Differentiation of Newly Diagnosed Glioblastoma Multiforme and Intracranial Diffuse Large B-cell Lymphoma Using 11C-Methionine and 18F-FDG PET

Abstract

Both SUVmax on FDG PET and ΔSUVmax on MET-PET were considered to be good diagnostic tests when encountering difficulties in this differential diagnosis.

Diagnostic value of using 18F-FDG PET and PET/CT in immunocompetent patients with primary central nervous system lymphoma: A systematic review and meta-analysis

“…Taking several studies together, this technique has a diagnostic sensitivity in PCNSL of 76%–100% [4, 28]. Maximum standardized uptake value (SUVmax) is higher in PCNSL than in gliomas [29, 30]. …”

Imaging of Brain Tumours

“…(i.e better signal to noise ratio) Methionine is involved in protein synthesis, energy production. I t is clear that MET is a powerful diagnostic tool for the detection of primary [61][62][63][64][65][66] and recurrent [42,52,62,[66][67][68][69][70] glioma, as well as having some benefit in prediction of survival. [30,55,[71][72][73][74] Numerous investigations have been performed comparing the diagnostic accuracy of FDG and MET, with reported findings clearly showing the superiority of MET in detection [21,30,75] and grading [30,31] of primary glioma.…”

“…In addition to the above methods, there is now significant interest in the use of PET radiotracers for assessing tumour hypoxia. Many radiotracers exist for investigating tumour hypoxia [160][161][162][163][164][165][166][167][168][169][170], including 18 F-HX4, 18 F-FAZA, 18 F-EF5, [124]I-IAZA, [123] / [125]I-IAZP, 64 Cu-ATSM, 18 F-FENI, 62 Cu-diacetyl-bis(N 4 -methylthiosemicarbazone), 18 F-FETA, 18 F-EF1 and [ 18 F]fluoroerythronitroimidazole. However, 18 F-Fluoromisonidazole (FMISO) PET is clearly the most widely used, as it provides the best compromise between sensitivity, specificity and invasiveness.…”

“…Methods that allow both tracers to be injected simultaneously reduce the scanning time but require that both tracers have different half-lives, with signal separation performed by exploiting the difference in tracer decay rates. Such methods include those by Huang et al, [189] who investigated 13 N, 18 F, 68 Ga and 64 Cu isotopes in phantoms, Figueiras et al, [190] who investigated FDG and ammonia in both phantoms and an ischemic rat model, and Kadrmas et al, [191] who exploited differing decay rates in conjunction with differing kinetics and distribution for FDG, ATSM and PTSM. Other methods, such as those by Koeppe et al [192] and Kadrmas et al, [193] employ a staggered injection that allows for the discrimination of tracer signals with the same half-life, increasing the selection of available radiotracers that can be used.…”

“…Additional benefits lie in the half-life of the radionuclides used to label macromolecules. Radiometals commonly used in labelling macromolecules are 68 Ga (68 minute half-life), 64 Cu (762.06 minute half-life) and 89 Zr (4704.6 minute half-life) each offering distinct advantages over the commonly used 11 C (half life = 20.3 minutes) and 18 F (half-life = 109.8 minutes). Due to the short half-life, a prerequisite for using 11 C and 18 F tracers is access to a cyclotron and radiochemistry facilities.…”