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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 1/2010

Open Access 01-01-2010 | Original Article

Volumetry of [11C]-methionine PET uptake and MRI contrast enhancement in patients with recurrent glioblastoma multiforme

Authors: Norbert Galldiks, Roland Ullrich, Michael Schroeter, Gereon R. Fink, Lutz W. Kracht

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2010

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Abstract

Purpose

We investigated the relationship between three-dimensional volumetric data of the metabolically active tumour volume assessed using [11C]-methionine positron emission tomography (MET-PET) and the area of gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) enhancement assessed using magnetic resonance imaging (MRI) in patients with recurrent glioblastoma (GBM).

Material and methods

MET-PET and contrast-enhanced MRI with Gd-DTPA were performed in 12 uniformly pretreated patients with recurrent GBM. To calculate the volumes in cubic centimetres, a threshold-based volume-of-interest (VOI) analysis of the metabolically active tumour volume (MET uptake indexes of ≥1.3 and ≥1.5) and of the area of Gd-DTPA enhancement was performed after coregistration of all images.

Results

In all patients, the metabolically active tumour volume as shown using a MET uptake index of ≥1.3 was larger than the volume of Gd-DTPA enhancement (30.2 ± 22.4 vs. 13.7 ± 10.6 cm3; p = 0.04). Metabolically active tumour volumes as shown using MET uptake indexes of ≥1.3 and ≥1.5 and the volumes of Gd-DTPA enhancement showed a positive correlation (r = 0.76, p = 0.003, for an index of ≥1.3, and r = 0.74, p = 0.005, for an index of ≥1.5).

