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Positron
emission tomography with injection of methionine as a prognostic
factor in glioma
De
Witte O, Goldberg I, Wikler D, Rorive S, Damhaut P, Monclus M, Salmon
I, Brotchi J, Goldman S
Department of Neurosurgery, Hopital Erasme, Universite Libre de
Bruxelles, Brussels, Belgium. odewitte@ulb.ac.be
Object. Positron emission tomography with
L-[methyl-11C]methionine (MET-PET) provides information on the
metabolism of gliomas.
The
aim of this study was to determine the predictive value of MET-PET in
the treatment of patients with gliomas.
Methods.
Since 1992, 85 patients with a World Health Organization (WHO)
classification-verified glioma underwent PET studies in which MET was
injected before (74 cases) or after treatment (11 cases).
Analysis
of PET data was conducted by the same investigator using two scales: a
qualitative visual grading scale and a quantitative scale (ratio
between tumor uptake and normal brain uptake, classified on a
seven-level scale).
Uptake
of MET was present in 98% of gliomas.
The
investigator judged this uptake to be moderate to very high based on
visual inspection (qualitative scale).
For
all grades of gliomas, a visual grade of 3 was statistically
associated with a shorter patient survival period (p <
0.005).
The
tumor/normal brain uptake ratio was significantly influenced by the
histological grade of the tumor.
A
statistically poor outcome was demonstrated when this ratio was higher
than a threshold of 2.2 for a WHO Grade II tumor and 2.8 for WHO Grade
III tumor. For Grade II and III tumors, oligodendrogliomas had a
higher uptake of MET than astrocytomas.
Conclusions.
Uptake of MET was present in 98% of the gliomas studied.
A
high uptake is statistically associated with a poor survival
time.
The
intensity of MET uptake represents a prognostic factor for WHO Grade
II and III tumors considered separately.
PMID: 11702862 [PubMed - indexed for MEDLINE]
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