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Characteristics of time-activity curves obtained from dynamic 11C-methionine PET in common primary brain tumors

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Abstract

Purpose

The aim of this study was to assess whether dynamic PET with 11C-methionine (MET) (MET-PET) is useful in the diagnosis of brain tumors.

Methods

One hundred sixty patients with brain tumors (139 gliomas, 9 meningiomas, 4 hemangioblastomas and 8 primary central nervous system lymphomas [PCNSL]) underwent dynamic MET-PET with a 3-dimensional acquisition mode, and the maximum tumor MET-standardized uptake value (MET-SUV) was measured consecutively to construct a time-activity curve (TAC). Furthermore, receiver operating characteristic (ROC) curves were generated from the time-to-peak (TTP) and the slope of the curve in the late phase (SLOPE).

Results

The TAC patterns of MET-SUVs (MET-TACs) could be divided into four characteristic types when MET dynamics were analyzed by dividing the MET-TAC into three phases. MET-SUVs were significantly higher in early and late phases in glioblastoma compared to anaplastic astrocytoma, diffuse astrocytoma and the normal frontal cortex (P < 0.05). The SLOPE in the late phase was significantly lower in tumors that included an oligodendroglial component compared to astrocytic tumors (P < 0.001). When we set the cutoff of the SLOPE in the late phase to − 0.04 h−1 for the differentiation of tumors that included an oligodendroglial component from astrocytic tumors, the diagnostic accuracy was 74.2% sensitivity and 64.9% specificity. The area under the ROC curve was 0.731.

Conclusions

The results of this study show that quantification of the MET-TAC for each brain tumor identified by a dynamic MET-PET study could be helpful in the non-invasive discrimination of brain tumor subtypes, in particular gliomas.

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Abbreviations

AA:

Anaplastic astrocytoma

AO:

Anaplastic oligoastrocytoma

AOA:

Anaplastic oligoastrocytoma

BBB:

Blood brain barrier

2D:

2-Dimensional

3D:

3-Dimensional

DA:

Diffuse astrocytoma

FET:

O-(2-[18F]-fluoroethyl)-l-tyrosine

GBM:

Glioblatoma multiforme

MET:

11C-methionine

MET-SUV:

MET-standardized uptake value

MET-TAC:

Time-activity curve of MET-SUV

OA:

Oligoastrocytoma

OD:

Oligodendroglioma

PCNSL:

Primary central nervous system lymphoma

ROI:

Region of interest

SLOPE:

Regression coefficient of TAC slope

SUV:

Standardized uptake value

TAC:

Time activity curve

TBF:

Tissue blood flow

TBV:

Tissue blood volume

TTP:

Time-to-peak

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Acknowledgements

The authors would like to thank Dr. Kazutoshi Yokoyama, Dr. Takeshi Ito, and Dr. Makoto Okada at the Department of Neurosurgery, Kizawa Memorial Hospital, and Dr. Soko Ikuta at the Department of Neurosurgery, Tokyo Women’s Medical University for referring patients. They would also like to thank Mr. Yukinori Kasuya, Mr. Ryuji Okumura, Mr. Yu-ichi Yamada, and Mr. Seisuke Fukuyama for technical support with MRI/PET scanning.

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Authors and Affiliations

  1. Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, Gifu, 505-0034, Japan

    Yuichi Nomura, Yoshitaka Asano, Jun Shinoda, Yuka Ikegame & Tomohiro Kawasaki

  2. Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Minokamo, Japan

    Yoshitaka Asano, Jun Shinoda & Yuka Ikegame

  3. Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan

    Yuichi Nomura, Hirohito Yano, Tomohiro Kawasaki, Noriyuki Nakayama & Toru Iwama

  4. Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan

    Takashi Maruyama & Yoshihiro Muragaki

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  1. Yuichi Nomura
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Correspondence to Yuichi Nomura.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the research committee of Gifu University Hospital and Kizawa Memorial Hospital Foundation and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Nomura, Y., Asano, Y., Shinoda, J. et al. Characteristics of time-activity curves obtained from dynamic 11C-methionine PET in common primary brain tumors. J Neurooncol 138, 649–658 (2018). https://doi.org/10.1007/s11060-018-2834-4

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