Multimodal metabolic imaging of cerebral gliomas: positron emission tomography with [18F]fluoroethyl-l-tyrosine and magnetic resonance spectroscopy

Restricted access

Object. The purpose of this study was to determine the predictive value of [18F]fluoroethyl-l-tyrosine (FET)—positron emission tomography (PET) and magnetic resonance (MR) spectroscopy for tumor diagnosis in patients with suspected gliomas.

Methods. Both FET-PET and MR spectroscopy analyses were performed in 50 consecutive patients with newly diagnosed intracerebral lesions supposed to be diffuse gliomas on contrast-enhanced MR imaging. Lesion/brain ratios of FET uptake greater than 1.6 were considered positive, that is, indicative of tumor. Results of MR spectroscopy were considered positive when N-acetylaspartate (NAA) was decreased in conjunction with an absolute increase of choline (Cho) and an NAA/Cho ratio of 0.7 or less. An FET lesion/brain ratio, an NAA/Cho ratio, and signal abnormalities on MR images were compared with histological findings in neuronavigated biopsy specimens.

The FET lesion/brain ratio and the NAA/Cho ratio were identified as significant independent predictors for the histological identification of tumor tissue. The accuracy in distinguishing neoplastic from nonneoplastic tissue could be increased from 68% with the use of MR imaging alone to 97% with MR imaging in conjunction with FET-PET and MR spectroscopy. Sensitivity and specificity for tumor detection were 100 and 81% for MR spectroscopy and 88 and 88% for FET-PET, respectively. Results of histological studies did not reveal tumor tissue in any of the lesions that were negative on FET-PET and MR spectroscopy. In contrast, a tumor diagnosis was made in 97% of the lesions that were positive with both methods.

Conclusions. In patients with intracerebral lesions supposed to be diffuse gliomas on MR imaging, FET-PET and MR spectroscopy analyses markedly improved the diagnostic efficacy of targeted biopsies.

Article Information

Contributor Notes

Address reprint requests to: Frank Willi Floeth, M.D., Department of Neurosurgery, Heinrich-Heine-University of Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany. email: floethf@uni-duesseldorf.de.

© AANS, except where prohibited by US copyright law.

Headings
References
  • 1.

    Bernstein MParrent AG: Complications of CT-guided stereotactic biopsy of intra-axial brain lesions. J Neurosurg 81:1651681994Bernstein M Parrent AG: Complications of CT-guided stereotactic biopsy of intra-axial brain lesions. J Neurosurg 81:165–168 1994

    • Search Google Scholar
    • Export Citation
  • 2.

    Bottomley PA: Spatial localization in NMR spectroscopy in vivo. Ann NY Acad Sci 508:3333481987Bottomley PA: Spatial localization in NMR spectroscopy in vivo. Ann NY Acad Sci 508:333–348 1987

    • Search Google Scholar
    • Export Citation
  • 3.

    Braun VDempf SWeller RReske SNSchachenmayr WRichter HP: 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 144:7777822002Braun V Dempf S Weller R Reske SN Schachenmayr W Richter HP: 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 144:777–782 2002

    • Search Google Scholar
    • Export Citation
  • 4.

    Burger PCHeinz ERShibata TKleihues P: Topographic anatomy and CT correlations in the untreated glioblastoma multiforme. J Neurosurg 68:6987041988Burger PC Heinz ER Shibata T Kleihues P: Topographic anatomy and CT correlations in the untreated glioblastoma multiforme. J Neurosurg 68:698–704 1988

    • Search Google Scholar
    • Export Citation
  • 5.

    Chandrasoma PTSmith MMApuzzo ML: Stereotactic biopsy in the diagnosis of brain masses: comparison of results of biopsy and resected surgical specimen. Neurosurgery 24:1601651989Chandrasoma PT Smith MM Apuzzo ML: Stereotactic biopsy in the diagnosis of brain masses: comparison of results of biopsy and resected surgical specimen. Neurosurgery 24:160–165 1989

    • Search Google Scholar
    • Export Citation
  • 6.

    Chung JKKim YKKim SKLee YJPaek SYeo JSet al: 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 29:1761822002Chung JK Kim YK Kim SK Lee YJ Paek S Yeo JS et al: 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 2002

    • Search Google Scholar
    • Export Citation
  • 7.

