11C] methionine and [18F] fluorodeoxyglucose PET in the follow-up of glioblastoma multiforme |
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Authors: | Pötzi Christian Becherer Alexander Marosi Christine Karanikas Georgios Szabo Monika Dudczak Robert Kletter Kurt Asenbaum Susanne |
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Institution: | Department of Nuclear Medicine, Medical University of Vienna, W?hringer Gürtel 18-20, 1090, Vienna, Austria. |
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Abstract: | Background The aim of this study was to evaluate the value of 11C] methionine (MET) and 18F] fluorodeoxyglucose (FDG) PET in the follow-up
of glioblastoma multiforme (GBM).
Patients and methods After surgical and/or conservative treatment, 28 patients (pts) with GBM underwent FDG and MET PET on average 12.7 months
after the diagnosis had been established. Scans were evaluated visually and by calculating the maximal tumor SUV as well as
the ratio of tumor vs. contralateral region (RTu). The degree of tracer uptake was compared with survival time, disease duration
and MRI findings.
Results The mean overall duration of survival was 12.7 months. The patients were divided into two groups: those that survived less
than 12 months and those that survived longer than 12 months. Focally increased uptake was revealed by MET PET in 24 patients
and by FDG PET in 2 patients. On MRI scans, viable tumor tissue was suspected in 18 patients. No correlations were registered
between FDG/MET uptake and survival time or disease duration respectively; Kaplan–Meier calculations were negative in this
regard. Similarly, negative results were obtained in subgroups of patients who had undergone microsurgical resection and whose
disease was at least of 6 months’ duration, and additionally in a subgroup who had undergone their last treatment longer than
6 months ago. With respect to survival groups, a positive MET PET was associated with a sensitivity of 86% and a specificity
of 8%. SUV and RTu values did not differ between patients with positive or negative MRI results.
Conclusions In this study FDG PET seems to be of limited value in the work-up of recurrent GBM because of its lower sensitivity than MET
PET and the fact that it allows no prediction of the outcome. MET PET visualizes viable tumor tissue without adding any prognostic
information and appears to be in no way superior to conventional imaging. |
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Keywords: | FDG Methionine Glioblastoma multiforme PET Tumor recurrence |
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