Non-invasive grading of brain tumours using dynamic amino acid PET imaging : does it work for 11C-Methionine?

Moulin-Romsee, G; Dhondt, Elisabeth; Groot, Tjibbe de; Goffin, Jan; Sciot, Raf; Mortelmans, Luc; Menten, Johan; Bormans, Guy; Laere, Koen Van

doi:10.1007/s00259-007-0557-4

Cited by 80 publications

(42 citation statements)

References 6 publications

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“…reported that 11 C-MET PET could be used for the early detection of recurrent brain tumor and for biopsy guidance [13], Zhang et al indicated the usefulness of 11 C-MET PET in the early evaluation of prognosis in patients with bone and soft tissue sarcomas treated by carbon ion radiotherapy [14]. Our clinical study [15] also showed that the SUV max of 11 C-MET was significantly higher in lung cancer than in the pneumoconiotic nodules.…”

Section: Introductionsupporting

confidence: 64%

“…The transport of 11 C-MET into a cell can be followed by rapid metabolization and trapping inside the cell. The exact trapping mechanism is not known but this selective uptake pattern results in a very high tumor-to-background (T/B) ratio enabling the clear delineation of tumors [13]. However, the exact mechanism underlying the accumulation of 11 C-MET in granulomas is not fully understood.…”

Section: Discussionmentioning

confidence: 99%

“…At later time points, the washout of 11 C-MET from the granuloma and continuous accumulation of 11 C-MET in the tumor were observed. It is also considered that the pathophysiological explanation for different 11 C-MET uptake patterns over time between inflammatory and malignant lesions is based on differences in the amino acid transporter or enzyme activity in the tumor and granuloma tissues [13,26,27].…”

Section: Discussionmentioning

confidence: 99%

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Dynamic 11C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

Kuge

Zhao

et al. 2011

Eur J Nucl Med Mol Imaging

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Purpose: We evaluated whether the dynamic profile of 11 C-MET may have an additional value in differentiating malignant tumors from granulomas in experimental rat models by small-animal PET.Methods: Rhodococcus aurantiacus and allogenic rat C6-glioma cells were inoculated respectively into the right and left calf muscles to generate a rat model bearing both granulomas and tumors (n=6). Ten days after the inoculations, dynamic 11 C-MET PET was performed by small-animal PET up to 120 min after injection of 11 C-MET. The next day, after overnight fasting, the rats were injected with 18 F-FDG, and dynamic 18 F-FDG PET was performed up to 180 min. The time-activity curves, static images, and mean standardized uptake value (SUV) in the lesions were calculated. Results:11 C-MET uptake in the granuloma showed a slow exponential clearance after an initial distribution, while the uptake in the tumor gradually increased with time. The dynamic pattern of 11 C-MET uptake in the granuloma was significantly different from that in the tumor (p<0.001). In the static analysis of 11 C-MET, visual assessment and SUV analysis could not differentiate the tumor from the granuloma in all cases, although the mean SUV in the granuloma (1.48 ± 0.09) was significantly lower than that in the tumor (1.72 ± 0.18, p < 0.01). The dynamic patterns, static images, and mean SUVs of 18 F-FDG in the granuloma were similar to those in the tumor (p=ns). Conclusions: Dynamic 11C-MET PET has an additional value for differentiating malignant tumors from 3 granulomatous lesions, which deserve further elucidation in clinical settings.

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Section: Introductionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Dynamic 11C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

Kuge

Zhao

et al. 2011

Eur J Nucl Med Mol Imaging

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“…Time-activity curves of high-grade gliomas are characterized by an early peak of 18 F-FET uptake followed by a constant descent, whereas low-grade gliomas and benign brain lesions typically show a steadily increasing curve pattern. In contrast, 11 C-MET PET studies showed no different curve patterns in high-and low-grade gliomas (31).…”

Section: Discussionmentioning

confidence: 78%

Role of O-(2-¹⁸F-Fluoroethyl)-l-Tyrosine PET for Differentiation of Local Recurrent Brain Metastasis from Radiation Necrosis