    Derlon JMChapon FNoel MHKhouri SBenali KPetit-Taboue MCet al: Non-invasive grading of oligodendrogliomas: correlation between in vivo metabolic pattern and histopathology. Eur J Nucl Med 27:7787872000Derlon JM Chapon F Noel MH Khouri S Benali K Petit-Taboue MC et al: Non-invasive grading of oligodendrogliomas: correlation between in vivo metabolic pattern and histopathology. Eur J Nucl Med 27:778–787 2000

    • Search Google Scholar
    • Export Citation
  • 8.

    Derlon JMPetit-Taboue MCChapon FBeaudouin VNoel MHCreveuil Cet al: The in vivo metabolic pattern of low-grade brain gliomas: a positron emission tomographic study using 18F-fluorodeoxyglucose and 11C-l-methylmethionine. Neurosurgery 40:2762881997Derlon JM Petit-Taboue MC Chapon F Beaudouin V Noel MH Creveuil C et al: The in vivo metabolic pattern of low-grade brain gliomas: a positron emission tomographic study using 18F-fluorodeoxyglucose and 11C-l-methylmethionine. Neurosurgery 40:276–288 1997

    • Search Google Scholar
    • Export Citation
  • 9.

    De Witte OGoldberg IWikler DRorive SDamhaut PMonclus Met al: Positron emission tomography with injection of methionine as a prognostic factor in glioma. J Neurosurg 95:7467502001De Witte O Goldberg I Wikler D Rorive S Damhaut P Monclus M et al: Positron emission tomography with injection of methionine as a prognostic factor in glioma. J Neurosurg 95:746–750 2001

    • Search Google Scholar
    • Export Citation
  • 10.

    Dowling CBollen AWNoworolski SMMcDermott MWBarbaro NMDay MRet al: Preoperative proton MR spectroscopic imaging of brain tumors: correlation with histopathologic analysis of resection specimens. AJNR 22:6046122001Dowling C Bollen AW Noworolski SM McDermott MW Barbaro NM Day MR et al: Preoperative proton MR spectroscopic imaging of brain tumors: correlation with histopathologic analysis of resection specimens. AJNR 22:604–612 2001

    • Search Google Scholar
    • Export Citation
  • 11.

    Duijn JHMatson GBMaudsley AAWeiner MW: 3D phase encoding 1H spectroscopic imaging of human brain. Magn Reson Imaging 10:3153191992Duijn JH Matson GB Maudsley AA Weiner MW: 3D phase encoding 1H spectroscopic imaging of human brain. Magn Reson Imaging 10:315–319 1992

    • Search Google Scholar
    • Export Citation
  • 12.

    Edner G: Stereotactic biopsy of intracranial space occupying lesions. Acta Neurochir 57:2132341981Edner G: Stereotactic biopsy of intracranial space occupying lesions. Acta Neurochir 57:213–234 1981

    • Search Google Scholar
    • Export Citation
  • 13.

    Fulham MJBizzi ADietz MJShih HHRaman RSobering GSet al: Mapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance. Radiology 185:6756861992Fulham MJ Bizzi A Dietz MJ Shih HH Raman R Sobering GS et al: Mapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance. Radiology 185:675–686 1992

    • Search Google Scholar
    • Export Citation
  • 14.

    Goldman SLevivier MPirotte BBrucher JMWikler DDamhaut Pet al: Regional glucose metabolism and histopathology of gliomas. A study based on positron emission tomography-guided stereotactic biopsy. Cancer 78:109811061996Goldman S Levivier M Pirotte B Brucher JM Wikler D Damhaut P et al: Regional glucose metabolism and histopathology of gliomas. A study based on positron emission tomography-guided stereotactic biopsy. Cancer 78:1098–1106 1996

    • Search Google Scholar
    • Export Citation
  • 15.

    Goldstein SGumerlock MKNeuwelt EA: Comparison of CT-guided and stereotaxic cranial diagnostic needle biopsies. J Neurosurg 67:3413481987Goldstein S Gumerlock MK Neuwelt EA: Comparison of CT-guided and stereotaxic cranial diagnostic needle biopsies. J Neurosurg 67:341–348 1987

    • Search Google Scholar
    • Export Citation
  • 16.

    Grosu ALWeber WFeldmann HJWuttke BBartenstein PGross MWet al: First experience with I-123-alpha-methyl-tyrosine spect in the 3-D radiation treatment planning of brain gliomas. Int J Radiat Oncol Biol Phys 47:5175262000Grosu AL Weber W Feldmann HJ Wuttke B Bartenstein P Gross MW et al: First experience with I-123-alpha-methyl-tyrosine spect in the 3-D radiation treatment planning of brain gliomas. Int J Radiat Oncol Biol Phys 47:517–526 2000

    • Search Google Scholar
    • Export Citation
  • 17.

