Skip to main content
SpringerLink
Log in

Detection of histological anaplasia in gliomas with oligodendroglial components using positron emission tomography with 18F-FDG and 11C-methionine: report of two cases

  • Case Report
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Gliomas are regionally heterogeneous tumors. Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) and 11C-methionine (MET) evaluates the heterogeneity of histological malignancy within the tumor. We present two patients with oligodendrocytic tumors that showed discrepancies in the highest uptake areas with these two tracers. PET studies with MET and FDG were performed on the same day, 2 weeks before surgery. In both cases, biopsy specimens were separately obtained from the highest MET and FDG uptake areas guided by intraoperative neuronavigation. Histological examinations demonstrated that the specimens from the highest MET uptake area revealed low-grade oligoastrocytoma or oligodendroglioma, whereas histological anaplasias were contained in the specimens from the highest FDG uptake area. With gliomas with oligodendroglial components, the MET uptake ratio does not always correspond to histological anaplasia, which can be detected only by FDG PET. Sole application of MET PET for preoperative evaluation may lead to misunderstanding of histological heterogeneity in gliomas, especially those with oligodendroglial components. FDG and MET tracers play complementary roles in preoperative evaluation of gliomas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Paulus W, Peiffer J (1989) Intratumoral histologic heterogeneity of gliomas. A quantitative study. Cancer 64:442–447

    Article  CAS  PubMed  Google Scholar 

  2. Singhal T, Narayanan TK, Jain V, Mukherjee J, Mantil J (2008) 11C-L-methionine positron emission tomography in the clinical management of cerebral gliomas. Mol Imaging Biol 10:1–18

    Article  PubMed  Google Scholar 

  3. Pirotte B, Goldman S, Dewitte O, Massager N, Wikler D, Lefranc F, Ben Taib NO, Rorive S, David P, Brotchi J, Levivier M (2006) Integrated positron emission tomography and magnetic resonance imaging-guided resection of brain tumors: a report of 103 consecutive procedures. J Neurosurg 104:238–253

    Article  PubMed  Google Scholar 

  4. Tovi M, Lilja A, Bergstrom M, Ericsson A, Bergstrom K, Hartman M (1990) Delineation of gliomas with magnetic resonance imaging using Gd-DTPA in comparison with computed tomography and positron emission tomography. Acta Radiol 31:417–429

    CAS  PubMed  Google Scholar 

  5. Kim S, Chung JK, Im SH, Jeong JM, Lee DS, Kim DG, Jung HW, Lee MC (2005) 11C-methionine PET as a prognostic marker in patients with glioma: comparison with 18F-FDG PET. Eur J Nucl Med Mol Imaging 32:52–59

    Article  CAS  PubMed  Google Scholar 

  6. Langen KJ, Muhlensiepen H, Holschbach M, Hautzel H, Jansen P, Coenen HH (2000) Transport mechanisms of 3-[123I]iodo-alpha-methyl-L-tyrosine in a human glioma cell line: comparison with [3H]methyl]-L-methionine. J Nucl Med 41:1250–1255

    CAS  PubMed  Google Scholar 

  7. Kaschten B, Stevenaert A, Sadzot B, Deprez M, Degueldre C, Del Fiore G, Luxen A, Reznik M (1998) Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med 39:778–785

    CAS  PubMed  Google Scholar 

  8. De Witte O, Goldberg I, Wikler D, Rorive S, Damhaut P, Monclus M, Salmon I, Brotchi J, Goldman S (2001) Positron emission tomography with injection of methionine as a prognostic factor in glioma. J Neurosurg 95:746–750

    Article  PubMed  Google Scholar 

  9. 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 (1998) 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 50:1316–1322

    CAS  PubMed  Google Scholar 

  10. Kato T, Shinoda J, Oka N, Miwa K, Nakayama N, Yano H, Maruyama T, Muragaki Y, Iwama T (2008) Analysis of 11C-methionine uptake in low-grade gliomas and correlation with proliferative activity. AJNR Am J Neuroradiol 29:1867–1871

    Article  CAS  PubMed  Google Scholar 

  11. Nojiri T, Nariai T, Aoyagi M, Senda M, Ishii K, Ishiwata K, Ohno K (2009) Contributions of biological tumor parameters to the incorporation rate of L: -[methyl-(11)C] methionine into astrocytomas and oligodendrogliomas. J Neurooncol 93:233–241

    Article  CAS  PubMed  Google Scholar 

  12. Ribom D, Eriksson A, Hartman M, Engler H, Nilsson A, Langstrom B, Bolander H, Bergstrom M, Smits A (2001) Positron emission tomography (11)C-methionine and survival in patients with low-grade gliomas. Cancer 92:1541–1549

