BACKGROUND: Static imaging of amino acids does not allow differentiation of low versus high grade brain tumours. It has been shown that dynamic imaging of the amino acid analogue (18)F-fluoroethyltyrosine (FET) can achieve this goal. In many centres, (11)C-methionine (MET) is used for tumour imaging, but no clinical studies on the use of dynamic scanning for grading have been performed. METHODS: Thirty-four patients with primary brain glioma and histopathological confirmation were retrospectively studied using 40 min dynamic MET-PET with 220 MBq 11C-methionine. In relation to histopathological grading, various metabolic indices and temporal parameters as documented by Poepperl et al. (JNM 2006;47:393-403) were analyzed. RESULTS: None of the evaluated static or temporal parameters allowed discrimination between high and low grade tumours. On average, low grade tumours showed washout after the initial uptake maximum, while both increases and decreases were seen for high grade tumours. Only the relative early versus late uptake ratio showed a trend towards significance (-0.16 +/- 0.17 for low grade versus 0.01 +/- 0.25 for high grade; p = 0.07). CONCLUSION: Unlike FET-PET, the uptake characteristics of MET-PET do not allow classification of low and high grade tumours on an individual patient basis. Since literature data indicate that both tracers have a similar performance regarding biopsy location, tumour delineation, and detection of recurrence, FET-PET should be advocated over MET-PET as its uptake mechanism also allows noninvasive grading in glioma.
BACKGROUND: Static imaging of amino acids does not allow differentiation of low versus high grade brain tumours. It has been shown that dynamic imaging of the amino acid analogue (18)F-fluoroethyltyrosine (FET) can achieve this goal. In many centres, (11)C-methionine (MET) is used for tumour imaging, but no clinical studies on the use of dynamic scanning for grading have been performed. METHODS: Thirty-four patients with primary brain glioma and histopathological confirmation were retrospectively studied using 40 min dynamic MET-PET with 220 MBq 11C-methionine. In relation to histopathological grading, various metabolic indices and temporal parameters as documented by Poepperl et al. (JNM 2006;47:393-403) were analyzed. RESULTS: None of the evaluated static or temporal parameters allowed discrimination between high and low grade tumours. On average, low grade tumours showed washout after the initial uptake maximum, while both increases and decreases were seen for high grade tumours. Only the relative early versus late uptake ratio showed a trend towards significance (-0.16 +/- 0.17 for low grade versus 0.01 +/- 0.25 for high grade; p = 0.07). CONCLUSION: Unlike FET-PET, the uptake characteristics of MET-PET do not allow classification of low and high grade tumours on an individual patient basis. Since literature data indicate that both tracers have a similar performance regarding biopsy location, tumour delineation, and detection of recurrence, FET-PET should be advocated over MET-PET as its uptake mechanism also allows noninvasive grading in glioma.
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Authors: Gabriele Pöpperl; Friedrich W Kreth; Jochen Herms; Walter Koch; Jan H Mehrkens; Franz J Gildehaus; Hans A Kretzschmar; Jörg C Tonn; Klaus Tatsch Journal: J Nucl Med Date: 2006-03 Impact factor: 10.057
Authors: Roger Stupp; Monika E Hegi; Martin J van den Bent; Warren P Mason; Michael Weller; René O Mirimanoff; J Gregory Cairncross Journal: Oncologist Date: 2006-02
Authors: Nathalie L Albert; Michael Weller; Bogdana Suchorska; Norbert Galldiks; Riccardo Soffietti; Michelle M Kim; Christian la Fougère; Whitney Pope; Ian Law; Javier Arbizu; Marc C Chamberlain; Michael Vogelbaum; Ben M Ellingson; Joerg C Tonn Journal: Neuro Oncol Date: 2016-04-21 Impact factor: 12.300
Authors: Norbert Galldiks; Antoine Verger; Timothée Zaragori; Marcus Unterrainer; Bogdana Suchorska; Philipp Lohmann; Jörg C Tonn; Karl-Josef Langen; Nathalie L Albert Journal: Neuro Oncol Date: 2019-12-17 Impact factor: 12.300