    Hamacher KCoenen HH: Efficient routine production of the 18F-labelled amino acid O-2-(18F) fluoroethyl-L-tyrosine. Appl Radiat Isot 57:8538562002Hamacher K Coenen HH: Efficient routine production of the 18F-labelled amino acid O-2-(18F) fluoroethyl-L-tyrosine. Appl Radiat Isot 57:853–856 2002

    • Search Google Scholar
    • Export Citation
  • 18.

    Hamilton RJSweeney PJPelizzari CAYetkin FZHolman BLGarada Bet al: Functional imaging in treatment planning of brain lesions. Int J Radiat Oncol Biol Phys 37:1811881997Hamilton RJ Sweeney PJ Pelizzari CA Yetkin FZ Holman BL Garada B et al: Functional imaging in treatment planning of brain lesions. Int J Radiat Oncol Biol Phys 37:181–188 1997

    • Search Google Scholar
    • Export Citation
  • 19.

    Hayashi TKumabe TJokura HFujihara KShiga YWatanabe Met al: Inflammatory demyelinating disease mimicking malignant glioma. J Nucl Med 44:5655692003Hayashi T Kumabe T Jokura H Fujihara K Shiga Y Watanabe M et al: Inflammatory demyelinating disease mimicking malignant glioma. J Nucl Med 44:565–569 2003

    • Search Google Scholar
    • Export Citation
  • 20.

    Heiss PMayer SHerz MWesler HJSchwaiger MSenekowitsch-Schmidtke R: Investigation of transport mechanism and uptake kinetics of O-(2-[18F]fluoroethyl)-l-tyrosine in vitro and in vivo. J Nucl Med 40:136713731999Heiss P Mayer S Herz M Wesler HJ Schwaiger M Senekowitsch-Schmidtke R: Investigation of transport mechanism and uptake kinetics of O-(2-[18F]fluoroethyl)-l-tyrosine in vitro and in vivo. J Nucl Med 40:1367–1373 1999

    • Search Google Scholar
    • Export Citation
  • 21.

    Herholz KHolzer TBauer BSchroder RVoges JErnestus RIet al: 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 50:131613221998Herholz K Holzer T Bauer B Schroder R Voges J Ernestus RI et al: 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 50:1316–1322 1998

    • Search Google Scholar
    • Export Citation
  • 22.

    Jager PLVaalburg WPruim Jde Vries EGLangen KJPiers DA: Radiolabeled amino acids: basic aspects and clinical applications in oncology. J Nucl Med 42:4324452001Jager PL Vaalburg W Pruim J de Vries EG Langen KJ Piers DA: Radiolabeled amino acids: basic aspects and clinical applications in oncology. J Nucl Med 42:432–445 2001

    • Search Google Scholar
    • Export Citation
  • 23.

    Janus TJKim EETilbury RBruner JMYung WK: Use of [18F] fluorodeoxyglucose positron emission tomography in patients with primary malignant brain tumors. Ann Neurol 33:5405481993Janus TJ Kim EE Tilbury R Bruner JM Yung WK: Use of [18F] fluorodeoxyglucose positron emission tomography in patients with primary malignant brain tumors. Ann Neurol 33:540–548 1993

    • Search Google Scholar
    • Export Citation
  • 24.

    Kaim AHWeber BKurrer MOWestera GSchweitzer AGottschalk Jet al: (18)F-FDG and (18)F-FET uptake in experimental soft tissue infection. Eur J Nucl Med Mol Imaging 29:6486542002Kaim AH Weber B Kurrer MO Westera G Schweitzer A Gottschalk J et al: (18)F-FDG and (18)F-FET uptake in experimental soft tissue infection. Eur J Nucl Med Mol Imaging 29:648–654 2002

    • Search Google Scholar
    • Export Citation
  • 25.

    Kaschten BStevenaert ASadzot BDeprez MDegueldre CDel Fiore Get al: Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med 39:7787851998Kaschten B Stevenaert A Sadzot B Deprez M Degueldre C Del Fiore G et al: Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med 39:778–785 1998

    • Search Google Scholar
    • Export Citation
  • 26.

