%0 Journal Article
%T [11C]-Methionine Positron Emission Tomography in the Postoperative Imaging and Followup of Patients with Primary and Recurrent Gliomas
%A Matteo Santoni
%A Cristina Nanni
%A Alessandro Bittoni
%A Gabriele Polonara
%A Alessandro Paccapelo
%A Roberto Trignani
%A Mariagrazia De Lisa
%A Franco Rychlicki
%A Luciano Burattini
%A Rossana Berardi
%A Stefano Fanti
%A Stefano Cascinu
%J ISRN Oncology
%D 2014
%R 10.1155/2014/463152
%X We investigated the sensitivity and specificity of [11C]-methionine positron emission tomography ([11C]-MET PET) in the management of glioma patients. We retrospectively analysed data from 53 patients with primary gliomas (16 low grade astrocytomas, 15 anaplastic astrocytomas and 22 glioblastomas) and Karnofsky Performance Status (KPS) > 70. Patients underwent [11C]-MET PET scans ( ) and parallel contrast-enhanced MRI ( ) and/or CT ( ) controls. In low grade glioma patients, MRI or CT findings associated with [11C]-MET PET additional data allowed discrimination residual disease from postsurgical changes in 96.22% of these cases. [11C]-MET PET early allowed detection of malignant progression from low grade to anaplastic astrocytoma with high sensitivity (91.56%) and specificity (95.18%). In anaplastic astrocytomas, we registered high sensitivity (93.97%) and specificity (95.18%) in the postoperative imaging and during the followup of these patients. In GBM patients, CT and/or MRI scans with additional [11C]-MET PET data registered a sensitivity of 96.92% in the postsurgical evaluation and in the tumour assessment during temozolomide therapy. A significant correlation was found between [11C]-MET mean uptake index and histologic grading ( ). These findings support the notion that complementary information derived from [11C]-MET PET may be helpful in postoperative and successive tumor assessment of glioma patients. 1. Introduction The therapeutic approach to glioma patients remains a major challenge in clinical neurooncology, mainly for the inefficiency of the conventional instrumental methods to assess the response to the different therapeutic tools. In fact, an adequate imaging may affect the assessment of an objective response rate and the determination of the progression-free survival, thus influencing the therapeutic course of glioma patients. In neuroradiology, contrast enhancement reflects blood-brain barrier damage regions and it is considered an indirect marker for active tumor tissue. However, MRI contrast enhancement often does not adequately differentiate viable tumor tissue from necrosis induced by therapy or occurring spontaneously during tumour progression [1]. Furthermore, contrast enhancement may be confused by dexamethasone, which reduces the uptake of contrast agents [2]. Positron emission tomography (PET) may improve the management of malignant glioma by identifying areas of increased metabolic activity beyond the area of contrast enhancement on MRI, which may correspond to the areas at highest risk of recurrence. Moreover, PET imaging
%U http://www.hindawi.com/journals/isrn.oncology/2014/463152/