Metabolic characterization of childhood brain tumors -: Comparison of 18F-fluorodeoxyglucose and 11C-methionine positron emission tomography
Metabolic characterization of childhood brain tumors -: Comparison of 18F-fluorodeoxyglucose and 11C-methionine positron emission tomography
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作者：
Utriainen, M;Metsähonkala, L;Minn, H
背景对儿童原发性脑肿瘤患者进行正电子发射断层扫描（PET），以检查代谢特征是否可用作临床侵袭性的指标。对27例未经治疗的原发性中枢神经系统肿瘤的儿科患者进行了PET扫描研究，使用2-[F-18]氟-2-脱氧-D-葡萄糖（FDG）和/或L-[甲基-C-11]甲硫氨酸（MET）。用FDG和MET标准化摄取值（SUV）和SUV与正常脑比值评估的代谢特征与组织病理学和选定的组织化学特征（如增殖活性（Ki-67（MIB-1））和凋亡、血管和细胞密度指数）进行比较。中位随访时间为43个月。FDG和MET在高级别肿瘤中的蓄积明显高于低级别肿瘤，但两者有相当大的重叠，且两者的蓄积与年龄呈正相关。高级别肿瘤比低级别肿瘤具有更高的增殖活性和血管分布。在单因素分析中，FDG-PET、MET-PET和凋亡指数是无事件生存率的独立预测因子。我们发现儿童脑肿瘤的FDG和MET摄取与恶性程度相关。然而，在低级别和高级别肿瘤之间没有明确的SUV和SUV与正常脑比率的限制，这使得在个体病例中使用PET扫描的代谢成像评估恶性程度变得困难。虽然FDG-PET和MET-PET不能弥补组织病理学评价，但它们可以提供有价值的额外信息，特别是在无法通过侵入性手术获得组织病理学样本的情况下。(C)2002年美国癌症协会。
BACKGROUND. Positron emission tomography (PET) scans of primary brain tumors were performed in pediatric patients to examine whether metabolic characteristics could be used as an index of clinical aggressiveness.METHODS. Twenty-seven pediatric patients with untreated primary central nervous system neoplasms were studied with PET scans using 2-[F-18] fluoro-2-deoxy-D-glucose (FDG) and/or L-[methyl-C-11] methionine (MET). Metabolic characteristics as assessed with FDG and MET standardized uptake values (SUV) and SUV-to-normal brain ratios were compared with histopathology and selected histochemical features such as proliferation activity (Ki-67(MIB-1)) and apoptotic, vascular, and cell density indices. The median followup time was 43 months.RESULTS. The accumulation of both FDG and MET was significantly higher in high-grade than in low-grade tumors, but a considerable overlap was found. The accumulation of both tracers was associated positively with age. High-grade tumors showed higher proliferative activity and vascularity than the low-grade tumors. In univariate analysis, FDG-PET, MET-PET, and apoptotic index were independent predictors of event-free survival.CONCLUSION. We found that both FDG and MET uptake in pediatric brain tumors are associated with malignancy grade. However, no clear limits of SUVs and SUV-to-normal brain ratios can be set between low-grade and high-grade tumors, which makes the assessment of malignancy grade using metabolic imaging with PET scan difficult in individual cases. Although FDG-PET and MET-PET do not compensate for histopathologic evaluation, they may give valuable additional information especially if invasive procedures to obtain histopathologic samples are not feasible. (C) 2002 American Cancer Society.