    Kinoshita YKajiwara HYokota AKoga Y: Proton magnetic resonance spectroscopy of brain tumors: an in vitro study. Neurosurgery 35:6066141994Kinoshita Y Kajiwara H Yokota A Koga Y: Proton magnetic resonance spectroscopy of brain tumors: an in vitro study. Neurosurgery 35:606–614 1994

    • Search Google Scholar
    • Export Citation
  • 27.

    Kleihues PCavenee WK (eds): World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Nervous System. Lyon: IARC Press2000Kleihues P Cavenee WK (eds): orld Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Nervous System. Lyon: IARC Press 2000

    • Search Google Scholar
    • Export Citation
  • 28.

    Kracht LWFriese MHerholz KSchroeder RBauer BJacobs Aet al: 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 30:8688732003Kracht LW Friese M Herholz K Schroeder R Bauer B Jacobs A et al: 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 2003

    • Search Google Scholar
    • Export Citation
  • 29.

    Kreth FWMuacevic AMedele RBise KMeyer TReulen HJ: The risk of haemorrhage after image guided stereotactic biopsy of intra-axial brain tumours—a prospective study. Acta Neurochir 143:5395462001Kreth FW Muacevic A Medele R Bise K Meyer T Reulen HJ: The risk of haemorrhage after image guided stereotactic biopsy of intra-axial brain tumours—a prospective study. Acta Neurochir 143:539–546 2001

    • Search Google Scholar
    • Export Citation
  • 30.

    LangenKJ: Amino acid transport studies in brain tumors in Feinendegen LEShreeve WWEckelman WCet al (eds): Molecular Nuclear Medicine: The Challenge of Genomics and Proteomics to Clinical Practice. Berlin: Springer-Verlag2003 pp 477485Langen KJ: Amino acid transport studies in brain tumors in Feinendegen LE Shreeve WW Eckelman WC et al (eds): Molecular Nuclear Medicine: The Challenge of Genomics and Proteomics to Clinical Practice. Berlin: Springer-Verlag 2003 pp 477–485

    • Search Google Scholar
    • Export Citation
  • 31.

    Langen KJJarosch MMuhlensiepen HHamacher KBroer SJansen Pet al: Comparison of fluorotyrosines and methionine uptake in F98 rat gliomas. Nucl Med Biol 30:5015082003Langen KJ Jarosch M Muhlensiepen H Hamacher K Broer S Jansen P et al: Comparison of fluorotyrosines and methionine uptake in F98 rat gliomas. Nucl Med Biol 30:501–508 2003

    • Search Google Scholar
    • Export Citation
  • 32.

    Law MYang SWang HBabb JSJohnson GCha Set al: Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR 24:198919982003Law M Yang S Wang H Babb JS Johnson G Cha S et al: Glioma grading: sensitivity specificity and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR 24:1989–1998 2003

    • Search Google Scholar
    • Export Citation
  • 33.

    Lunsford LDSomaza SKondziolka DFlickinger JC: Brain astrocytomas: biopsy, then irradiation. Clin Neurosurg 42:4644791995Lunsford LD Somaza S Kondziolka D Flickinger JC: Brain astrocytomas: biopsy then irradiation. Clin Neurosurg 42:464–479 1995

    • Search Google Scholar
    • Export Citation
  • 34.

    Maciunas RJKessler RMMaurer CMandava VWatt GSmith G: Positron emission tomography imaging-directed stereotactic neurosurgery. Stereotact Funct Neurosurg 58:1341401992Maciunas RJ Kessler RM Maurer C Mandava V Watt G Smith G: Positron emission tomography imaging-directed stereotactic neurosurgery. Stereotact Funct Neurosurg 58:134–140 1992

    • Search Google Scholar
    • Export Citation
  • 35.

    Massager NDavid PGoldman SPirotte BWikler DSalmon Iet al: Combined magnetic resonance imaging— and positron emission tomography—guided stereotactic biopsy in brainstem mass lesions: diagnostic yield in a series of 30 patients. J Neurosurg 93:9519572000Massager N David P Goldman S Pirotte B Wikler D Salmon I et al: Combined magnetic resonance imaging— and positron emission tomography—guided stereotactic biopsy in brainstem mass lesions: diagnostic yield in a series of 30 patients. J Neurosurg 93:951–957 2000

    • Search Google Scholar
    • Export Citation
  • 36.

