11C-methionine PET for differential diagnosis of low-grade gliomas
11C-methionine PET for differential diagnosis of low-grade gliomas
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DOI：
10.1212/wnl.50.5.1316
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发表时间：
1998-05-01
期刊：
影响因子：
9.9
通讯作者：
Heiss, WD
中科院分区：
文献类型：
--
作者：
Herholz, K;Hölzer, T;Heiss, WD
低级别胶质瘤的治疗仍然是一项具有挑战性的任务，因为 CT 和 MRI 并不总是能与非肿瘤病变区分开来。此外，肿瘤范围；由于缺乏对比度增强，攻击性常常不清楚。先前的研究表明，大量中性氨基酸示踪剂在大多数脑肿瘤中积聚，包括低级别神经胶质瘤，可能是由于内皮和血脑屏障功能的变化。我们描述了在 196 名连续患者中使用 PET 测量的 C-11-蛋氨酸摄取情况，其中大多数患者因疑似低级别神经胶质瘤而接受研究。相对于对侧，最活跃病变区域的摄取在高级别胶质瘤、低级别胶质瘤和慢性或亚急性非肿瘤病变之间存在显着差异，并且这种差异与 CT 或 MRI 的对比增强无关。皮质类固醇对低级别神经胶质瘤的蛋氨酸摄取没有显着影响，但适度降低高级别神经胶质瘤的蛋氨酸摄取。通过简单阈值区分胶质瘤和非肿瘤病变的正确率为 79%。复发性或残留肿瘤的摄取量高于原发性神经胶质瘤。总之，C-11-蛋氨酸摄取对功能性内皮或血脑屏障变化的高敏感性表明该示踪剂对于低级别神经胶质瘤的评估和随访特别有用。
Management of low-grade gliomas continues to be a challenging task, because CT and MRI do not always differentiate from nontumoral lesions. Furthermore, tumor extent; and aggressiveness often remain unclear because of a lack of contrast enhancement. Previous studies indicated that large neutral amino acid tracers accumulate in most brain tumors, including low-grade gliomas, probably because of changes of endothelial and blood-brain barrier function. We describe C-11-methionine uptake measured with PET in a series of 196 consecutive patients, most of whom were studied because of suspected low-grade gliomas. Uptake in the most active lesion area, relative to contralateral side, was significantly different among high-grade gliomas, low-grade gliomas, and chronic or subacute nontumoral lesions, and this difference was independent from contrast enhancement in CT or MRI. Corticosteroids had no significant effect on methionine uptake in low-grade gliomas but reduced uptake moderately in high-grade gliomas. Differentiation between gliomas and nontumoral lesions by a simple threshold was correct in 79%. Recurrent or residual tumors had a higher uptake than primary gliomas. In conclusion, the high sensitivity of C-11-methionine uptake for functional endothelial or blood-brain barrier changes suggests that this tracer is particularly useful for evaluation and follow-up of low-grade gliomas.