Background/Objectives: The classification and staging of brainstem glioma have its own pitfalls. Surgical biopsy is only possible in a small number of cases. Diagnosis relies mainly on radiological features. Any treatment may have a significant impact on quality of life; therefore, the correct and early identification of potentially malignant lesions is essential to initiate proper therapy. Amino acid PET/CT with accurate metabolic mapping can help in this decision-making. Methods: We performed a retrospective analysis of 20 patients who underwent static FET PET/CT with uncertain brainstem lesions between November 2019 and April 2023. We used multiple tumor-to-brain ratios (TBR) to assess patient subgroups showing long-term and short-term survival. Results: The maximum Youden index was reached at TBR = 2.9. With this ratio, the estimated sensitivity was at the desired level (91.7%), both positive and negative predictive values are in the good performance range (68.8 and 75.0%), while specificity was lower than expected (37.5%). Conclusions: The prognosis of brainstem glioma remains challenging. The use of static FET PET/CT results in more accurate detection of high-grade lesions. In our analysis, we found a TBR value of 2.9 to be the most appropriate for identifying patients with a poor prognosis.
背景/目的：脑干胶质瘤的分类与分期存在其固有局限性。手术活检仅适用于少数病例，诊断主要依赖影像学特征。任何治疗都可能对生活质量产生显著影响，因此正确且早期识别潜在恶性病变对启动恰当治疗至关重要。具有精确代谢成像功能的氨基酸PET/CT可为临床决策提供重要参考。方法：我们对2019年11月至2023年4月期间20例脑干病变性质不明且接受静态FET PET/CT检查的患者进行回顾性分析，采用多种肿瘤-脑摄取比值评估长期与短期生存患者亚组。结果：当TBR=2.9时达到最大约登指数。在此临界值下，检测灵敏度达到预期水平（91.7%），阳性与阴性预测值均处于良好区间（分别为68.8%和75.0%），但特异性低于预期（37.5%）。结论：脑干胶质瘤的预后评估仍具挑战性。静态FET PET/CT的应用能更准确检测高级别病变。本研究发现TBR值2.9是识别不良预后患者的最适临界值。
肿瘤(癌症)患者之家