    Matsukado YMacCarty CSKernohan JW: The growth of glioblastoma multiforme (astrocytomas, grades 3 and 4) in neurosurgical practice. J Neurosurg 18:6366441961Matsukado Y MacCarty CS Kernohan JW: The growth of glioblastoma multiforme (astrocytomas grades 3 and 4) in neurosurgical practice. J Neurosurg 18:636–644 1961

    • Search Google Scholar
    • Export Citation
  • 37.

    McGirt MJVillavicencio ATBulsara KRFriedman AH: MRI-guided stereotactic biopsy in the diagnosis of glioma: comparison of biopsy and surgical resection specimen. Surg Neurol 59:2772822003McGirt MJ Villavicencio AT Bulsara KR Friedman AH: MRI-guided stereotactic biopsy in the diagnosis of glioma: comparison of biopsy and surgical resection specimen. Surg Neurol 59:277–282 2003

    • Search Google Scholar
    • Export Citation
  • 38.

    McKnight TRvon dem Bussche MHVigneron DBLu YBerger MSMcDermott MWet al: Histopathological validation of a three-dimensional magnetic resonance spectroscopy index as a predictor of tumor presence. J Neurosurg 97:7948022002McKnight TR von dem Bussche MH Vigneron DB Lu Y Berger MS McDermott MW et al: Histopathological validation of a three-dimensional magnetic resonance spectroscopy index as a predictor of tumor presence. J Neurosurg 97:794–802 2002

    • Search Google Scholar
    • Export Citation
  • 39.

    Messing-Junger AMFloeth FWPauleit DReifenberger GWilling RGartner Jet al: Multimodal target point assessment for stereotactic biopsy in children with diffuse bithalamic astrocytomas. Childs Nerv Syst 18:4454492002Messing-Junger AM Floeth FW Pauleit D Reifenberger G Willing R Gartner J et al: Multimodal target point assessment for stereotactic biopsy in children with diffuse bithalamic astrocytomas. Childs Nerv Syst 18:445–449 2002

    • Search Google Scholar
    • Export Citation
  • 40.

    Michaelis TMerboldt KDBruhn HHanicke WFrahm J: Absolute concentrations of metabolites in the adult human brain in vivo: quantification of localized proton MR spectra. Radiology 187:2192271993Michaelis T Merboldt KD Bruhn H Hanicke W Frahm J: Absolute concentrations of metabolites in the adult human brain in vivo: quantification of localized proton MR spectra. Radiology 187:219–227 1993

    • Search Google Scholar
    • Export Citation
  • 41.

    Negendank WGSauter RBrown TREvelhoch JLFalini AGotsis EDet al: Proton magnetic resonance spectroscopy in patients with glial tumors: a multicenter study. J Neurosurg 84:4494581996Negendank WG Sauter R Brown TR Evelhoch JL Falini A Gotsis ED et al: Proton magnetic resonance spectroscopy in patients with glial tumors: a multicenter study. J Neurosurg 84:449–458 1996

    • Search Google Scholar
    • Export Citation
  • 42.

    Nelson SJVigneron DBDillon WP: Serial evaluation of patients with brain tumors using volume MRI and 3D 1H MRSI. NMR Biomed 12:1231381999Nelson SJ Vigneron DB Dillon WP: Serial evaluation of patients with brain tumors using volume MRI and 3D 1H MRSI. NMR Biomed 12:123–138 1999

    • Search Google Scholar
    • Export Citation
  • 43.

    Nuutinen JSonninen PLehikoinen PSutinen EValavaara REronen Eet al: Radiotherapy treatment planning and long-term follow-up with [(11)C]methionine PET in patients with low-grade astrocytoma. Int J Radiat Oncol Biol Phys 48:43522000Nuutinen J Sonninen P Lehikoinen P Sutinen E Valavaara R Eronen E et al: Radiotherapy treatment planning and long-term follow-up with [(11)C]methionine PET in patients with low-grade astrocytoma. Int J Radiat Oncol Biol Phys 48:43–52 2000

    • Search Google Scholar
    • Export Citation
  • 44.

    Ogawa TShishido FKanno IInugami AFujita HMurakami Met al: Cerebral glioma: evaluation with methionine PET. Radiology 186:45531993Ogawa T Shishido F Kanno I Inugami A Fujita H Murakami M et al: Cerebral glioma: evaluation with methionine PET. Radiology 186:45–53 1993

    • Search Google Scholar
    • Export Citation
  • 45.

