Positron emission tomography with injection of methionine as a prognostic factor in glioma

View More View Less
  • 1 Departments of Neurosurgery and Neuropathology, and PET-Biomedical Cyclotron Unit, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
Print or Print + Online

Object. Positron emission tomography with l-[methyl-11C]methionine (MET-PET) provides information on the metabolism of gliomas. The aim of this study was to determine the predictive value of MET-PET in the treatment of patients with gliomas.

Methods. Since 1992, 85 patients with a World Health Organization (WHO) classification—verified glioma underwent PET studies in which MET was injected before (74 cases) or after treatment (11 cases). Analysis of PET data was conducted by the same investigator using two scales: a qualitative visual grading scale and a quantitative scale (ratio between tumor uptake and normal brain uptake, classified on a seven-level scale).

Uptake of MET was present in 98% of gliomas. The investigator judged this uptake to be moderate to very high based on visual inspection (qualitative scale). For all grades of gliomas, a visual grade of 3 was statistically associated with a shorter patient survival period (p < 0.005). The tumor/normal brain uptake ratio was significantly influenced by the histological grade of the tumor. A statistically poor outcome was demonstrated when this ratio was higher than a threshold of 2.2 for a WHO Grade II tumor and 2.8 for WHO Grade III tumor. For Grade II and III tumors, oligodendrogliomas had a higher uptake of MET than astrocytomas.

Conclusions. Uptake of MET was present in 98% of the gliomas studied. A high uptake is statistically associated with a poor survival time. The intensity of MET uptake represents a prognostic factor for WHO Grade II and III tumors considered separately.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
  • 1.

    Bergstrom M, , Ericson K, & Hagenfeldt L, et al: PET study of methionine accumulation in glioma and normal brain tissue competition with branched chain amino acids. J Comput Assist Tomogr 11:208213, 1987 Bergstrom M, Ericson K, Hagenfeldt L, et al: PET study of methionine accumulation in glioma and normal brain tissue competition with branched chain amino acids. J Comput Assist Tomogr 11:208–213, 1987

    • Search Google Scholar
    • Export Citation
  • 2.

    Bustany P, , Chatel M, & Derlon JM, et al: Brain tumor protein synthesis and histological grades: a study by positron emission tomography (PET) with C11-L-Methionine. J Neurooncol 3:397404, 1986 Bustany P, Chatel M, Derlon JM, et al: Brain tumor protein synthesis and histological grades: a study by positron emission tomography (PET) with C11-L-Methionine. J Neurooncol 3:397–404, 1986

    • Search Google Scholar
    • Export Citation
  • 3.

    Comar D, , Cartron J, & Mazière M, et al: Labeling and metabolism of methionine-methyl-11C. Eur J Nucl Med 1:1114, 1976 Comar D, Cartron J, Mazière M, et al: Labeling and metabolism of methionine-methyl-11C. Eur J Nucl Med 1:11–14, 1976

    • Search Google Scholar
    • Export Citation
  • 4.

    De Witte O, , Levivier M, & Violon P, et al: Prognostic value of positron emission tomography with [18F]fluoro-2-deoxy-D-glucose in the low-grade glioma. Neurosurgery 39:470477, 1996 De Witte O, Levivier M, Violon P, et al: Prognostic value of positron emission tomography with [18F]fluoro-2-deoxy-D-glucose in the low-grade glioma. Neurosurgery 39:470–477, 1996

    • Search Google Scholar
    • Export Citation
  • 5.

    Derlon JM, , Bourdet C, & Bustany P, et al: [11C]L-methionine uptake in gliomas. Neurosurgery 25:720728, 1989 Derlon JM, Bourdet C, Bustany P, et al: [11C]L-methionine uptake in gliomas. Neurosurgery 25:720–728, 1989

    • Search Google Scholar
    • Export Citation
  • 6.

    Goldman S, , Levivier M, & Pirotte B, et al: Regional methionine and glucose uptake in high-grade gliomas: a comparative study on PET-guided stereotactic biopsy. J Nucl Med 38:14591462, 1997 Goldman S, Levivier M, Pirotte B, et al: Regional methionine and glucose uptake in high-grade gliomas: a comparative study on PET-guided stereotactic biopsy. J Nucl Med 38:1459–1462, 1997

    • Search Google Scholar
    • Export Citation
  • 7.

