11C-methionine PET for differential diagnosis of low-grade gliomas

Neurology. 1998 May;50(5):1316-22. doi: 10.1212/wnl.50.5.1316.

Abstract

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.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Astrocytoma / diagnostic imaging
  • Carbon Radioisotopes
  • Diagnosis, Differential
  • Female
  • Glioblastoma / diagnostic imaging
  • Glioma / diagnostic imaging*
  • Glioma / metabolism
  • Glioma / pathology
  • Humans
  • Image Enhancement / methods
  • Magnetic Resonance Imaging
  • Male
  • Methionine / metabolism*
  • Middle Aged
  • Oligodendroglioma / diagnostic imaging
  • Predictive Value of Tests
  • Tomography, Emission-Computed*
  • Tomography, X-Ray Computed

Substances

  • Carbon Radioisotopes
  • Methionine