    Oppitz UMaessen DZunterer HRichter SFlentje M: 3D-recurrence-patterns of glioblastomas after CT-planned postoperative irradiation. Radiother Oncol 53:53571999Oppitz U Maessen D Zunterer H Richter S Flentje M: 3D-recurrence-patterns of glioblastomas after CT-planned postoperative irradiation. Radiother Oncol 53:53–57 1999

    • Search Google Scholar
    • Export Citation
  • 46.

    Ostertag CBMennel HDKiessling M: Stereotactic biopsy of brain tumors. Surg Neurol 14:2752831980Ostertag CB Mennel HD Kiessling M: Stereotactic biopsy of brain tumors. Surg Neurol 14:275–283 1980

    • Search Google Scholar
    • Export Citation
  • 47.

    Pauleit DFloeth FHerzog HHamacher KTellmann LMuller HWet al: Whole-body distribution and dosimetry of o-(2[18F] fluoroethyl)-L-tyrosine. Eur J Nucl Med Mol Imaging 30:5195242003Pauleit D Floeth F Herzog H Hamacher K Tellmann L Muller HW et al: Whole-body distribution and dosimetry of o-(2[18F] fluoroethyl)-L-tyrosine. Eur J Nucl Med Mol Imaging 30:519–524 2003

    • Search Google Scholar
    • Export Citation
  • 48.

    Pirzkall ANelson SJMcKnight TRTakehashi MMLi XGraves EEet al: Metabolic imaging of low-grade gliomas with three-dimensional magnetic resonance spectroscopy. Int J Radiat Oncol Biol Phys 53:125412642002Pirzkall A Nelson SJ McKnight TR Takehashi MM Li X Graves EE et al: Metabolic imaging of low-grade gliomas with three-dimensional magnetic resonance spectroscopy. Int J Radiat Oncol Biol Phys 53:1254–1264 2002

    • Search Google Scholar
    • Export Citation
  • 49.

    Poptani HGupta RKRoy RPandey RJain VKChhabra DK: Characterization of intracranial mass lesions with in vivo proton MR spectroscopy. AJNR 16:159316031995Poptani H Gupta RK Roy R Pandey R Jain VK Chhabra DK: Characterization of intracranial mass lesions with in vivo proton MR spectroscopy. AJNR 16:1593–1603 1995

    • Search Google Scholar
    • Export Citation
  • 50.

    Preul MCCaramanos ZCollins DLVillemure JGLeblanc ROlivier Aet al: Accurate, noninvasive diagnosis of human brain tumors by using proton magnetic resonance spectroscopy. Nature Med 2:3233251996Preul MC Caramanos Z Collins DL Villemure JG Leblanc R Olivier A et al: Accurate noninvasive diagnosis of human brain tumors by using proton magnetic resonance spectroscopy. Nature Med 2:323–325 1996

    • Search Google Scholar
    • Export Citation
  • 51.

    Provencher SW: Automatic quantitation of localized in vivo 1H spectra with LCModel. NMR Biomed 14:2602642001Provencher SW: Automatic quantitation of localized in vivo 1H spectra with LCModel. NMR Biomed 14:260–264 2001

    • Search Google Scholar
    • Export Citation
  • 52.

    Rau FCWeber WAWester HJHerz MBecker IKruger Aet al: o-(2-[18F]Fluoroethyl)-L-tyrosine (FET): a tracer for differentiation of tumour from inflammation in murine lymph nodes. Eur J Nucl Med Mol Imaging 29:103910462002Rau FC Weber WA Wester HJ Herz M Becker I Kruger A et al: o-(2-[18F]Fluoroethyl)-L-tyrosine (FET): a tracer for differentiation of tumour from inflammation in murine lymph nodes. Eur J Nucl Med Mol Imaging 29:1039–1046 2002

    • Search Google Scholar
    • Export Citation
  • 53.

    Ribom DEriksson AHartman MEngler HNilsson ALångström Bet al: Positron emission tomography 11C-methionine and survival in patients with low-grade gliomas. Cancer 92:154115492001Ribom D Eriksson A Hartman M Engler H Nilsson A Långström B et al: Positron emission tomography 11C-methionine and survival in patients with low-grade gliomas. Cancer 92:1541–1549 2001

    • Search Google Scholar
    • Export Citation
  • 54.

