Usefulness Of L-[methyl-11C] methionine-positron emission tomography as a biological monitoring tool in the treatment of glioma
Usefulness Of L-[methyl-11C] methionine-positron emission tomography as a biological monitoring tool in the treatment of glioma
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DOI：
10.3171/jns.2005.103.3.0498
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发表时间：
2005-09-01
影响因子：
4.1
通讯作者：
Ohno, K
中科院分区：
文献类型：
--
作者：
Nariai, T;Tanaka, Y;Ohno, K
对象。作者回顾性分析了接受L-[甲基- c -11]蛋氨酸(MET)-正电子发射断层扫描（PET）研究的患者的资料，以阐明MET摄取与肿瘤生物学特征的关系，并讨论MET-PET研究的临床应用价值。194例脑胶质瘤或疑似脑胶质瘤患者在注射MET 20分钟后进行PET扫描，以对侧健康脑组织对MET的摄取率（T/N比）表示。进行分析以确定MET摄取与肿瘤病理特征和预后的关系。测定了不同处理前后的T/N比。非肿瘤性病变、低级别胶质瘤和恶性胶质瘤的T/N比值有显著性差异。此外，患者生存与预处理T/N比率之间存在显著相关性。在恶性胶质瘤患者中，基于MET摄取升高，观察到术后肿瘤残留与非术后肿瘤残留患者的生存率有显著差异。即使在磁共振成像显示的均匀肿瘤区域中，MET摄取也是不均匀的。在MET摄取最高的区域检测到恶性病理特征。在某些肿瘤类型中，放疗或化疗的有效性表现为T/N比值的显著降低。MET-PET反映胶质瘤生物学性质的能力使其成为监测活性肿瘤组织的绝佳方法，基于其发现的治疗应在胶质瘤治疗过程中提供强有力的临床方案。
Object. The authors retrospectively analyzed the data obtained in patients who had undergone L-[methyl-C-11] methionine (MET)-positron emission tomography (PET) studies to clarify the relationship between MET uptake and tumor biological features and to discuss the clinical usefulness of MET-PET studies.Methods. One hundred ninety-four patients with cerebral glioma or suspected glioma underwent PET scanning 20 minutes after injection of MET, whose uptake into the tumor was expressed as a ratio to contralateral healthy brain tissue (T/N ratio). Analyses were performed to determine how MET uptake correlated with tumor pathological features and prognosis. The T/N ratios before and after various treatments were also examined.There were significant differences in the T/N ratio among the nonneoplastic lesions, low-grade gliomas, and malignant gliomas. Furthermore, there were significant correlations between patient survival and pretreatment T/N ratios. Among patients with malignant gliomas, a significant difference in survival was observed between cases with and without postoperative tumor remnant based on elevated MET uptake. The MET uptake was heterogeneous even among the homogeneous tumor areas demonstrated on MR imaging. Malignant pathological features were detected in the areas with the highest MET uptake. The effectiveness of radiotherapy or chemotherapy was expressed as a significantly decreased T/N ratio in some of the tumor types.Conclusions. The ability of MET-PET to reflect the biological nature of gliomas makes it an excellent method for monitoring active tumor tissue, and treatments based on its findings should provide a powerful clinical protocol in the course of glioma therapy.