    Herholz K, , Hölzer T, & Bauer B, et al: 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 50:13161322, 1998 Herholz K, Hölzer T, Bauer B, et al: 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 50:1316–1322, 1998

    • Search Google Scholar
    • Export Citation
  • 8.

    Hildebrand J, & Delecluse F: Malignant glioma, in Staquet M (ed): Randomized Trials in Cancer: A Critical Review by Sites. New York: Raven Press, 1986, pp 583604 Hildebrand J, Delecluse F: Malignant glioma, in Staquet M (ed): Randomized Trials in Cancer: A Critical Review by Sites. N ew York: Raven Press, 1986, pp 583–604

    • Search Google Scholar
    • Export Citation
  • 9.

    Inoue T, , Shibasaki T, & Oriuchi N, et al: 18F alpha-methyl tyrosine PET studies in patients with brain tumors. J Nucl Med 40:399405, 1999 Inoue T, Shibasaki T, Oriuchi N, et al: 18F alpha-methyl tyrosine PET studies in patients with brain tumors. J Nucl Med 40:399–405, 1999

    • Search Google Scholar
    • Export Citation
  • 10.

    Kaschten B: Contribution à l'étude du Métabolisme et de la Croissance des Tumeurs Cérébrales. Définitions d'indices Pronostiques. Academic Thesis, University of Liege, Belgium, 1997, pp 159162 Kaschten B: Contribution à l'étude du Métabolisme et de la Croissance des Tumeurs Cérébrales. Définitions d'indices Pronostiques. A cademic Thesis, University of Liege, Belgium, 1997, pp 159–162

    • Search Google Scholar
    • Export Citation
  • 11.

    Kaschten B, , Stevenaert A, & Sadzot B, et al: Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med 39:778785, 1998 Kaschten B, Stevenaert A, Sadzot B, 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
  • 12.

    Keles GE, , Anderson B, & Berger MS: The effect of extent of resection on time to tumor progression and survival in patients with glioblastoma multiforme of the cerebral hemisphere. Surg Neurol 52:371379, 1999 Keles GE, Anderson B, Berger MS: The effect of extent of resection on time to tumor progression and survival in patients with glioblastoma multiforme of the cerebral hemisphere. Surg Neurol 52:371–379, 1999

    • Search Google Scholar
    • Export Citation
  • 13.

    Kleihues P, , Burger PC, & Scheithauer BW: The new WHO classification of brain tumours. Brain Pathol 3:255268, 1993 Kleihues P, Burger PC, Scheithauer BW: The new WHO classification of brain tumours. Brain Pathol 3:255–268, 1993

    • Search Google Scholar
    • Export Citation
  • 14.

    Langen KJ, , Bonnie R, & Mühlensiepen H, et al: 3-(123I)iodo-α-methyl-L-tyrosine transport and 4F2 antigen expression in human glioma cells. Nucl Med Biol 28:511, 2001 Langen KJ, Bonnie R, Mühlensiepen H, et al: 3-(123I)iodo-α-methyl-L-tyrosine transport and 4F2 antigen expression in human glioma cells. Nucl Med Biol 28:5–11, 2001

    • Search Google Scholar
    • Export Citation
  • 15.

    Levivier M, , Goldman S, & Bidaut LM, et al: Positron emission tomography-guided stereotactic brain biopsy. Neurosurgery 31:792797, 1992 Levivier M, Goldman S, Bidaut LM, et al: Positron emission tomography-guided stereotactic brain biopsy. Neurosurgery 31:792–797, 1992

    • Search Google Scholar
    • Export Citation
  • 16.

    Levivier M, , Goldman S, & Pirotte B, et al: Diagnostic yield of stereotactic brain biopsy guided by positron emission tomography with [18F]fluorodeoxyglucose. J Neurosurg 82:445452, 1995 Levivier M, Goldman S, Pirotte B, et al: Diagnostic yield of stereotactic brain biopsy guided by positron emission tomography with [18F]fluorodeoxyglucose. J Neurosurg 82:445–452, 1995

    • Search Google Scholar
    • Export Citation
  • 17.

