Stereotactic Brain Biopsy Guided by Positron Emission Tomography (PET) with [F-18]Fluorodeoxyglucose and [C-11]Methionine

Pirotte, Benoît; Goldman, Serge; David, Philippe; Wikler, David; Damhaut, Philippe; Vandesteene, Arlette; Salmon, Isabelle; Brotchi, Jacques; Levivier, Marc

doi:10.1007/978-3-7091-6513-3_25

Cited by 33 publications

(31 citation statements)

References 18 publications

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“…For preoperative visualization of areas of highest malignancy and definition of the biopsy target, the metabolic information of PET [25,26] or multivoxel MR spectroscopy CSI [15,34] have been suggested: The high diagnostic accuracy of these advanced imaging methods has previously been confirmed by histopathological comparison of a biopsy specimen from the region of highest metabolism with the tumor bulk from subsequent open surgical removal [34]. An intraoperative confirmation of the correct targeting during stereotactic biopsy, however, is still missing as intraoperative MRI is not widely available [12].…”

Section: Discussionmentioning

confidence: 99%

Strong 5-aminolevulinic acid-induced fluorescence is a novel intraoperative marker for representative tissue samples in stereotactic brain tumor biopsies

et al. 2012

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Stereotactic biopsies represent a routine neurosurgical procedure for the diagnosis of intracranial lymphomas and selected diffusely infiltrating gliomas. Acquisition of tissue samples that do not allow correct tumor typing and grading is, however, not uncommon. Five-aminolevulinic acid (5-ALA) has been shown to accumulate in malignant tumor tissue. The aim of this study was to prospectively investigate the clinical usability of 5-ALA for intraoperative detection of representative tissue in stereotactic tumor biopsies. Fifty consecutive patients underwent frameless stereotactic biopsy for a suspected brain tumor. 5-ALA was administered 4 h before anesthesia. Serial biopsy samples were obtained and intraoperatively checked for 5-ALA fluorescence (strong, vague, or none) using a modified neurosurgical microscope. All samples were examined for the presence of representative tumor tissue according to neuroimaging (MRI, positron emission tomography, and/or chemical shift imaging) and histopathological parameters. Visible 5-ALA fluorescence was observed in 43/50 patients (strong in 39 and vague fluorescence in four cases). At biopsy target, 52/53 samples of glioblastomas, 9/10 samples of gliomas grade III, and 14/16 samples of lymphomas revealed strong 5-ALA fluorescence. Samples with strong 5-ALA fluorescence were only observed at, but not outside the biopsy target. All tissue samples with strong 5-ALA fluorescence were representative according to our neuroimaging and histopathological criteria (positive predictive value of 100%). Our data indicate that strong 5-ALA fluorescence is a reliable and immediately available intraoperative marker of representative tumor tissue of malignant gliomas and intracranial lymphomas in stereotactic biopsies. Thereby, the application of 5-ALA in stereotactic brain tumor biopsies may in future reduce costs for operating room and neuropathology and may decrease procedure-related morbidity.

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Section: Discussionmentioning

confidence: 99%

Strong 5-aminolevulinic acid-induced fluorescence is a novel intraoperative marker for representative tissue samples in stereotactic brain tumor biopsies

et al. 2012

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“…Therefore, suitable targets for biopsy will have positive contrast enhancement on T1-weighted MRI, a high choline-peak on MRS, hypermetabolism on [ 18 F]FDG-PET, [127][128][129] and high accumulation of [ 11 C]methionine. 92,130,131 Moreover, in the development of new experimental therapies, multimodal imaging procedures help identify the most active tumor parts for targeted placement of local infusion catheters (FIG. 5).…”

Section: Imaging For Planning Stereotaxic Biopsy and Targeted Applicamentioning

confidence: 99%

Imaging in neurooncology

et al. 2005

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“…Stereotactic biopsies guided by [ 11 C]MET-PET are more successful in finding tumor tissue than CT-only guided ones (16). Mosskin et al (17) in 1987 could demonstrate that [ 11 C]MET-PET accurately delineated the tumor in 22 of 31 cases when compared with histologic findings in stereotactic biopsies, but scanner resolution with 8-mm full width at half maximum and a slice thickness of 11 mm was low at that time.…”

Section: Introductionmentioning

confidence: 99%

Delineation of Brain Tumor Extent with [11C]l-Methionine Positron Emission Tomography

Kracht

Miletić²,

Busch³

et al. 2004

Clinical Cancer Research

276

171

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Stereotactic Brain Biopsy Guided by Positron Emission Tomography (PET) with [F-18]Fluorodeoxyglucose and [C-11]Methionine

Cited by 33 publications

References 18 publications

Strong 5-aminolevulinic acid-induced fluorescence is a novel intraoperative marker for representative tissue samples in stereotactic brain tumor biopsies

Strong 5-aminolevulinic acid-induced fluorescence is a novel intraoperative marker for representative tissue samples in stereotactic brain tumor biopsies

Imaging in neurooncology

Delineation of Brain Tumor Extent with [11C]l-Methionine Positron Emission Tomography

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