11C-methionine PET for differential diagnosis of low-grade gliomas.

Abstract:

:Management of low-grade gliomas continues to be a challenging task, because CT and MRI do not always differentiate from nontumoral lesions. Furthermore, tumor extent and aggressiveness often remain unclear because of a lack of contrast enhancement. Previous studies indicated that large neutral amino acid tracers accumulate in most brain tumors, including low-grade gliomas, probably because of changes of endothelial and blood-brain barrier function. We describe 11C-methionine uptake measured with PET in a series of 196 consecutive patients, most of whom were studied because of suspected low-grade gliomas. Uptake in the most active lesion area, relative to contralateral side, was significantly different among high-grade gliomas, low-grade gliomas, and chronic or subacute nontumoral lesions, and this difference was independent from contrast enhancement in CT or MRI. Corticosteroids had no significant effect on methionine uptake in low-grade gliomas but reduced uptake moderately in high-grade gliomas. Differentiation between gliomas and nontumoral lesions by a simple threshold was correct in 79%. Recurrent or residual tumors had a higher uptake than primary gliomas. In conclusion, the high sensitivity of 11C-methionine uptake for functional endothelial or blood-brain barrier changes suggests that this tracer is particularly useful for evaluation and follow-up of low-grade gliomas.

journal_name

Neurology

journal_title

Neurology

authors

Herholz K,Hölzer T,Bauer B,Schröder R,Voges J,Ernestus RI,Mendoza G,Weber-Luxenburger G,Löttgen J,Thiel A,Wienhard K,Heiss WD

doi

10.1212/wnl.50.5.1316

subject

Has Abstract

pub_date

1998-05-01 00:00:00

pages

1316-22

issue

5

eissn

0028-3878

issn

1526-632X

journal_volume

50

pub_type

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