Summary
We performed this study in order to assess the clinical potential of 13N-ammonia PET in patients with cerebral astrocytoma.
Methods
Dynamic 13N-ammonia PET was performed in 25 patients with suspected cerebral gliomas or recurrent cerebral astrocytomas (19 male and 6 female patients; age range 18–64 years) detected by MRI. The histopathological diagnoses were made for all cases either by biopsy or craniotomy, except for one patient with brain infarction and one patient with brain radiation necrosis confirmed by repeated MRI imaging. PET images were visually inspected, and the tumor-to-white matter count (T/W) ratios and the perfusion index (PI) of the tumors were determined.
Results
Six out of nine cases of low-grade gliomas were detected with 13N-ammonia PET, and three non-astrocytoma low-grade gliomas were not detected with 13N-ammonia PET. All 11 high-grade astrocytomas exhibited markedly increased uptake of 13N-ammonia. The five non-neoplastic lesions exhibited low uptake, low T/W ratios and low PI. The significant differences were observed between high-grade and low-grade gliomas with respect to both the T/W ratios and PI (T/W ratios: 5.92±2.27, n=11 vs. 1.66±0.61, n=9, P<0.01; PI: 5.22±1.67, n=11 vs. 1.60±0.54, n=9, P<0.01). There were the significant differences between the T/W ratios and PI in low-grade astrocytomas and that in non-neoplastic lesions (T/W ratios: 2.00±0.42, n=6 vs. 0.97±0.11, n=5, P<0.01; PI: 1.89±0.37, n=6 vs. 0.99±0.03, n=5, P<0.01).
Conclusions
There is a substantial uptake of 13N-ammonia in cerebral astrocytomas. 13N-ammonia PET may enable differentiation between low- and high-grade astrocytomas, and has the potential to enable differentiation between low-grade astrocytomas and non-neoplastic lesions.
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Acknowledgement
The authors are highly grateful to the anonymous referees for their significant and constructive critiques and suggestions, which improve the paper very much. This work was partially supported by grant 031652 from the Nature Sciences Foundation of Guangdong Province, China.
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Xiangsong, Z., Changhong, L., Weian, C. et al. PET Imaging of cerebral astrocytoma with 13N-ammonia. J Neurooncol 78, 145–151 (2006). https://doi.org/10.1007/s11060-005-9069-x
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DOI: https://doi.org/10.1007/s11060-005-9069-x