Use of 11C-methionine PET to monitor the effects of temozolomide chemotherapy in malignant gliomas
Use of 11C-methionine PET to monitor the effects of temozolomide chemotherapy in malignant gliomas
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DOI：
10.1007/s00259-005-0002-5
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发表时间：
2006-05-01
影响因子：
9.1
通讯作者：
Herholz, K
中科院分区：
文献类型：
--
作者：
Galldiks, N;Kracht, LW;Herholz, K
目的：本研究旨在应用[C-11]蛋氨酸（[C-11]methionine，MET）重复正电子发射断层扫描（PET）技术监测替莫唑胺（TMZ）化疗对恶性胶质瘤代谢的影响。所有患者在TMZ化疗的第三个周期之前和之后进行了MET-PET研究，12例患者在第六个周期之后也进行了MET-PET研究。在第一个周期之前和第六个周期之后，对12例患者进行了钆增强MRI研究。采用改良的兰金量表评估临床状态。通过计算疾病进展时间（TTP）（months.Results）评估长期结局：治疗期间MET摄取下降对应于稳定的临床状态。MET摄取下降的患者中位TTP显著长于MET摄取增加的患者（23 vs 3.5个月; p=0.01，对数秩检验）。MET摄取的变化和对比度增强的变化之间没有显着的相关性，在治疗过程中为所有patients.Conclusion：目前的数据表明，临床稳定，这往往是根据TMZ化疗的恶性胶质瘤，对应于肿瘤氨基酸代谢的下降或稳定。在三个化疗周期后，已经可以用MET-PET证明肿瘤反应，并且当时没有进展表明在接下来的三个周期中进一步稳定的可能性很高。TMZ治疗期间MET摄取的减少预示着有利的临床结局。通过MET-PET的氨基酸摄取的分子成像提供了测量复发性胶质瘤的生物活性的新方法。
Purpose: The purpose of this study was to monitor the metabolic effects of temozolomide (TMZ) chemotherapy in malignant gliomas by means of repeated positron emission tomography (PET) with [C-11]methionine (MET).Methods: Fifteen patients with histologically proven malignant glioma were treated by TMZ chemotherapy. MET-PET studies were performed before and after the third cycle of TMZ chemotherapy in all patients, and in 12 patients also after the sixth cycle. Gadolinium-enhanced MRI studies were performed in 12 patients before the first and after the sixth cycle. Clinical status was assessed by the modified Rankin scale. Long-term outcome was assessed by calculating the time to progression (TTP) in months.Results: Decline in MET uptake during therapy corresponded to a stable clinical status. The median TTP was significantly longer in patients with decline in MET uptake than in those with increasing MET uptake (23 vs 3.5 months; p=0.01, log rank test). There was no significant correlation between change in MET uptake and change in contrast enhancement during treatment for all patients.Conclusion: The present data demonstrate that clinical stability, which is often achieved under TMZ chemotherapy of malignant glioma, corresponds to a decline in or stability of tumour amino acid metabolism. Tumour responses can already be demonstrated with MET-PET after three cycles of chemotherapy, and absence of progression at that time indicates a high probability of further stability during the next three cycles. A reduction in MET uptake during TMZ treatment predicts a favourable clinical outcome. Molecular imaging of amino acid uptake by MET-PET offers a new method of measurement of the biological activity of recurrent glioma.