Surgical Target Selection in Cerebral Glioma Surgery: Linking Methionine (MET) PET Image Fusion and Neuronavigation
| Autor: | K. Kletter, D. Prayer, Karl Roessler, Engelbert Knosp, S. Asenbaum, J. Hainfellner, M. Paul, B. Gatterbauer, A. Becherer, R. Hoeftberger |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Mixed Glioma medicine.medical_specialty Neuronavigation Adolescent Oligodendroglioma Standardized uptake value Fluid-attenuated inversion recovery Sensitivity and Specificity Diagnosis Differential Methionine Predictive Value of Tests Glioma Preoperative Care Biopsy Image Processing Computer-Assisted medicine Humans Carbon Radioisotopes Child Anaplasia Aged medicine.diagnostic_test Brain Neoplasms business.industry Histology General Medicine Middle Aged medicine.disease Positron-Emission Tomography Female Surgery Neurology (clinical) Radiology medicine.symptom business |
| Zdroj: | min - Minimally Invasive Neurosurgery. 50:273-280 |
| ISSN: | 1439-2291 0946-7211 |
| DOI: | 10.1055/s-2007-991143 |
| Popis: | OBJECTIVE: The objective of this study was to investigate the histological correlate of 11 C-methionine (MET) PET uptake of brain gliomas by image fusion for navigated surgery. METHODS: Twenty-seven patients (18 male, 9 female; mean age 42 years; range 11-77 years; 8 low-grade and 11 high-grade astrocytomas or mixed gliomas, 8 oligodendrogliomas) underwent MET PET studies preoperatively. RESULTS: MET PET tumor uptake was detected in 26 of 27 patients (96.3%). The quantitative MET tumor standardized uptake value (SUV) ratio was significantly higher in malignant gliomas and oligodendrogliomas than in low-grade gliomas (2.76/2.62 vs. 1.67, p=0.03). Generally, qualitative visual grading of MET uptake revealed 2 main patterns: focal MET uptake in 12 and uniform global MET uptake in 11 patients. Focal uptake corresponded to malignant glioma histology in 66.7%, and uniform global uptake to oligodendroglial histology in 72.7%. In oligodendrogliomas, global MET uptake constituted 81.5% (range 53.8-135%) of the MRI T 1 tumor volume on average and was limited to the MRI FLAIR tumor volume in 86% (7/8) of patients. Tissue samples of focal MET uptake areas correlated with histological anaplasia in 66.6% (8/12 glioma patients), although 62.5% (5/8 patients) lacked MRI contrast enhancement. CONCLUSION: MET PET image fusion may facilitate the targeting of anaplastic foci in homogeneous MRI non-enhancing gliomas for biopsy, may identify oligodendroglial histology preoperatively as well as characterize biologically active tumor volumes within MRI T 1 /FLAIR tumor areas of candidate patients for resection. |
| Databáze: | OpenAIRE |
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