Metabolic Assessment of Gliomas Using¹¹C-Methionine, [¹⁸F] Fluorodeoxyglucose, and¹¹C-Choline Positron-Emission Tomography

Abstract

BACKGROUND AND PURPOSE:Positron-emission tomography (PET) is a useful tool in oncology. The aim of this study was to assess the metabolic activity of gliomas using 11 C-methionine (MET), [ 18 F] fluorodeoxyglucose (FDG), and 11 C-choline (CHO) PET and to explore the correlation between the metabolic activity and histopathologic features.

11C‐methionine uptake and intraoperative 5‐aminolevulinic acid‐induced fluorescence as separate index markers of cell density in glioma

“…Positron emission tomography (PET) with administration 18 F-FDG), 11 C-methionine, 11 C-choline, or 18 F-fluoroethyl-tyrosine ( 18 F-FET) has been applied to the delineation of tumor extension, prediction of prognosis, monitoring of therapeutic effects, and diagnosis of tumor grade, although the clinical utility for these purposes remains controversial. 5,[7][8][9][10][11][12][13][14][15][16] To take advantage of PET, images from this modality have been integrated into neuronavigation for image-guided resection of gliomas. In fact, a previous report showed that complete resection of areas showing increased PET tracer uptake significantly prolonged survival among patients with high-grade glioma, whereas total resection based on MRI contrast enhancement did not.…”

62Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) PET in Human Gliomas: Comparative Study with [18F]Fluorodeoxyglucose and L-Methyl-[11C]Methionine PET

“…Many clinical PET studies with FDG and MET have been conducted to discriminate among World Health Organization grades of gliomas. 4,5,7,8 Several imaging studies have demonstrated the usefulness of FDG-PET in the differentiation between low-grade and high-grade gliomas and even between grade III and grade IV gliomas. 5,7,8 Because of the associated increased glucose uptake and high rates of glycolysis, FDG-PET shows high FDG uptake in GBM.…”

“…The uptake values of the 62 Cu-ATSM, FDG, and MET tracers were determined by assessment of the maximum standardized uptake value (SUV max ) values and T/B ratios. Dr. View version R 2.5 for LINUX (Infocom, Tokyo, Japan) software was used to merge the PET images with the MR images, 4,13,14 and each PET and MR image was volumetrically compared. To evaluate volumetric analysis, we extracted the uptake regions of the 62 Cu-ATSM images on the basis of the optimal T/B ratio thresholds of Ն1.8, a cutoff value for predicting hypoxiainducible factor-1␣ expression in our previous study.…”

“…2 This increased transport and high metabolism oc-cur commonly in GBM and can be detected by widely used techniques, such as FDG-PET and L-methyl-[ 11 C]methionine (MET)-PET. [3][4][5][6][7][8][9] However, the predictive value of these PET imaging techniques has not been adequate for a diagnosis of GBM because uptake of these tracers is not specific in GBM. 3,4 On the other hand, tissue hypoxia and necrosis are cardinal features of GBM that are often associated with resistance to radiation therapy and chemotherapy.…”

11C-methionine PET/CT findings in benign brain disease

“…The accumulation of MET through these mechanisms is visualized as tissue uptake on PET images, with MET being incorporated into most brain tumors, including low-grade gliomas. In general, MET uptake is lower in low-grade than in high-grade gliomas, although there is considerable overlap between these two groups, as well as between histological types [4,5]. However, several previous reports have demonstrated MET uptake in lesions associated with benign brain diseases [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23].…”