Detection of histological anaplasia in gliomas with oligodendroglial components using positron emission tomography with 18F-FDG and 11C-methionine: report of two cases |
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| Authors: | Yamaguchi Shigeru Kobayashi Hiroyuki Hirata Kenji Shiga Tohru Tanaka Shinya Murata Junichi Terasaka Shunsuke |
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| Institution: | (1) Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, North-15, West-7, Kita-ku, Sapporo Hokkaido, 060-8638, Japan;(2) Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan;(3) Department of Pathology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan;(4) Sapporo Asabu Neurosurgical Hospital, Sapporo, Japan; |
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| Abstract: | Gliomas are regionally heterogeneous tumors. Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) and 11C-methionine (MET) evaluates the heterogeneity of histological malignancy within the tumor. We present two patients with oligodendrocytic
tumors that showed discrepancies in the highest uptake areas with these two tracers. PET studies with MET and FDG were performed
on the same day, 2 weeks before surgery. In both cases, biopsy specimens were separately obtained from the highest MET and
FDG uptake areas guided by intraoperative neuronavigation. Histological examinations demonstrated that the specimens from
the highest MET uptake area revealed low-grade oligoastrocytoma or oligodendroglioma, whereas histological anaplasias were
contained in the specimens from the highest FDG uptake area. With gliomas with oligodendroglial components, the MET uptake
ratio does not always correspond to histological anaplasia, which can be detected only by FDG PET. Sole application of MET
PET for preoperative evaluation may lead to misunderstanding of histological heterogeneity in gliomas, especially those with
oligodendroglial components. FDG and MET tracers play complementary roles in preoperative evaluation of gliomas. |
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