Evaluation of Focal Cortical Dysplasia and Mixed Neuronal and Glial Tumors in Pediatric Epilepsy Patients Using<sup>18</sup>F-FDG and<sup>11</sup>C-Methionine PET

Phi, Ji Hoon; Paeng, Jin Chul; Lee, Hyo Sang; Wang, Kyu Chang; Cho, Byung Kyu; Lee, Ji Yeoun; Park, Shin Young; Lee, Joongyub; Lee, Dong Hoon; Kim, Seung Ki

doi:10.2967/jnumed.109.070920

Cited by 54 publications

(37 citation statements)

References 24 publications

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“…[3] In 11 cerebral low-grade gangliogliomas, only one patient showed a moderately hypermetabolic lesion. [10] Löbel et al . have reported a case of cerebellar low-grade ganglioglioma which showed striking hypermetabolism on 18 F-FDG PET.…”

Section: Discussionmentioning

confidence: 99%

Discrepancy between radiological and histological findings in ganglioglioma of the optic chasm: Case report

et al. 2017

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Background:Gangliogliomas involving the optic nerve or chiasm are extremely rare tumors, which can be confused radiologically with other neoplasms. α-[N-methyl-11C]-methylaminoisobutyric acid (11C-MeAIB) is a new artificial amino acid positron emission tomography (PET) tracer, which is metabolically more stable in vivo and may be more specific for tumors than 11C-methionine. However, the utility of 11C-MeAIB PET in the diagnosis of brain tumors has not yet been reported.Case Description:A 26-year-old man presented with visual field defects and headache, and magnetic resonance imaging demonstrated a suprasellar mass involving the optic chiasm. A biopsy and partial tumor resection were performed via an interhemispheric approach. We diagnosed the tumor as ganglioglioma (WHO grade I) involving the optic chiasm. Although this lesion was histologically benign, 11C-MeAIB PET, 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG) PET and proton magnetic resonance spectroscopy indicated malignant features.Conclusion:The discrepancy between radiological and histological findings implies that this new amino acid tracer PET may have a limitation in the diagnosis of gangliogliomas. Although further study is necessary, gangliogliomas should be included in the differential diagnosis of suprasellar tumors, even if PET findings show malignant features.

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Section: Discussionmentioning

confidence: 99%

Discrepancy between radiological and histological findings in ganglioglioma of the optic chasm: Case report

et al. 2017

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“…This region of hypometabolism typically extends over a larger region than the region of hyperperfusion identified with ictal SPECT. Thus, the ictal SPECT region can be ''inscribed'' within the hypometabolic PET region in the same patient [50]. Since FDG-PET frequently identifies a rather large area of hypometabolism, extending beyond the actual epileptogenic cortex, it is not a reliable method to precisely confirm the region to be removed surgically.…”

Section: Ictal Spectmentioning

confidence: 99%

Nuclear medicine in pediatric refractory epilepsy

Treves

Goodkind

Grant

2016

Clin Transl Imaging

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The nuclear medicine procedures 99m Tc-ECD SPECT and 18 F-FDG PET play an important diagnostic role in children with refractory seizures. In select patients, surgical removal of epileptogenic cortex is a therapeutic option. Magnetic resonance imaging (MRI) is the principal imaging method used to identify which patients would benefit from the surgery. However, there are cases when MRI does not detect an abnormality (MRI-negative epilepsy). Under these, and other circumstances, functional nuclear medicine studies are helpful in the workup of these patients. A combination of nuclear medicine procedures with MRI and CT depicts functional-anatomic relationships and assists in the non-invasive localization of epileptogenic cortex. Information derived from these procedures is valuable in the selection of candidates for surgical resection. Timing of tracer administration in relation to imaging and monitoring the state of brain activation are essential for accurate interpretation. Ictal and interictal perfusion single photon computed tomography (SPECT), with digital subtraction and registration to MRI can define the region of ictal cortical hyperperfusion more clearly than separate image interpretation. Ictal SPECT is more sensitive than interictal positron emission computed tomography (PET) and interictal PET is more sensitive than interictal SPECT. Interictal SPECT and PET are easier to obtain than ictal SPECT, since they do not require coordination between seizure onset and tracer administration. When surface electrode grids or depth electrodes are planned, anatomic-functional images can assist in their anatomic positioning. The best results are obtained when the planning, execution and interpretation of nuclear medicine procedures are carried out with the support of a well-trained multidisciplinary team familiar with children and refractory seizures.

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“…Despite some distinctive features on MRI, nonspecific DNET is difficult to diagnose. In most cases, both DNETs and gangliogliomas are hypometabolic on FDG-PET [1, 17, 19, 22, 33]. Therefore, several investigators studied various amino acid PET tracers for differentiating DNETs from other tumor types and non-tumorous lesions.…”

Section: Pet Imaging In Pretreatment Evaluation Of Pediatric Gliomasmentioning

confidence: 99%

“…Increased methionine uptake on PET was reported in both gangliogliomas and DNETs, with significantly higher tumor-to-gray matter ratios as compared to focal cortical dysplasia [33]. Other studies, however, reported no or minimal MET uptake in DNETs, suggesting that MET-PET may be helpful to differentiate such tumors from gliomas that typically show strong MET accumulation [17, 40].…”

Section: Pet Imaging In Pretreatment Evaluation Of Pediatric Gliomasmentioning

confidence: 99%

PET and SPECT studies in children with hemispheric low-grade gliomas

Juhász

Bosnyák

2016

Childs Nerv Syst

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Molecular imaging is playing an increasing role in the pre-treatment evaluation of low-grade gliomas. While glucose positron emission tomography (PET) can be helpful to differentiate low-grade from high-grade tumors, PET imaging with amino acid radiotracers has several advantages, such as better differentiation between tumors and non-tumorous lesions, optimized biopsy targeting and improved detection of tumor recurrence. This review provides a brief overview of single photon emission computed tomography (SPECT) studies followed by a more detailed review of clinical applications of glucose and amino acid PET imaging in low-grade hemispheric gliomas. We discuss key differences in the performance of the most commonly utilized PET radiotracers and highlight the advantage of PET/MRI fusion to obtain optimal information about tumor extent, heterogeneity and metabolism. Recent data also suggest that simultaneous acquisition of PET/MR images and the combination of advanced MRI techniques with quantitative PET can further improve the pre- and post-treatment evaluation of pediatric brain tumors.

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Evaluation of Focal Cortical Dysplasia and Mixed Neuronal and Glial Tumors in Pediatric Epilepsy Patients Using¹⁸F-FDG and¹¹C-Methionine PET

Cited by 54 publications

References 24 publications

Discrepancy between radiological and histological findings in ganglioglioma of the optic chasm: Case report

Discrepancy between radiological and histological findings in ganglioglioma of the optic chasm: Case report

Nuclear medicine in pediatric refractory epilepsy

PET and SPECT studies in children with hemispheric low-grade gliomas

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Evaluation of Focal Cortical Dysplasia and Mixed Neuronal and Glial Tumors in Pediatric Epilepsy Patients Using18F-FDG and11C-Methionine PET

Cited by 54 publications

References 24 publications

Discrepancy between radiological and histological findings in ganglioglioma of the optic chasm: Case report

Discrepancy between radiological and histological findings in ganglioglioma of the optic chasm: Case report

Nuclear medicine in pediatric refractory epilepsy

PET and SPECT studies in children with hemispheric low-grade gliomas

Contact Info

Product

Resources

About

Evaluation of Focal Cortical Dysplasia and Mixed Neuronal and Glial Tumors in Pediatric Epilepsy Patients Using¹⁸F-FDG and¹¹C-Methionine PET