HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Miwa, K Articles by Sakai, N Search for Related Content PubMed PubMed Citation Articles by Miwa, K Articles by Sakai, N

Discrepancy between lesion distributions on methionine PET and MR images in patients with glioblastoma multiforme: insight from a PET and MR fusion image study

¹ Department of Neurosurgery, Gifu University School of Medicine, Gifu, Japan
² Chubu Medical Centre for Prolonged Traumatic Brain Dysfunction, Minokamo, Japan

Correspondence to:
Correspondence to:
Dr J Shinoda
Department of Neurosurgery, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu 500-8705, Japan; junshino{at}cc.gifu-u.ac.jp

Objective: To examine ¹¹C-methyl methionine (MET) accumulation on positron emission tomographic (PET) imaging of glioblastoma multiforme to determine the distribution of metabolic abnormality compared with magnetic resonance imaging (MRI).

Methods: Contemporaneous MRI was superimposed on corresponding MET-PET images in 10 patients with newly diagnosed glioblastoma multiforme before treatment. Differences between the extended area of MET accumulation on PET imaging (MET area), the gadolinium (Gd) enhanced area on T1 weighted images (Gd area), and the abnormal high signal intensity area on T2 weighted images (T2-high area) were assessed.

Results: The MET area was larger than the Gd area and included the entire Gd area. The discrepancy in volume between the MET and Gd areas became greater with increasing tumour diameter. On average, 58.6% of the MET area was located within the Gd area, 90.1% within 10 mm outside the Gd area, 98.1% within 20 mm, and 99.8% within 30 mm. A newly developed Gd area had emerged in five of the 10 cases up to the time of study. In three of the five cases this was in the MET area even after complete surgical resection of the Gd area on the initial MRI; in the remaining two it originated in the residual Gd area after surgery. In all cases, the T2-high area was larger than the MET area. The MET area extended partly beyond the T2-high area in nine cases, and was completely within it in one.

Conclusions: Glioblastoma multiforme cells may extend over the Gd area and more widely with increasing tumour size on Gd-MRI. The T2-high area includes the greater part of the tumour but not its entire area. The methods reported may be useful in planning surgical resection, biopsy, or radiosurgery.

Keywords: positron emission tomography; methionine; tumour invasion; glioblastoma multiforme; magnetic resonance imaging

This article has been cited by other articles:

				T. Kato, J. Shinoda, N. Nakayama, K. Miwa, A. Okumura, H. Yano, S. Yoshimura, T. Maruyama, Y. Muragaki, and T. Iwama Metabolic Assessment of Gliomas Using 11C-Methionine, [18F] Fluorodeoxyglucose, and 11C-Choline Positron-Emission Tomography AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1176 - 1182. [Abstract] [Full Text] [PDF]

				E. T. Wong and S. Brem Taming Glioblastoma: Targeting Angiogenesis J. Clin. Oncol., October 20, 2007; 25(30): 4705 - 4706. [Full Text] [PDF]