Volumetry of [11C]-methionine PET uptake and MRI contrast enhancement in patients with recurrent glioblastoma multiforme

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Purpose

We investigated the relationship between three-dimensional volumetric data of the metabolically active tumour volume assessed using [ ¹¹C]-methionine positron emission tomography (MET-PET) and the area of gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) enhancement assessed using magnetic resonance imaging (MRI) in patients with recurrent glioblastoma (GBM).

Material and methods

MET-PET and contrast-enhanced MRI with Gd-DTPA were performed in 12 uniformly pretreated patients with recurrent GBM. To calculate the volumes in cubic centimetres, a threshold-based volume-of-interest (VOI) analysis of the metabolically active tumour volume (MET uptake indexes of ≥1.3 and ≥1.5) and of the area of Gd-DTPA enhancement was performed after coregistration of all images.

Results

In all patients, the metabolically active tumour volume as shown using a MET uptake index of ≥1.3 was larger than the volume of Gd-DTPA enhancement (30.2 ± 22.4 vs. 13.7 ± 10.6 cm ³; p = 0.04). Metabolically active tumour volumes as shown using MET uptake indexes of ≥1.3 and ≥1.5 and the volumes of Gd-DTPA enhancement showed a positive correlation ( r = 0.76, p = 0.003, for an index of ≥1.3, and r = 0.74, p = 0.005, for an index of ≥1.5).

Conclusion

The present data suggest that in patients with recurrent GBM the metabolically active tumour volume may be substantially underestimated by Gd-DTPA enhancement. The findings support the notion that complementary information derived from MET uptake and Gd-DTPA enhancement may be helpful in developing individualized, patient-tailored therapy strategies in patients with recurrent GBM.

Related collections

Most cited references 27

Record: found
Abstract: found
Article: not found

Response criteria for phase II studies of supratentorial malignant glioma.

D R Macdonald, T L Cascino, S C Schold … (1990)

We suggest "new" response criteria for phase II studies of supratentorial malignant glioma and favor rigorous criteria similar to those in medical oncology, with important modifications. Four response categories are proposed: complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). Response in this scheme is based on major changes in tumor size on the enhanced computed tomographic (CT) or magnetic resonance imaging (MRI) scan. Scan changes are interpreted in light of steroid use and neurologic findings. We advocate careful patient selection, emphasize pitfalls in the assessment of response, and suggest guidelines to minimize misinterpretations of response.

0 comments Cited 267 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Radiolabeled amino acids: basic aspects and clinical applications in oncology.

Helga E. de Vries, W Vaalburg, Randall J. Pruim … (2001)

As the applications of metabolic imaging are expanding, radiolabeled amino acids may gain increased clinical interest. This review first describes the basic aspects of amino acid metabolism, then continues with basic aspects of radiolabeled amino acids, and finally describes clinical applications, with an emphasis on diagnostic value. A special focus is on (11)C-methionine, (11)C-tyrosine, and (123)I-iodomethyltyrosine, because these have been most used clinically, although their common affinity for the L-transport systems may limit generalization to other classes of amino acids. The theoretic and preclinical background of amino acid imaging is sound and supports clinical applications. The fact that amino acid imaging is less influenced by inflammation may be advantageous in comparison with (18)F-FDG PET imaging, although tumor specificity is not absolute. In brain tumor imaging, the use of radiolabeled amino acids is established, the diagnostic accuracy of amino acid imaging seems adequate, and the diagnostic value seems advantageous. The general feasibility of amino acid imaging in other tumor types has sufficiently been shown, but more research is required in larger patient series and in well-defined clinical settings.

0 comments Cited 64 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Delineation of brain tumor extent with [11C]L-methionine positron emission tomography: local comparison with stereotactic histopathology.

L. Kracht, M Hoevels, Richard Jacobs … (2004)

Methyl-[11C]L-methionine ([11C]MET) positron emission tomography (PET) in brain tumors reflects amino acid transport and has been shown to be more sensitive than magnetic resonance imaging in stereotactic biopsy planning. It remains unclear whether the increased [11C]MET uptake is limited to solid tumor tissue or even detects infiltrating tumor parts. In 30 patients, a primary or recurrent brain tumor was suspected on magnetic resonance imaging. Patients were investigated with [11C]MET-PET before stereotactic biopsy. The biopsy trajectories were plotted into the [11C]MET-PET images with a newly designed C-based software program. The exact local [11C]MET uptake was determined within rectangular regions of interest of 4 mm in width and length aligned with the biopsy specimen. Individual histologic specimens were rated for the presence of solid tumor tissue, infiltration area, and nontumorous tissue changes. Receiver operating characteristics analysis demonstrated a sensitivity of 87% and specificity of 89% for the detection of tumor tissue at a threshold of 1.3-fold [11C]MET uptake relative to normal brain tissue. At this threshold, only 13 of 100 tumor positive specimen were false negative mainly in grade 2 astrocytoma. In grade 2 astrocytoma, mean [11C]MET uptake in the infiltration area was significantly higher than in solid tumor tissue (P < 0.003). [11C]MET-PET detects solid parts of brain tumors, as well as the infiltration area at high sensitivity and specificity. High [11C]MET uptake in infiltrating tumor of astrocytoma WHO grade 2 reflects high activity in this tumor compartment. Molecular imaging, with [11C]MET, will guide improved management of patients with brain tumors.

0 comments Cited 60 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

: +49-221-4784455 , +49-221-4787005 , norbert.galldiks@uk-koeln.de

Journal

Journal ID (nlm-ta): Eur J Nucl Med Mol Imaging

Title: European Journal of Nuclear Medicine and Molecular Imaging

Publisher: Springer-Verlag (Berlin/Heidelberg )

ISSN (Print): 1619-7070

ISSN (Electronic): 1619-7089

Publication date (Electronic): 7 August 2009

Publication date PMC-release: 7 August 2009

Publication date (Print): January 2010

Volume: 37

Issue: 1

Pages: 84-92

Affiliations

[1 ]Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924 Cologne, Germany

[2 ]Max Planck-Institute for Neurological Research, Cologne, Germany

Article

Publisher ID: 1219

DOI: 10.1007/s00259-009-1219-5

PMC ID: 2791473

PubMed ID: 19662410

SO-VID: 3634d4bf-ac22-4434-ac83-c9c75db3f128

History

Date received : 15 March 2009

Date accepted : 1 July 2009

Custom metadata

ScienceOpen disciplines: Radiology & Imaging

Keywords: patient-tailored therapy,three-dimensional assessment,active tumour volume,volume-of-interest (voi) analysis,gd-dtpa enhancement

Data availability:

ScienceOpen disciplines: Radiology & Imaging

Keywords: patient-tailored therapy, three-dimensional assessment, active tumour volume, volume-of-interest (voi) analysis, gd-dtpa enhancement