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Purpose <p>This study aimed to identify prognostic factors for survival outcomes in patients with high-grade gliomas (HGGs) using <sup>11</sup>C-methionine positron emission tomography/magnetic resonance imaging (MET PET/MR) to evaluate tumor response following surgical resection and concurrent chemoradiotherapy (CCRT).</p> Methods <p>Twenty-nine patients with histologically confirmed grade 3 and 4 HGGs were enrolled between November 2019 and May 2022. All patients underwent baseline MET PET/MR scans within one month post-surgery, followed by standard Stupp protocol chemoradiotherapy. Twenty-three patients completed follow-up scans post-CCRT. Treatment response was evaluated using PET RANO 1.0 criteria for PET, and RANO 2.0 criteria for MRI. Prognostic factors were analyzed using Cox proportional hazards models.</p> Results <p>Among 23 patients evaluated post-CCRT, PET RANO 1.0 classified 18 as responders and 5 as non-responders. PET responders demonstrated significantly superior median progression-free survival (PFS) (22.4 vs. 4.0 months, <i>P</i> &lt; 0.001) and overall survival (OS) (47.9 vs. 11.4 months, <i>P</i> &lt; 0.001) compared with non-responders. Conversely, MRI RANO 2.0 criteria did not show statistically significant differences in survival outcomes (median PFS: 20.9 vs. 9.2 months, <i>P</i> = 0.510; median OS: 44.0 vs. 17.3 months, <i>P</i> = 0.902). Multivariate analysis confirmed MET PET response as an independent prognostic factor for both PFS and OS.</p> Conclusions <p>MET PET response assessment based on PET RANO 1.0 criteria demonstrated potential prognostic utility, offering complementary information to conventional MRI-based assessment.</p>

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PET RANO 1.0 criteria improve prognostic stratification in high-grade gliomas using 11C-methionine PET/MR

  • 期刊论文

  • 发表日期：

    2026年1月23日

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  • Shih-Hsin Chen,
  • Hsin-Ning Wang,
  • Cheng Hong Toh,
  • Kuo-Chen Wei,
  • Ko-Ting Chen,
  • Chen-Kan Tseng,
  • Kung-Chu Ho

摘要

Purpose

This study aimed to identify prognostic factors for survival outcomes in patients with high-grade gliomas (HGGs) using 11C-methionine positron emission tomography/magnetic resonance imaging (MET PET/MR) to evaluate tumor response following surgical resection and concurrent chemoradiotherapy (CCRT).

Methods

Twenty-nine patients with histologically confirmed grade 3 and 4 HGGs were enrolled between November 2019 and May 2022. All patients underwent baseline MET PET/MR scans within one month post-surgery, followed by standard Stupp protocol chemoradiotherapy. Twenty-three patients completed follow-up scans post-CCRT. Treatment response was evaluated using PET RANO 1.0 criteria for PET, and RANO 2.0 criteria for MRI. Prognostic factors were analyzed using Cox proportional hazards models.

Results

Among 23 patients evaluated post-CCRT, PET RANO 1.0 classified 18 as responders and 5 as non-responders. PET responders demonstrated significantly superior median progression-free survival (PFS) (22.4 vs. 4.0 months, P < 0.001) and overall survival (OS) (47.9 vs. 11.4 months, P < 0.001) compared with non-responders. Conversely, MRI RANO 2.0 criteria did not show statistically significant differences in survival outcomes (median PFS: 20.9 vs. 9.2 months, P = 0.510; median OS: 44.0 vs. 17.3 months, P = 0.902). Multivariate analysis confirmed MET PET response as an independent prognostic factor for both PFS and OS.

Conclusions

MET PET response assessment based on PET RANO 1.0 criteria demonstrated potential prognostic utility, offering complementary information to conventional MRI-based assessment.