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Carbon-11-Methionine PET Evaluation of Intracerebral Hematoma: Distinguishing Neoplastic from Non-Neoplastic Hematoma

Departments of Radiology and Nuclear Medicine and Surgical Neurology, Research Institute of Brain and Blood Vessels, Akita, Japan
Department of Neurosurgical Service, Akita University School of Medicine, Akita, Japan

Correspondence: For correspondence or reprints contact: T. Ogawa, Department of Radiology and Nuclear Medicine, Research Institute of Brain and Blood Vessels-Akita, 6-10, Senshu-kubota-machi, Akita City, 010, Akita, Japan.

ABSTRACT

We evaluated whether PET with L-methyl-¹¹C-methionine (¹¹C-methionine) was clinically useful in distinguishing neoplastic from non-neoplastic intracerebral hematoma. Methods: We examined eight patients with neoplastic (n = 4) or non-neo plastic (n = 4) intracerebral hematomas between 5 and 68 days after the bleeding episode using PET with ¹¹C-methionine (Met-PET). Results: Carbon-11-methionine accumulated in the area surrounding the hematoma in both groups, except in one patient with an acute hypertensive hematoma. Between 22 and 45 days after the ictus, non-neoplastic hematomas showed increased ¹¹C-methionine accumulation largely in accordance with the contrast-enhanced areas on CT or MR images; whereas between 14 and 68 days after bleeding, neoplastic hematomas showed increased ¹¹C-methionine accumulation that extended beyond the contrast-enhanced areas on CT or MR images. The intensity ¹¹C-methionine accumulation in tumor tissue was greater than that in non-neoplastic hematomes. Conclusion: Preliminary results suggest that Met-PET can distinguish neoplastic from non-neoplastic hematomas on the basis of differences in lesion extent compared with CT or MR findings.

Key Words: positron emission tomography • carbon-11-methionine • intracerebral hematoma • brain tumor

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