Usefulness of 11C-methionine PET in the evaluation of brain lesions that are hypo- or isometabolic on 18F-FDG PET
Usefulness of 11C-methionine PET in the evaluation of brain lesions that are hypo- or isometabolic on 18F-FDG PET
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DOI：
10.1007/s00259-001-0690-4
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发表时间：
2002-02-01
影响因子：
9.1
通讯作者：
Lee, MC
中科院分区：
文献类型：
--
作者：
Chung, JK;Kim, YK;Lee, MC
事实上，一些脑肿瘤在氟 18 氟脱氧葡萄糖正电子发射断层扫描 (FDG PET) 上显示低代谢或同代谢，这一事实在原发性或复发性肿瘤的检测以及与良性病变的鉴别中造成了问题。我们研究了碳 11 蛋氨酸 PET 在表征这些条件下脑损伤的有用性。对 45 名患有脑损伤的患者（其中 34 名用于初步诊断，11 名用于检测复发）进行了 C-11-蛋氨酸 PET 检测，这些患者在 FDG PET 上显示与正常脑组织相比代谢低下或等代谢。注射 555-740 MBq C-11-蛋氨酸 10 分钟后，使用专用 PET 扫描仪获得衰减校正的脑部图像。脑部病灶包括24例胶质瘤、5例转移性脑肿瘤、4例脑膜瘤、2例其他脑肿瘤和10例良性病变（其中囊虫病3例、放射性坏死2例、结核性肉芽肿1例、血管瘤1例、良性囊肿1例、机化性梗死1例），采用Ki-67免疫染色法测定胶质瘤组织的增殖活性。 35 例脑肿瘤中的 31 例（敏感性为 89%）显示，尽管 FDG PET 存在同代谢或低代谢，但 C-11-蛋氨酸摄取增加。相比之下，所有十个良性病变均显示 C-11-蛋氨酸摄取减少或正常（100% 特异性）。 24个胶质瘤中有22个（92%）显示C-11-蛋氨酸摄取增加，其范围和程度超过F-18-FDG摄取，并且C-11-蛋氨酸摄取与增殖指数相关（r=0.67）。 FDG 和 C-11-蛋氨酸 PET 上神经胶质瘤与正常脑的平均 (+/-SD) 摄取比分别为 0.92+/-0.34 和 2.54+/-1.25。除一例外，所有转移性肿瘤在整个肿瘤或肿瘤的外周边缘均显示出强烈的 C-11-甲硫氨酸摄取。在脑膜瘤中，C-11-蛋氨酸的摄取呈现出不同程度的增加。总之，使用 C-11-蛋氨酸 PET 可以以高灵敏度和良好的对比度检测和区分 FDG PET 上显示低代谢或同代谢的脑部病变。当与 FDG PET 结合使用来评估这些患者时，C-11-蛋氨酸 PET 可以提供更多信息。
The fact that some brain tumors show hypo- or isometabolism on fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) has caused problems in the detection of primary or recurrent tumors and in the differentiation from benign lesions. We investigated the usefulness of carbon-11 methionine PET in characterizing brain lesions under these conditions. C-11-methionine PET was performed in 45 patients with brain lesions (in 34 for initial diagnosis and in 11 for detection of recurrence) that showed hypo- or isometabolism compared with normal brain tissue on FDG PET. Ten minutes after the injection of 555-740 MBq of C-11-methionine, attenuation-corrected brain images were obtained with a dedicated PET scanner. The brain lesions comprised 24 gliomas, five metastatic brain tumors, four meningiomas, two other brain tumors and ten benign lesions (including three cases of cysticercosis, two cases of radiation necrosis, one tuberculous granuloma, one hemangioma, one benign cyst, and one organizing infarction), Proliferative activity was measured using the Ki-67 immunostaining method in glioma tissues. Thirty-one of 35 brain tumors (89% sensitivity) showed increased C-11-methionine uptake despite iso- or hypometabolism on FDG PET. By contrast, all ten benign lesions showed decreased or normal C-11-methionine uptake (100% specificity). Twenty-two of 24 gliomas (92%) showed increased C-11-methionine uptake, the extent and degree of which exceeded F-18-FDG uptake, and the C-11-methionine uptake correlated with the proliferation index (r=0.67). The mean (+/-SD) uptake ratios of glioma to normal brain on FDG and C-11-methionine PET were 0.92+/-0.34 and 2.54+/-1.25, respectively. All metastatic tumors except one showed intense C-11-methionine uptake in the entire tumor or in the peripheral margin of the tumor. In meningiomas, C-11-methionine uptake showed a variable increase. In conclusion, brain lesions that show hypo- or isometabolism on FDG PET can be detected and differentiated with high sensitivity and good contrast using C-11-methionine PET. C-11-methionine PET can provide additional information when used in combination with FDG PET in the evaluation of these patients.