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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 5/2006

01-05-2006 | Original Article

Use of 11C-methionine PET to monitor the effects of temozolomide chemotherapy in malignant gliomas

Authors: Norbert Galldiks, Lutz W. Kracht, Lothar Burghaus, Anne Thomas, Andreas H. Jacobs, Wolf–Dieter Heiss, Karl Herholz

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2006

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Abstract

Purpose

The purpose of this study was to monitor the metabolic effects of temozolomide (TMZ) chemotherapy in malignant gliomas by means of repeated positron emission tomography (PET) with [11C]methionine (MET).

Methods

Fifteen patients with histologically proven malignant glioma were treated by TMZ chemotherapy. MET-PET studies were performed before and after the third cycle of TMZ chemotherapy in all patients, and in 12 patients also after the sixth cycle. Gadolinium-enhanced MRI studies were performed in 12 patients before the first and after the sixth cycle. Clinical status was assessed by the modified Rankin scale. Long-term outcome was assessed by calculating the time to progression (TTP) in months.

Results

Decline in MET uptake during therapy corresponded to a stable clinical status. The median TTP was significantly longer in patients with decline in MET uptake than in those with increasing MET uptake (23 vs 3.5 months; p=0.01, log rank test). There was no significant correlation between change in MET uptake and change in contrast enhancement during treatment for all patients.

Conclusion

The present data demonstrate that clinical stability, which is often achieved under TMZ chemotherapy of malignant glioma, corresponds to a decline in or stability of tumour amino acid metabolism. Tumour responses can already be demonstrated with MET-PET after three cycles of chemotherapy, and absence of progression at that time indicates a high probability of further stability during the next three cycles. A reduction in MET uptake during TMZ treatment predicts a favourable clinical outcome. Molecular imaging of amino acid uptake by MET-PET offers a new method of measurement of the biological activity of recurrent glioma.
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Metadata
Title
Use of 11C-methionine PET to monitor the effects of temozolomide chemotherapy in malignant gliomas
Authors
Norbert Galldiks
Lutz W. Kracht
Lothar Burghaus
Anne Thomas
Andreas H. Jacobs
Wolf–Dieter Heiss
Karl Herholz
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2006
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-005-0002-5

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