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Comparison of 18F-FDG and 11C-Methionine for PET-Guided Stereotactic Brain Biopsy of Gliomas

Benoit Pirotte, MD1, Serge Goldman, MD, PhD2, Nicolas Massager, MD1, Philippe David, MD3, David Wikler, MS1, Arlette Vandesteene, MD, PhD4, Isabelle Salmon, MD, PhD5, Jacques Brotchi, MD, PhD1 and Marc Levivier, MD, PhD1

1 Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
2 PET/Biomedical Cyclotron Unit, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
3 Department of Neuroradiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
4 Department of Anesthesiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
5 Department of Neuropathology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium



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  		FIGURE 1. PET performed with 18F-FDG (A) and Met (B) on a 32-y-old man with an AA in the left frontorolandic cortical area. Uptake of 18F-FDG in tumor was equivalent to that in cortical gray matter. Uptake of Met was higher in tumor than in cortex, allowing definition of a target for biopsy. When PET images obtained with the 2 tracers were coregistered, the focus of highest Met uptake corresponded to the unique focus of 18F-FDG uptake within the tumor (crosses).

 


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  		FIGURE 2. PET performed with 18F-FDG (A) and Met (B) on a 62-y-old woman with a GB in the right prerolandic cortical area. Uptake of 18F-FDG was reduced in the tumor area except for 1 spot of uptake equivalent to that in the surrounding gray matter. Uptake of Met was higher in tumor than in cortex, allowing definition of a target for biopsy. When PET images obtained with the 2 tracers were coregistered, the highest focus of Met uptake corresponded to the hot spot of 18F-FDG (crosses).

 


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  		FIGURE 3. PET performed with 18F-FDG (A) and Met (B) on a 74-y-old man with a GB in the right basal ganglia. Uptake of 18F-FDG was higher in tumor than in surrounding gray matter and allowed definition of a target for biopsy. Uptake of Met was also higher in tumor than in surrounding gray matter, and zones of highest uptake of both tracers corresponded on coregistered images (crosses).

 


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  		FIGURE 4. MRI (A) and PET performed with 18F-FDG (B) and Met (C) on a 57-y-old woman with an infiltrating AA in the left basal ganglia and subcortical frontal region. Uptake of 18F-FDG was higher in tumor than in surrounding gray matter and allowed definition of a target for biopsy. Uptake of Met was also higher in tumor than in surrounding gray matter. Coregistration of PET images showed that Met uptake was more extended than 18F-FDG uptake but that zones of highest uptake corresponded (crosses).

 




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