    Article  CAS  PubMed  Google Scholar 

  13. Braun V, Dempf S, Weller R, Reske SN, Schachenmayr W, Richter HP (2002) Cranial neuronavigation with direct integration of (11)C methionine positron emission tomography (PET) data–results of a pilot study in 32 surgical cases. Acta Neurochir (Wien) 144:777–782 discussion 782

    Article  CAS  Google Scholar 

  14. Kracht LW, Miletic H, Busch S, Jacobs AH, Voges J, Hoevels M, Klein JC, Herholz K, Heiss WD (2004) Delineation of brain tumor extent with [11C]L-methionine positron emission tomography: local comparison with stereotactic histopathology. Clin Cancer Res 10:7163–7170

    Article  CAS  PubMed  Google Scholar 

  15. Warburg O (1956) On respiratory impairment in cancer cells. Science 124:269–270

    CAS  PubMed  Google Scholar 

  16. Alavi JB, Alavi A, Chawluk J, Kushner M, Powe J, Hickey W, Reivich M (1988) Positron emission tomography in patients with glioma. A predictor of prognosis. Cancer 62:1074–1078

    Article  CAS  PubMed  Google Scholar 

  17. Borbely K, Nyary I, Toth M, Ericson K, Gulyas B (2006) Optimization of semi-quantification in metabolic PET studies with 18F-fluorodeoxyglucose and 11C-methionine in the determination of malignancy of gliomas. J Neurol Sci 246:85–94

    Article  CAS  PubMed  Google Scholar 

  18. Goldman S, Levivier M, Pirotte B, Brucher JM, Wikler D, Damhaut P, Stanus E, Brotchi J, Hildebrand J (1996) Regional glucose metabolism and histopathology of gliomas. A study based on positron emission tomography-guided stereotactic biopsy. Cancer 78:1098–1106

    Article  CAS  PubMed  Google Scholar 

  19. Ogawa T, Inugami A, Hatazawa J, Kanno I, Murakami M, Yasui N, Mineura K, Uemura K (1996) Clinical positron emission tomography for brain tumors: comparison of fludeoxyglucose F 18 and L-methyl-11C-methionine. AJNR Am J Neuroradiol 17:345–353

    CAS  PubMed  Google Scholar 

  20. Padma MV, Said S, Jacobs M, Hwang DR, Dunigan K, Satter M, Christian B, Ruppert J, Bernstein T, Kraus G, Mantil JC (2003) Prediction of pathology and survival by FDG PET in gliomas. J Neurooncol 64:227–237

    Article  CAS  PubMed  Google Scholar 

  21. Benard F, Romsa J, Hustinx R (2003) Imaging gliomas with positron emission tomography and single-photon emission computed tomography. Semin Nucl Med 33:148–162

    Article  PubMed  Google Scholar 

  22. Chen W (2007) Clinical applications of PET in brain tumors. J Nucl Med 48:1468–1481

    Article  PubMed  Google Scholar 

  23. Kubota K (2001) From tumor biology to clinical Pet: a review of positron emission tomography (PET) in oncology. Ann Nucl Med 15:471–486

    Article  CAS  PubMed  Google Scholar 

  24. Delbeke D, Meyerowitz C, Lapidus RL, Maciunas RJ, Jennings MT, Moots PL, Kessler RM (1995) Optimal cutoff levels of F-18 fluorodeoxyglucose uptake in the differentiation of low-grade from high-grade brain tumors with PET. Radiology 195:47–52

    CAS  PubMed  Google Scholar 

  25. Chung JK, Kim YK, Kim SK, Lee YJ, Paek S, Yeo JS, Jeong JM, Lee DS, Jung HW, Lee MC (2002) Usefulness of 11C-methionine PET in the evaluation of brain lesions that are hypo- or isometabolic on 18F-FDG PET. Eur J Nucl Med Mol Imaging 29:176–182

    Article  CAS  PubMed  Google Scholar 

  26. Sato N, Suzuki M, Kuwata N, Kuroda K, Wada T, Beppu T, Sera K, Sasaki T, Ogawa A (1999) Evaluation of the malignancy of glioma using 11C-methionine positron emission tomography and proliferating cell nuclear antigen staining. Neurosurg Rev 22:210–214

    Article  CAS  PubMed  Google Scholar 

  27. Kato T, Shinoda J, Nakayama N, Miwa K, Okumura A, Yano H, Yoshimura S, Maruyama T, Muragaki Y, Iwama T (2008) Metabolic assessment of gliomas using 11C-methionine, [18F] fluorodeoxyglucose, and 11C-choline positron-emission tomography. AJNR Am J Neuroradiol 29:1176–1182

