11C-methionine (MET) and 18F-fluorothymidine (FLT) PET in patients with newly diagnosed glioma

Hatakeyama, Tetsuhiro; Kawai, Nobuyuki; Nishiyama, Yoshihiro; Yamamoto, Yuka; Sasakawa, Yasuhiro; Ichikawa, Tomotsugu; Tamiya, Takashi

doi:10.1007/s00259-008-0847-5

Cited by 147 publications

(109 citation statements)

References 28 publications

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“…A kinetic analysis of 18 F-FLT uptake permits the assessment of tumor proliferation rates in high-grade gliomas, whereas uptake ratios of 11 C-MET and 18 F-FLT failed to correlate with the in vitro-determined proliferation index by Ki-67 immunostaining (46). In another study (49), 18 F-FLT PET was superior to 11 C-MET PET in tumor grading and assessment of proliferation in different gliomas, and the combination with 11 C-MET PET added significant information.…”

Section: Petmentioning

confidence: 99%

Multimodality Assessment of Brain Tumors and Tumor Recurrence

Heiss¹,

Raab²,

Lanfermann³

2011

J Nucl Med

125

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the differences in the information obtained by various MRI and PET modalities and (2) the best combination of imaging procedures to detect brain tumors, to define the biologic activity or malignancy of a tumor, to validate therapeutic effects, and to differentiate between recurrent tumor and tissue necrosis.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNM designates each JNM continuing education article for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only credit commensurate with the extent of their participation in the activity.For CE credit, participants can access this activity through the SNM Web site (http://www.snm.org/ce_online) through October 2012.Neuroimaging plays a significant role in the diagnosis of intracranial tumors, especially brain gliomas, and must consist of an assessment of location and extent of the tumor and of its biologic activity. Therefore, morphologic imaging modalities and functional, metabolic, or molecular imaging modalities should be combined for primary diagnosis and for following the course and evaluating therapeutic effects. MRI is the gold standard for providing detailed morphologic information and can supply some additional insights into metabolism (MR spectroscopy) and perfusion (perfusion-weighted imaging) but still has limitations in identifying tumor grade, invasive growth into neighboring tissue, and treatment-induced changes, as well as recurrences. These insights can be obtained by various PET modalities, including imaging of glucose metabolism, amino acid uptake, nucleoside uptake, and hypoxia. Diagnostic accuracy can benefit from coregistration of PET results and MRI, combining the high-resolution morphologic images with the biologic information. These procedures are optimized by the newly developed combination of PET and MRI modalities, permitting the simultaneous assessment of morphologic, functional, metabolic, and molecular information on the human brain. Brai n tumors are newly formed alterations of morphology, and for their diagnosis, therefore, CT or MRI is mandatory. These imaging modalities are essential for delineating the normal and pathologic anatomy and also for assessing vascular supply and impairment of the blood-brain barrier (BBB) (perfusion-weighted imaging; contrast enhancement). Additionally, MRI is capable of giving functional information on microstructural (diffusion-weighted imaging [DWI]), physiologic, and metabolic (MR spectroscopy [MRS]) changes of tumor tissues. PET and MRI provide physiologic, biochemical, and molecular information related to tumor metabolism, proliferation rate, invasiveness, and interaction with surrounding and remote areas-informati...

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Section: Petmentioning

confidence: 99%

Multimodality Assessment of Brain Tumors and Tumor Recurrence

Heiss¹,

Raab²,

Lanfermann³

2011

J Nucl Med

125

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“…No survival analysis dealing with a homogenous group of patients with low-grade gliomas undergoing FLT-PET before therapy is available. Previously published papers have dealt with gliomas of various grades [3][4][5] or with different timing during their management (before/after therapy). Other studies concentrated on predictions of prognosis in treated high-grade gliomas [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Several clinically-oriented small-size studies concerning FLT-PET in human brain gliomas have been published to date. A significant correlation of FLT uptake with tumour grade and Ki-67 immunohistochemistry has been found in patients with newly diagnosed and recurrent gliomas [3][4][5]. The quantitative parameters of FLT uptake correlate with regional variations in cellular proliferation [6] and can help to differentiate between recurrent glioma and radiation necrosis [7,8].…”

Section: Introductionmentioning

confidence: 99%

FLT-PET in previously untreated patients with low-grade glioma can predict their overall survival

et al. 2014

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“…Moreover, the physiological high dependence of normal brain on glucose metabolism results in normally increased fluoro-deoxyglucose uptake, which accounts for the tracer's suboptimal diagnostic performance. Among radiolabeled amino acids, 11 C-MET is the most extensively studied with encouraging results, still the short-lived 11 C precludes its use in centers without a cyclotron on-site (Kim et al, 2005;Hatakeyama et al, 2008). 11 C-thymidine PET is of great interest, since thymidine is the native pyrimidine base used in DNA synthesis, yet suffers from rapid in vivo degradation and the limited availability issues of 11 C. To overcome these restrictions, 18 F-FLT has been developed as an alternative estimator of the DNA synthesis rate and is currently proving a useful proliferation imaging tracer, correlating well with Ki-67 (Shields et al, 1996;Ullrich et al, 2008).…”

Section: Other Metabolic Imaging Modalities: Petmentioning

confidence: 99%