Conclusion

The present data suggest that in patients with recurrent GBM the metabolically active tumour volume may be substantially underestimated by Gd-DTPA enhancement. The findings support the notion that complementary information derived from MET uptake and Gd-DTPA enhancement may be helpful in developing individualized, patient-tailored therapy strategies in patients with recurrent GBM.
Literature
1.
Nazzaro JM, Neuwelt EA. The role of surgery in the management of supratentorial intermediate and high-grade astrocytomas in adults. J Neurosurg 1990;73:331–44.CrossRefPubMed
2.
Halperin EC, Bentel G, Heinz ER, Burger PC. Radiation therapy treatment planning in supratentorial glioblastoma multiforme: an analysis based on post mortem topographic anatomy with CT correlations. Int J Radiat Oncol Biol Phys 1989;17:1347–50.PubMed
3.
Lunsford LD, Martinez AJ, Latchaw RE. Magnetic resonance imaging does not define tumor boundaries. Acta Radiol Suppl 1986;369:154–6.PubMed
4.
Levivier M, Becerra A, De Witte O, Brotchi J, Goldman S. Radiation necrosis or recurrence. J Neurosurg 1996;84:148–9.PubMed
5.
Cairncross JG, Macdonald DR, Pexman JH, Ives FJ. Steroid-induced CT changes in patients with recurrent malignant glioma. Neurology 1988;38:724–6.PubMed
6.
Ostergaard L, Hochberg FH, Rabinov JD, Sorensen AG, Lev M, Kim L, et al. Early changes measured by magnetic resonance imaging in cerebral blood flow, blood volume, and blood-brain barrier permeability following dexamethasone treatment in patients with brain tumors. J Neurosurg 1999;90:300–5.CrossRefPubMed
7.
Kracht LW, Miletic H, Busch S, Jacobs AH, Voges J, Hoevels M, et al. Delineation of brain tumor extent with [11C]L-methionine positron emission tomography: local comparison with stereotactic histopathology. Clin Cancer Res 2004;10:7163–70.CrossRefPubMed
8.
Herholz K, Holzer T, Bauer B, Schroder R, Voges J, Ernestus RI, et al. 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 1998;50:1316–22.PubMed
9.
Reinhardt MJ, Kubota K, Yamada S, Iwata R, Yaegashi H. Assessment of cancer recurrence in residual tumors after fractionated radiotherapy: a comparison of fluorodeoxyglucose, L-methionine and thymidine. J Nucl Med 1997;38:280–7.PubMed
10.
Sonoda Y, Kumabe T, Takahashi T, Shirane R, Yoshimoto T. Clinical usefulness of 11C-MET PET and 201T1 SPECT for differentiation of recurrent glioma from radiation necrosis. Neurol Med Chir (Tokyo) 1998;38:342–7; discussion 347–8.CrossRef
11.
Kim DK, Kanai Y, Choi HW, Tangtrongsup S, Chairoungdua A, Babu E, et al. Characterization of the system L amino acid transporter in T24 human bladder carcinoma cells. Biochim Biophys Acta 2002;1565:112–21.CrossRefPubMed
12.
Jager PL, Vaalburg W, Pruim J, de Vries EG, Langen KJ, Piers DA. Radiolabeled amino acids: basic aspects and clinical applications in oncology. J Nucl Med 2001;42:432–45.PubMed
13.
Bustany P, Chatel M, Derlon JM, Darcel F, Sgouropoulos P, Soussaline F, et al. Brain tumor protein synthesis and histological grades: a study by positron emission tomography (PET) with C11-L-methionine. J Neurooncol 1986;3:397–404.CrossRefPubMed
14.
Bergstrom M, Collins VP, Ehrin E, Ericson K, Eriksson L, Greitz T, et al. Discrepancies in brain tumor extent as shown by computed tomography and positron emission tomography using [68Ga]EDTA, [11C]glucose, and [11C]methionine. J Comput Assist Tomogr 1983;7:1062–6.CrossRefPubMed
15.
Tovi M, Lilja A, Bergstrom M, Ericsson A, Bergstrom K, Hartman M. Delineation of gliomas with magnetic resonance imaging using Gd-DTPA in comparison with computed tomography and positron emission tomography. Acta Radiol 1990;31:417–29.PubMed
16.
Miwa K, Shinoda J, Yano H, Okumura A, Iwama T, Nakashima T, et al. Discrepancy between lesion distributions on methionine PET and MR images in patients with glioblastoma multiforme: insight from a PET and MR fusion image study. J Neurol Neurosurg Psychiatry 2004;75:1457–62.CrossRefPubMed
17.
Pirotte B, Goldman S, Dewitte O, Massager N, Wikler D, Lefranc F, et al. Integrated positron emission tomography and magnetic resonance imaging-guided resection of brain tumors: a report of 103 consecutive procedures. J Neurosurg 2006;104:238–53.CrossRefPubMed
18.
Grosu AL, Weber WA, Riedel E, Jeremic B, Nieder C, Franz M, et al. L-(methyl-11C) methionine positron emission tomography for target delineation in resected high-grade gliomas before radiotherapy. Int J Radiat Oncol Biol Phys 2005;63:64–74.PubMed
19.
Braun V, Dempf S, Weller R, Reske SN, Schachenmayr W, Richter HP. Cranial neuronavigation with direct integration of (11)C methionine positron emission tomography (PET) data – results of a pilot study in 32 surgical cases. Acta Neurochir (Wien) 2002;144:777–82; discussion 782.CrossRef
20.
Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352:987–96.CrossRefPubMed
21.
Macdonald DR, Cascino TL, Schold SC Jr, Cairncross JG. Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 1990;8:1277–80.PubMed
22.
Berger G, Maziere M, Knipper R, Prenant C, Comar D. Automated synthesis of 11C-labelled radiopharmaceuticals: imipramine, chlorpromazine, nicotine and methionine. Int J Appl Radiat Isot 1979;30:393–9.CrossRefPubMed
23.
Vollmar S, Hampl J, Kracht L, Herholz K. Integration of functional data (PET) into brain surgery planning and neuronavigation. In: Buzug TM, Holz D, Bongartz J, Kohl-Bareis M, Hartmann U, Weber S (editors) Advances in medical engineering. Berlin: Springer; 2007. p. 98–103.CrossRef
24.
Kinoshita M, Hashimoto N, Goto T, Yanagisawa T, Okita Y, Kagawa N, et al. Use of fractional anisotropy for determination of the cut-off value in 11C-methionine positron emission tomography for glioma. Neuroimage 2009;45:312–8.CrossRefPubMed
25.
Galldiks N, Kracht LW, Burghaus L, Thomas A, Jacobs AH, Heiss WD, et al. Use of 11C-methionine PET to monitor the effects of temozolomide chemotherapy in malignant gliomas. Eur J Nucl Med Mol Imaging 2006;33:516–24.CrossRefPubMed
26.
Cizek J, Herholz K, Vollmar S, Schrader R, Klein J, Heiss WD. Fast and robust registration of PET and MR images of human brain. Neuroimage 2004;22:434–42.CrossRefPubMed
27.
Schmidt KF, Ziu M, Schmidt NO, Vaghasia P, Cargioli TG, Doshi S, et al. Volume reconstruction techniques improve the correlation between histological and in vivo tumor volume measurements in mouse models of human gliomas. J Neurooncol 2004;68:207–15.CrossRefPubMed
28.
Grosu AL, Weber WA, Astner ST, Adam M, Krause BJ, Schwaiger M, et al. 11C-methionine PET improves the target volume delineation of meningiomas treated with stereotactic fractionated radiotherapy. Int J Radiat Oncol Biol Phys 2006;66:339–44.PubMed
29.
Mahasittiwat P, Mizoe JE, Hasegawa A, Ishikawa H, Yoshikawa K, Mizuno H, et al. l-[METHYL-(11)C] methionine positron emission tomography for target delineation in malignant gliomas: impact on results of carbon ion radiotherapy. Int J Radiat Oncol Biol Phys 2008;70:515–22.PubMed
30.
Pirotte BJ, Levivier M, Goldman S, Massager N, Wikler D, Dewitte O, et al. Positron emission tomography-guided volumetric resection of supratentorial high-grade gliomas: a survival analysis in 66 consecutive patients. Neurosurgery. 2009;64:471–81; discussion 481.CrossRefPubMed
Metadata
Title
Volumetry of [11C]-methionine PET uptake and MRI contrast enhancement in patients with recurrent glioblastoma multiforme
Authors
Norbert Galldiks
Roland Ullrich
Michael Schroeter
Gereon R. Fink
Lutz W. Kracht
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2010
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-009-1219-5

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