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11C-methionine
PET for differential diagnosis of low-grade gliomas
Herholz
K, Holzer T, Bauer B, Schroder R, Voges J, Ernestus RI, Mendoza G,
Weber-Luxenburger G, Lottgen J, Thiel A, Wienhard K, Heiss WD
Klinik
fur Neurologie, Universitat zu Koln, Germany.
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.
PMID:
9595980 [PubMed - indexed for MEDLINE]
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