et al. 2012

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The aim of this study was to investigate the potential of O-(2-18 F-fluoroethyl)-L-tyrosine ( 18 F-FET) PET for differentiating local recurrent brain metastasis from radiation necrosis after radiation therapy because the use of contrast-enhanced MRI for this issue is often difficult. Methods: Thirty-one patients (mean age 6 SD, 53 6 11 y) with single or multiple contrastenhancing brain lesions (n 5 40) on MRI after radiation therapy of brain metastases were investigated with dynamic 18 F-FET PET. Maximum and mean tumor-to-brain ratios (TBR max and TBR mean , respectively; 20-40 min after injection) of 18 F-FET uptake were determined. Time-activity curves were generated, and the time to peak (TTP) was calculated. Furthermore, time-activity curves of each lesion were assigned to one of the following curve patterns: (I) constantly increasing 18 F-FET uptake, (II) 18 F-FET uptake peaking early (TTP # 20 min) followed by a plateau, and (III) 18 F-FET uptake peaking early (TTP # 20 min) followed by a constant descent. The diagnostic accuracy of the TBR max and TBR mean of 18 F-FET uptake and the curve patterns for the correct identification of recurrent brain metastasis were evaluated by receiver-operating-characteristic analyses or Fisher exact test for 2 · 2 contingency tables using subsequent histologic analysis (11 lesions in 11 patients) or clinical course and MRI findings (29 lesions in 20 patients) as reference. Results: Both TBR max and TBR mean were significantly higher in patients with recurrent metastasis (n 5 19) than in patients with radiation necrosis (n 5 21) (TBR max , 3.2 6 0.9 vs. 2.3 6 0.5, P , 0.001; TBR mean , 2.1 6 0.4 vs. 1.8 6 0.2, P , 0.001). The diagnostic accuracy of 18 F-FET PET for the correct identification of recurrent brain metastases reached 78% using TBR max (area under the ROC curve [AUC], 0.822 6 0.07; sensitivity, 79%; specificity, 76%; cutoff, 2.55; P 5 0.001), 83% using TBR mean (AUC, 0.851 6 0.07; sensitivity, 74%; specificity, 90%; cutoff, 1.95; P , 0.001), and 92% for curve patterns II and III versus curve pattern I (sensitivity, 84%; specificity, 100%; P , 0.0001). The highest accuracy (93%) to diagnose local recurrent metastasis was obtained when both a TBR mean greater than 1.9 and curve pattern II or III were present (AUC, 0.959 6 0.03; sensitivity, 95%; specificity, 91%; P , 0.001). Conclusion: Our findings suggest that the combined evaluation of the TBR mean of 18 F-FET uptake and the pattern of the timeactivity curve can differentiate local brain metastasis recurrence from radionecrosis with high accuracy. 18 F-FET PET may thus contribute significantly to the management of patients with brain metastases. The improvement in the treatment of solid tumors has led to an increasing number of patients who experience brain metastases during the course of the disease. Stereotactic radiosurgery (SRS) and whole-brain radiation therapy (WBRT) are commonly used to treat brain metastases, and a growing percentage of patients live long enough to experience a local relapse of these me...

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“…Investigations of adult brain tumor patients with PET using 11 C-MET and 18 F-FET have reported comparable results for the 2 tracers (10). The evaluation of time-activity curves of 18 F-FET PET uptake may, however, provide valuable additional diagnostic information due to differential kinetic patterns of tracer uptake in high-and low-grade glioma (11-13), a phenomenon not observed with 11 C-MET PET (14). For example, the kinetic pattern of a high-grade glioma appears to be characterized by an early peak after injection within the first 20 min, followed by a decrease of 18 F-FET uptake.…”

mentioning

confidence: 99%

The Usefulness of Dynamic O-(2-¹⁸F-Fluoroethyl)-l-Tyrosine PET in the Clinical Evaluation of Brain Tumors in Children and Adolescents

et al. 2014

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Experience regarding O-(2-18F-fluoroethyl)-L-tyrosine ( 18 F-FET) PET in children and adolescents with brain tumors is limited. Methods: Sixty-nine 18 F-FET PET scans of 48 children and adolescents (median age, 13 y; range, 1-18 y) were analyzed retrospectively. Twenty-six scans to assess newly diagnosed cerebral lesions, 24 scans for diagnosing tumor progression or recurrence, 8 scans for monitoring of chemotherapy effects, and 11 scans for the detection of residual tumor after resection were obtained. Maximum and mean tumor-tobrain ratios (TBRs) were determined at 20-40 min after injection, and time-activity curves of 18 F-FET uptake were assigned to 3 different patterns: constant increase; peak at greater than 20-40 min after injection, followed by a plateau; and early peak (#20 min), followed by a constant descent. The diagnostic accuracy of 18 F-FET PET was assessed by receiver-operating-characteristic curve analyses using histology or clinical course as a reference. Results: In patients with newly diagnosed cerebral lesions, the highest accuracy (77%) to detect neoplastic tissue (19/26 patients) was obtained when the maximum TBR was 1.7 or greater (area under the curve, 0.80 ± 0.09; sensitivity, 79%; specificity, 71%; positive predictive value, 88%; P 5 0.02). For diagnosing tumor progression or recurrence, the highest accuracy (82%) was obtained when curve patterns 2 or 3 were present (area under the curve, 0.80 ± 0.11; sensitivity, 75%; specificity, 90%; positive predictive value, 90%; P 5 0.02). During chemotherapy, a decrease of TBRs was associated with a stable clinical course, and in 2 patients PET detected residual tumor after presumably complete tumor resection. Conclusion: Our findings suggest that 18 F-FET PET can add valuable information for clinical decision making in pediatric brain tumor patients.

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Non-invasive grading of brain tumours using dynamic amino acid PET imaging : does it work for 11C-Methionine?

Cited by 80 publications

References 6 publications

Dynamic 11C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

Dynamic 11C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

Role of O-(2-¹⁸F-Fluoroethyl)-l-Tyrosine PET for Differentiation of Local Recurrent Brain Metastasis from Radiation Necrosis

The Usefulness of Dynamic O-(2-¹⁸F-Fluoroethyl)-l-Tyrosine PET in the Clinical Evaluation of Brain Tumors in Children and Adolescents

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Non-invasive grading of brain tumours using dynamic amino acid PET imaging : does it work for 11C-Methionine?

Cited by 80 publications

References 6 publications

Dynamic 11C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

Dynamic 11C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

Role of O-(2-18F-Fluoroethyl)-l-Tyrosine PET for Differentiation of Local Recurrent Brain Metastasis from Radiation Necrosis

The Usefulness of Dynamic O-(2-18F-Fluoroethyl)-l-Tyrosine PET in the Clinical Evaluation of Brain Tumors in Children and Adolescents

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Role of O-(2-¹⁸F-Fluoroethyl)-l-Tyrosine PET for Differentiation of Local Recurrent Brain Metastasis from Radiation Necrosis

The Usefulness of Dynamic O-(2-¹⁸F-Fluoroethyl)-l-Tyrosine PET in the Clinical Evaluation of Brain Tumors in Children and Adolescents