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01-11-2008 | Research Article

¹¹C-Methionine-PET for Evaluation of Carbon Ion Radiotherapy in Patients with Pelvic Recurrence of Rectal Cancer

Authors: Mitsuru Koizumi, Tsuneo Saga, Kyosan Yoshikawa, Kazutoshi Suzuki, Shigeru Yamada, Mitsuhiko Hasebe, Seiya Ohashi, Sherif Abd-Elrazek, Hiroyuki Ishikawa, Kenji Sagou, Katsumi Tamura, Ryusuke Hara, Hirotoshi Kato, Shigeo Yasuda, Takeshi Yanagi, Hirohiko Tsujii

Published in: Molecular Imaging and Biology | Issue 6/2008

Abstract

Purpose

Progress of the novel carbon ion radiotherapy (CIRT) in the treatment of cancers has created the need for a method to accurately evaluate the response. We investigated whether l-[¹¹C]methyl-methionine (¹¹C-methionine) uptake at pre- and post-CIRT could be an early response predictor in patients with pelvic recurrence of rectal cancer.

Procedures

¹¹C-Methionine-positron emission tomography (PET) was performed prospectively in 53 patients with pelvic recurrence of rectal cancer before CIRT, and 48 patients were performed ¹¹C-methionine PET at 1 month after CIRT. ¹¹C-Methionine tumor uptake was measured by the tumor to muscle ratio (T/M ratio). The T/M ratios were evaluated in relation to clinical outcomes such as local re-recurrence, distant metastasis, and survival. The response to CIRT was also judged by computed tomography (CT) and magnetic resonance imaging (MRI). ¹¹C-Methionine PET judgment was compared with CT/MRI judgment regarding the relevance to clinical outcome.

Results

Baseline T/M ratio was 5.27 ± 1.90 (mean ± SD) in patients without developing local re-recurrence and 7.66 ± 3.17 in patients with local re-recurrence (p = 0.023, Mann–Whitney U test). Post-CIRT T/M ratios were 3.10 ± 1.28 in patients without local re-recurrence and 6.15 ± 2.98 in patients with local re-recurrence (p = 0.006, Mann–Whitney U test). By Kaplan–Meier analysis with log-rank test, patients with a baseline T/M ratio of ≦7.6 or a post-CIRT T/M ratio of ≦5.0 had significant lower pelvic re-recurrence rate. However, the percent change (reduction rate) from baseline to post-CIRT T/M ratio did not have significant relation to pelvic re-recurrence. There were no significant differences between ¹¹C-methionine results (baseline T/M ratio, post-CIRT T/M ratio and percent change) and other clinical parameters (distant metastasis and survival).

Conclusion

¹¹C-methionine-PET can be used for early prediction of local re-recurrence after CIRT. Because CIRT is local therapy, ¹¹C-methionine-PET cannot predict distant metastasis or survival after CIRT.

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Title: 11C-Methionine-PET for Evaluation of Carbon Ion Radiotherapy in Patients with Pelvic Recurrence of Rectal Cancer
Authors: Mitsuru Koizumi
Tsuneo Saga
Kyosan Yoshikawa
Kazutoshi Suzuki
Shigeru Yamada
Mitsuhiko Hasebe
Seiya Ohashi
Sherif Abd-Elrazek
Hiroyuki Ishikawa
Kenji Sagou
Katsumi Tamura
Ryusuke Hara
Hirotoshi Kato
Shigeo Yasuda
Takeshi Yanagi
Hirohiko Tsujii
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: Molecular Imaging and Biology / Issue 6/2008
Print ISSN: 1536-1632
Electronic ISSN: 1860-2002
DOI: https://doi.org/10.1007/s11307-008-0156-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

¹¹C-Methionine-PET for Evaluation of Carbon Ion Radiotherapy in Patients with Pelvic Recurrence of Rectal Cancer

Abstract

Purpose

Procedures

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Procedures

Results

Conclusion

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