    Sato NSuzuki MKuwata NKuroda KWada TBeppu Tet al: Evaluation of the malignancy of glioma using 11C-methionine positron emission tomography and proliferating cell nuclear antigen staining. Neurosurg Rev 22:2102141999Sato N Suzuki M Kuwata N Kuroda K Wada T Beppu T et al: Evaluation of the malignancy of glioma using 11C-methionine positron emission tomography and proliferating cell nuclear antigen staining. Neurosurg Rev 22:210–214 1999

    • Search Google Scholar
    • Export Citation
  • 55.

    Tedeschi GLundbom NRaman RBonavista SDuyn JHAlger JRet al: Increased choline signal coinciding with malignant degeneration of cerebral gliomas: a serial proton magnetic resonance spectroscopy imaging study. J Neurosurg 87:5165241997Tedeschi G Lundbom N Raman R Bonavista S Duyn JH Alger JR et al: Increased choline signal coinciding with malignant degeneration of cerebral gliomas: a serial proton magnetic resonance spectroscopy imaging study. J Neurosurg 87:516–524 1997

    • Search Google Scholar
    • Export Citation
  • 56.

    Usenius JPKauppinen RAVainio PAHernesniemi JAVapalahti MPPaljarvi LAet al: Quantitative metabolite patterns of human brain tumors: detection by 1H NMR spectroscopy in vivo and in vitro. J Comput Assist Tomogr 18:7057131994Usenius JP Kauppinen RA Vainio PA Hernesniemi JA Vapalahti MP Paljarvi LA et al: Quantitative metabolite patterns of human brain tumors: detection by 1H NMR spectroscopy in vivo and in vitro. J Comput Assist Tomogr 18:705–713 1994

    • Search Google Scholar
    • Export Citation
  • 57.

    Vigneron DBollen AMcDermott MWald LDay MMoyher-Noworolski Set al: Three-dimensional magnetic resonance spectroscopic imaging of histologically confirmed brain tumors. Magn Reson Imaging 19:891012001Vigneron D Bollen A McDermott M Wald L Day M Moyher-Noworolski S et al: Three-dimensional magnetic resonance spectroscopic imaging of histologically confirmed brain tumors. Magn Reson Imaging 19:89–101 2001

    • Search Google Scholar
    • Export Citation
  • 58.

    Wallner KEGalicich JHKrol GArbit EMalkin MG: Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma. Int J Radiat Oncol Biol Phys 16:140514091989Wallner KE Galicich JH Krol G Arbit E Malkin MG: Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma. Int J Radiat Oncol Biol Phys 16:1405–1409 1989

    • Search Google Scholar
    • Export Citation
  • 59.

    Weber WAWester HJGrosu ALHerz MDzewas BFeldmann HJet al: o-(2-[18F]Fluoroethyl)-l-tyrosine and l-[methyl-11C]methionine uptake in brain tumours: initial results of a comparative study. Eur J Nucl Med 27:5425492000Weber WA Wester HJ Grosu AL Herz M Dzewas B Feldmann HJ et al: o-(2-[18F]Fluoroethyl)-l-tyrosine and l-[methyl-11C]methionine uptake in brain tumours: initial results of a comparative study. Eur J Nucl Med 27:542–549 2000

    • Search Google Scholar
    • Export Citation
  • 60.

    Wester HJHerz MWeber WHeiss PSenekowitsch-Schmidtke RSchwaiger Met al: Synthesis and radiopharmacology of O-(2[18F]fluoroethyl)-L-tyrosine for tumor imaging. J Nucl Med 40:2052121999Wester HJ Herz M Weber W Heiss P Senekowitsch-Schmidtke R Schwaiger M et al: Synthesis and radiopharmacology of O-(2[18F]fluoroethyl)-L-tyrosine for tumor imaging. J Nucl Med 40:205–212 1999

    • Search Google Scholar
    • Export Citation
  • 61.

    Wilden JNKelly PJ: CT computerised stereotactic biopsy for low density CT lesions presenting with epilepsy. J Neurol Neurosurg Psychiatry 50:130213051987Wilden JN Kelly PJ: CT computerised stereotactic biopsy for low density CT lesions presenting with epilepsy. J Neurol Neurosurg Psychiatry 50:1302–1305 1987

    • Search Google Scholar
    • Export Citation
TrendMD
Cited By
Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 261 258 102
Full Text Views 183 94 2
PDF Downloads 133 68 3
EPUB Downloads 0 0 0
PubMed
Google Scholar