    Article  CAS  PubMed  Google Scholar 

  28. Miwa K, Shinoda J, Yano H, Iwama T (2007) Relatively decreased 11C-methionine uptake within the anaplastic component of a mixed-grade oligodendroglioma. AJNR Am J Neuroradiol 28:2005–2007

    Article  CAS  PubMed  Google Scholar 

  29. Sadeghi N, Salmon I, Decaestecker C, Levivier M, Metens T, Wikler D, Denolin V, Rorive S, Massager N, Baleriaux D, Goldman S (2007) Stereotactic comparison among cerebral blood volume, methionine uptake, and histopathology in brain glioma. AJNR Am J Neuroradiol 28:455–461

    CAS  PubMed  Google Scholar 

  30. Kracht LW, Friese M, Herholz K, Schroeder R, Bauer B, Jacobs A, Heiss WD (2003) Methyl-[11C]- l-methionine uptake as measured by positron emission tomography correlates to microvessel density in patients with glioma. Eur J Nucl Med Mol Imaging 30:868–873

    Article  CAS  PubMed  Google Scholar 

  31. Okita Y, Kinoshita M, Goto T, Kagawa N, Kishima H, Shimosegawa E, Hatazawa J, Hashimoto N, Yoshimine T (2010) (11)C-methionine uptake correlates with tumor cell density rather than with microvessel density in glioma: a stereotactic image-histology comparison. Neuroimage 49:2977–2982

    Article  PubMed  Google Scholar 

  32. Patronas NJ, Brooks RA, DeLaPaz RL, Smith BH, Kornblith PL, Di Chiro G (1983) Glycolytic rate (PET) and contrast enhancement (CT) in human cerebral gliomas. AJNR Am J Neuroradiol 4:533–535

    CAS  PubMed  Google Scholar 

  33. Goldman S, Levivier M, Pirotte B, Brucher JM, Wikler D, Damhaut P, Dethy S, Brotchi J, Hildebrand J (1997) Regional methionine and glucose uptake in high-grade gliomas: a comparative study on PET-guided stereotactic biopsy. J Nucl Med 38:1459–1462

    CAS  PubMed  Google Scholar 

  34. Bergstrom M, Collins VP, Ehrin E, Ericson K, Eriksson L, Greitz T, Halldin C, von Holst H, Langstrom B, Lilja A et al (1983) Discrepancies in brain tumor extent as shown by computed tomography and positron emission tomography using [68 Ga]EDTA, [11C]glucose, and [11C]methionine. J Comput Assist Tomogr 7:1062–1066

    Article  CAS  PubMed  Google Scholar 

  35. Mosskin M, Ericson K, Hindmarsh T, von Holst H, Collins VP, Bergstrom M, Eriksson L, Johnstrom P (1989) Positron emission tomography compared with magnetic resonance imaging and computed tomography in supratentorial gliomas using multiple stereotactic biopsies as reference. Acta Radiol 30:225–232

    Article  CAS  PubMed  Google Scholar 

  36. Derlon JM, Chapon F, Noel MH, Khouri S, Benali K, Petit-Taboue MC, Houtteville JP, Chajari MH, Bouvard G (2000) Non-invasive grading of oligodendrogliomas: correlation between in vivo metabolic pattern and histopathology. Eur J Nucl Med 27:778–787

    Article  CAS  PubMed  Google Scholar 

  37. Giammarile F, Cinotti LE, Jouvet A, Ramackers JM, Saint Pierre G, Thiesse P, Jouanneau E, Guyotat J, Pelissou-Guyotat I, Setiey A, Honnorat J, Le Bars D, Frappaz D (2004) High and low grade oligodendrogliomas (ODG): correlation of amino-acid and glucose uptakes using PET and histological classifications. J Neurooncol 68:263–274

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, North-15, West-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan

    Shigeru Yamaguchi, Hiroyuki Kobayashi & Shunsuke Terasaka

  2. Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Kenji Hirata & Tohru Shiga

  3. Department of Pathology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Shinya Tanaka

  4. Sapporo Asabu Neurosurgical Hospital, Sapporo, Japan

    Junichi Murata

Authors
  1. Shigeru Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroyuki Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kenji Hirata
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tohru Shiga
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shinya Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Junichi Murata
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shunsuke Terasaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shunsuke Terasaka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamaguchi, S., Kobayashi, H., Hirata, K. et al. Detection of histological anaplasia in gliomas with oligodendroglial components using positron emission tomography with 18F-FDG and 11C-methionine: report of two cases. J Neurooncol 101, 335–341 (2011). https://doi.org/10.1007/s11060-010-0262-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-010-0262-1

Keywords

Search

Navigation