    Mineura K, , Sasajima T, & Kowada M, et al: [Changes in the (11C-methyl)-L-methionine uptake index in gliomas following radiotherapy.] Gan No Rinsho 35:11011104, 1989 (Jpn) Mineura K, Sasajima T, Kowada M, et al: [Changes in the (11C-methyl)-L-methionine uptake index in gliomas following radiotherapy.] Gan No Rinsho 35:1101–1104, 1989 (Jpn)

    • Search Google Scholar
    • Export Citation
  • 18.

    Mineura K, , Sasajima T, & Suda Y, et al: Amino acid study of cerebral gliomas using positron emission tomography—analysis of (11C-methyl)-L-methionine uptake index. Neurol Med Chir 30:9971002, 1990 Mineura K, Sasajima T, Suda Y, et al: Amino acid study of cerebral gliomas using positron emission tomography—analysis of (11C-methyl)-L-methionine uptake index. Neurol Med Chir 30:997–1002, 1990

    • Search Google Scholar
    • Export Citation
  • 19.

    Ogawa T, , Kanno I, & Shishido F, et al: Clinical value of PET with 18F-fluorodeoxyglucose and L-methyl-11C-methionine for diagnosis of recurrent brain tumor and radiation injury. Acta Radiol 32:197202, 1991 Ogawa T, Kanno I, Shishido F, et al: Clinical value of PET with 18F-fluorodeoxyglucose and L-methyl-11C-methionine for diagnosis of recurrent brain tumor and radiation injury. Acta Radiol 32:197–202, 1991

    • Search Google Scholar
    • Export Citation
  • 20.

    Ogawa T, , Shishido F, & Kanno I, et al: Cerebral glioma evaluation with methionine PET. Radiology 186:4553, 1993 Ogawa T, Shishido F, Kanno I, et al: Cerebral glioma evaluation with methionine PET. Radiology 186:45–53, 1993

    • Search Google Scholar
    • Export Citation
  • 21.

    Pardridge WM: Brain metabolism a perspective from the blood—brain barrier. Physiol Rev 63:14811535, 1983 Pardridge WM: Brain metabolism a perspective from the blood—brain barrier. Physiol Rev 63:1481–1535, 1983

    • Search Google Scholar
    • Export Citation
  • 22.

    Plate KH: Mechanisms of angiogenesis in the brain. J Neuropathol Exp Neurol 58:313320, 1999 Plate KH: Mechanisms of angiogenesis in the brain. J Neuropathol Exp Neurol 58:313–320, 1999

    • Search Google Scholar
    • Export Citation
  • 23.

    Plate KH, & Risau W: Angiogenesis in malignant gliomas. Glia 15:339347, 1995 Plate KH, Risau W: Angiogenesis in malignant gliomas. Glia 15:339–347, 1995

    • Search Google Scholar
    • Export Citation
  • 24.

    Sato K, , Kameyama M, & Kayama T, et al: Serial positron emission tomography imaging of changes in amino acid metabolism in low grade astrocytoma after radio- and chemotherapy—case report. Neurol Med Chir 35:808812, 1995 Sato K, Kameyama M, Kayama T, et al: Serial positron emission tomography imaging of changes in amino acid metabolism in low grade astrocytoma after radio- and chemotherapy—case report. Neurol Med Chir 35:808–812, 1995

    • Search Google Scholar
    • Export Citation
  • 25.

    Theurillat JP, , Hainfellner J, & Maddalena A, et al: Early induction of angiogenetic signals in gliomas of GFAP-v-src transgenic mice. Am J Pathol 154:581590, 1999 Theurillat JP, Hainfellner J, Maddalena A, et al: Early induction of angiogenetic signals in gliomas of GFAP-v-src transgenic mice. Am J Pathol 154:581–590, 1999

    • Search Google Scholar
    • Export Citation
  • 26.

    Tovi M, , Thuomas KA, & Bergstrom K, et al: Tumour delineation with magnetic resonance imaging in gliomas. A comparison with positron emission tomography and computed tomography. Acta Radiol Suppl 369:161163, 1986 Tovi M, Thuomas KA, Bergstrom K, et al: Tumour delineation with magnetic resonance imaging in gliomas. A comparison with positron emission tomography and computed tomography. Acta Radiol Suppl 369:161–163, 1986

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 591 108 10
Full Text Views 178 9 0
PDF Downloads 105 5 0
EPUB Downloads 0 0 0