Zhang,
  • Xiao Chen

摘要

Purpose

To investigate the clinical utility of 18F-NOTA-NFB PET/MRI relative to 11C-methionine (11C-MET) PET/MRI and contrast-enhanced MRI (CE-MRI) for glioma recurrence detection.

Methods

Patients with suspected recurrence of glioma were prospectively enrolled. All patients underwent paired 18F-NOTA-NFB and 11C-MET PET/MRI. Diagnostic efficiency of glioma recurrence detection by different imaging methods were assessed and compared. The suspected lesions showed via 18F-NOTA-NFB and 11C-MET PET/MRI were compared by SUVmax and tumor-to-background ratio (TBR). The diagnostic performance of 18F-NOTA-NFB and 11C-MET SUVmax/TBR was tested by receiver operating characteristic curve.

Results

Thirty-eight patients with suspected recurrent glioma were included, with 28 positive for recurrent gliomas and 10 negative for recurrence which were confirmed by the pathology or clinical follow-up. For visual assessment, the accuracy and specificity of 18F-NOTA-NFB PET were equivalent to 11C-MET PET (accuracy: 92.11% vs. 94.74%, P = 1.00; specificity: 70.00% vs. 80.00%, P = 1.00) and higher than CE-MRI (accuracy: 92.11% vs. 76.32%, P = 0.031; specificity: 70.00% vs. 10.00%, P = 0.031). For quantitative analysis, in recurrent gliomas, 18F-NOTA-NFB PET revealed higher SUVmax (P = 0.007) and TBR (P = 0.002) than treatment-related effects, with higher TBR for recurrence than that of 11C-MET (P < 0.001). Although 11C-MET SUVmax had the highest AUC of 0.911 for detecting glioma recurrence, but with no significant difference relative to 11C-MET TBR (AUC = 0.889, P = 0.75), 18F-NOTA-NFB SUVmax (AUC = 0.793, P = 0.32), and 18F-NOTA-NFB TBR (AUC = 0.829, P = 0.42).

Conclusion

The diagnostic efficacy of 18F-NOTA-NFB PET or PET/MRI performed equivalent to 11C-MET PET or PET/MRI, and better than CE-MRI for diagnosis of recurrent gliomas. Compared to 11C-MET, 18F-NOTA-NFB PET/MRI exhibited higher TBR, giving advantages in glioma delineation that might provide valuable information for making treatment strategy.