Cerebral glioma: evaluation with methionine PET.

Abstract

The authors examined 50 patients with cerebral glioma with use of positron emission tomography (PET) and L-[methyl]-[11C]methionine to assess the grade of malignancy and the extent of cerebral glioma. Carbon-11 methionine was highly accumulated in the lesion in 31 of 32 patients with high-grade glioma and 11 of 18 patients with low-grade glioma. The rate of uptake of C-11 methionine in high-grade glioma was significantly higher than in low-grade glioma (P < .001). However, in individual cases it was difficult to evaluate the grade of malignancy only from the degree of C-11 methionine accumulation. In most cases, the area of increased accumulation of C-11 methionine did not correspond to the abnormalities seen at computed tomography (CT). Surgical intervention confirmed that methionine PET delineated the extent of cerebral glioma more clearly than did CT. The authors concluded that methionine PET has greater utility in assessing the extent rather than the grade of malignancy of cerebral glioma.

Positron emission tomography11C-methionine and survival in patients with low-grade gliomas

“…Although the role of the PET method and its clinical applications for patients with brain tumors is well established, correlative studies with PET have concentrated mainly on comparing tracer uptake with tumor histology. 24,25 The uptake of MET is considered to reflect a carrier-mediated transport over the cell membrane. 13,17 Because this transport is believed to be dependent on the proliferative activity of the cells, 26 the question of prognostic utility of the PET method is appropriate.…”

Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose

“…While in some cases of low-grade gliomas PET may show increased FDG uptake, in most cases FDG uptake is decreased [11,33,314], as in nontumoral lesions. In these cases, MET is very helpful, as the uptake of MET is increased in nearly all low-grade gliomas as well as in high-grade gliomas [319][320][321][322][323]. PET is, however, unsuccessful in differentiating between the various histological types of brain tumours, as high uptake of FDG is seen not only in gliomas but also in lymphomas [317,324,325], meningiomas [326], pituitary adenomas [327] and metastases [328].…”

“…Methionine studies in brain gliomas have also shown a correlation between the uptake of this tracer and the histological grade, but to our knowledge no correlation has been reported between the uptake of MET and prognosis [320,322,[349][350][351][352]. Few studies have compared FDG and MET; they have demonstrated that FDG is probably better for establishing the degree of malignancy, whereas MET better delineates the lesions, especially low-grade gliomas [319,321,323,353,354].…”

13C MR Imaging of Methionine-rich Gliomas at 4.7T: A Pilot Study

“…[3][4][5][6] After delivery of 13 C-labeled methionine to living organisms harboring tumors, 13 C-MRI may depict uptake of methionine by tumor metabolites without interference from background signals, but such depiction remains to be investigated. We explored the feasibility of using 13 C-MRI to depict gliomas enriched with 13 C-labeled methionine at 4.7 tesla.…”