Abstract

CASAS PARERA, Ignacio et al. Utility of ¹¹C-methionine PET/CT in neuro-oncology. Medicina (B. Aires) [online]. 2013, vol.73, n.3, pp.201-206. ISSN 0025-7680.

Positron emission tomography (PET) with ¹¹C-methionine (¹¹C-methionine PET/CT) is a new technique used to evaluate primary central nervous system (CNS) tumors. We describe our experience regarding the first 4 patients with glial tumors and 11C-methionine PET/CT. This is a descriptive, observational and prospective study of 4 patients between 38-50 years of age, with different gliomas (WHO classification). MRI and ¹¹C-methionine PET/CT were performed in all cases. Case 1, gliomatosis cerebri grade II post-radiotherapy. Case 2, oligodendroglioma grade II diagnosed and treated with radiotherapy in 1993. Case 3, glioblastoma grade IV post-radiotherapy + temozolomide. Case 4, anaplastic oligoastrocytoma grade III post-radiotherapy + temozolomide. The pattern of ¹¹C-methionine uptake compared with MRI showed tumor progression in cases 1, 3 and 4, and in case 2 showed uptake although the final diagnosis was pseudoprogression. Unlike ¹⁸fluordeoxiglucose PET/TC, ¹¹C-methionine uptake in normal brain tissue and pseudoprogression is low, and gliomas are displayed as metabolically active areas. The ¹¹C-methionine PET/CT provided valuable information on the tumoral behavior and extension, although in one case presented did not differentiate tumor progression from pseudoprogression. ¹¹C-methionine PET/CT could be a useful tool in the study and follow-up to patients with gliomas.

Keywords : Gliomas; ¹¹C-methionine PET/CT; Pseudo-progression.

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