PET findings in lymphomatosis and gliomatosis of the brain: a comparison of C-11 methionine PET/CT and F-18 FDG PET/CT

Abstract

Background Positron emission tomography (PET) findings for gliomatosis and lymphomatosis have been rarely reported. Purpose To compare PET/computed tomography (CT) findings using 11C-methionine (MET) from PET/CT findings using 18F-fluorodeoxy glucose (FDG) for patients with lymphomatosis or gliomatosis of the brain. Material and Methods Participants comprised all 10 patients with lymphomatosis or gliomatosis of the brain treated at our institution in the past 12 years. Underlying pathologies comprised intravascular lymphoma (n = 1), lymphomatosis (n = 3), and gliomatosis (n = 6). All cases were pathologically diagnosed. In seven patients, both MET-PET/CT and FDG-PET/CT were performed simultaneously in a single study. In three patients, only FDG-PET/CT was performed. The degree of tracer accumulation to the lesion was evaluated qualitatively. Quantitatively, the ratio of maximum standard uptake value (SUVmax) in tumor to that in normal tissue (T/N ratio) was measured and compared between FDG and MET. Results Qualitatively, MET accumulated to part of the lesion in six of seven patients and almost all of the lesion in one in seven patients. FDG accumulated to part of the lesion in three of ten patients and almost all of the lesion in one of ten patients. No FDG accumulation was seen in the lesion in six patients. Quantitatively, mean ± SD T/N ratio was significantly higher with MET (2.11 ± 0.63) than with FDG (1.18 ± 0.84; P < 0.05, Wilcoxon signed-rank test). Conclusion In lymphomatosis and gliomatosis, FDG accumulates in only part of the lesion. FDG is thus less suitable than MET for depicting these lesions.

Recapitulating the Key Advances in the Diagnosis and Prognosis of High-Grade Gliomas: Second Half of 2021 Update

“…The use of the radio metabolites 11 C-methionine and 18 F-fluorodeoxyglucose for the differential diagnosis of PCNSL or HGG by PET has been studied by Tomura and collaborators [ 34 ] (see also the above “MRI” section). It turned out that 18 F-FDG is less suitable for this type of investigation than 11 C-methionine is, since the former, unlike the latter, accumulates only in a part of the lesion.…”

Asymmetric and symmetric protein arginine methylation in methionine-addicted human cancer cells

“…Studies in xenograft mouse models show that treatment with recombinant methioninase, an enzyme that depletes plasma methionine levels, and/or a methionine-restricted diet can decrease tumor volume [10][11][12][13][14]. Clinically, the enhanced usage of methionine in cancer cells can be used to localize tumors with [ 11 C]-methionine positron emission tomography (MET--PET), particularly for cancers in the brain as well as organ cancers [15][16][17]. Additionally, methionine restriction has been used as a combination treatment with chemotherapy in cancer patients [9].…”