• Sebastiano Cosentino
  • Fabrizio Scopelliti
  • Gabriella Murè
  • Sara Baldari
  • Massimo Ippolito


Methionine (MET) is an essential α-amino acid which plays a role in several biochemical processes, such as biosynthesis of proteins.

L-Methionine labeled with 11C acts as a positron emission tomography tracer, as it is involved in synthesis of proteins in brain tumors.

Normal brain tissue recognizes only glucose as a metabolic substrate (thus having a very low physiological 11C-methionine uptake), whereas tumoral brain tissues present an increased 11C-methionine uptake. This makes the signal-to-noise ratio quite high, thus helping in reading and interpreting PET scans.

11C-Methionine PET is easy and fast to perform. Usually 370–740 MBq of tracer is injected intravenously and, because of the short half-life of 11C-labeled molecules (20 min), the uptake time ranges from only 10–30 min.

11C-Methionine PET is a useful diagnostic and therapeutic tool in neuro-oncology. It has a high sensitivity in identifying primary brain tumors (histologic grading, define the extent of tumor, identify optimal biopsy sites), metastases, recurrence, plan radiotherapy and response to therapy. Additionally it allows the study of myocardial infarction, hyperparathyroidism, squamous cell head and neck cancer, multiple myeloma, and lymphoma.


11C-Methionine Brain tumors Myeloma Lymphoma Hyperparathyroidism Squamous cell head and neck cancer 



Methyl iodide


11C-Methyl triflate


Carbon dioxide


Blood brain barrier


Biological target volume


Computed tomography


Focal cortical dysplasia


Fluid-attenuated inversion recovery


Gross tumor volume


Hydriodic acid


Squamous cell head and neck cancer


High-performance liquid chromatography




L-type amino acid transporter






Multiple myeloma


Magnetic resonance


Non-small cell lung cancer


Parathyroid adenoma


Parathyroid hyperplasia


Primary hyperparathyroidism


Parathyroid hormone


Response assessment in neuro-oncology


Standardized uptake value


Thin layer chromatography


  1. 1.
    Saha GB. Fundamentals of Nuclear Pharmacy 2014.Google Scholar
  2. 2.
    Pascali C, Bogni A, Cucchi C, et al. High efficiency preparation of L-[S-methyl-11C]methionine by on-column [11C]methylation on C18 Sep-Pak. J Radioanal Nucl Chem. 1999;288:405–9.Google Scholar
  3. 3.
    Harris SM, James C, et al. Evaluation of the biodistribution of 11C-methionine in children and young adults. J Nucl Med. 2013;54:1902–8.CrossRefGoogle Scholar
  4. 4.
    Nakajima R, et al. Optimization of scan ignition timing after 11C methionine administration for the diagnosis of suspected recurrent brain tumors. Ann Nucl Med. 2017;31(2):190–7.CrossRefGoogle Scholar
  5. 5.
    Calabria F., Schillaci O. Radiopharmaceuticals Metabolic pathways for PET/CT and PET/ME Moleculr Imaging - Chapter 11: 11C-methionine. 2018.Google Scholar
  6. 6.
    Hoffman RM. L-[Methyl-11C] methionine-positron-emission tomography (MET-PET). Methods Mol Biol. 2019;1866:267–71.CrossRefGoogle Scholar
  7. 7.
    Galldiks N, Langen K-J, Pope WB. From the clinician’s point of view - What is the status quo of positron emission tomography in patients with brain tumors? Neuro-Oncology. 2015;17(11):1434–44.CrossRefGoogle Scholar
  8. 8.
    Minamimoto R, et al. Differentiation of brain tumor recurrence from post-radiotherapy necrosis with 11C-methionine PET: visual assessment versus quantitative assessment. PLoS One. 2015;10(7):e0132515.CrossRefGoogle Scholar
  9. 9.
    Ceyssens S, Van Laere K, de Groot T, et al. [11C]Methionine PET, histopathology, and survival in primary brain tumors and recurrence. AJNR. 2006;27(7):1432–7.PubMedGoogle Scholar
  10. 10.
    Galldiks N, Stoffels G, Ruge MI, et al. Role of O-(2–18Ffluoroethyl)- L-tyrosine PET as a diagnostic tool for detection of malignant progression in patients with low-grade glioma. J Nucl Med. 2013;54(12):2046–54.CrossRefGoogle Scholar
  11. 11.
    Glaudemans AW, Enting RH, Heesters MA, et al. Value of 11C-methionine PET in imaging brain tumours and metastases. Eur J Nucl Med Mol Imaging. 2013;40(4):615–35.CrossRefGoogle Scholar
  12. 12.
    Grosu AL, Astner ST, Riedel E, et al. An interindividual comparison of O-(2-[11F]fluoroethyl)-L-tyrosine (FET)- and L-[methyl-11C]methionine (MET)-PET in patients with brain gliomas and metastases. Int J Radiat Oncol Biol Phys. 2011;81:1049–58.Google Scholar
  13. 13.
    Grègoire V, Haustermans K, Geets X, et al. PET-based treatment planning in Ra-diotherapy: a new standard? J Nucl Med. 2007;48:68S–76S.PubMedGoogle Scholar
  14. 14.
    Lohmann P, Werner J-M, Jon Shah N, Langen GRFK-J, Galldiks N. Combined amino acid positron emission tomography and advanced magnetic resonance imaging in glioma patients. Cancer. 2019;11:153.CrossRefGoogle Scholar
  15. 15.
    Kawasaki T, Miwa K, Shinoda J, Asano Y, Takei H, Ikegame Y, Yokoyama K, Yano H, Iwama T. Dissociation between 11C-methionine-PET and Gd-MRI in the longitudinal features of Glioblastoma after postoperative radiotherapy. World Neurosurg. 2019. pii: S1878-8750(19)30229-3Google Scholar
  16. 16.
    Qiao Z, Zhao X, Wang K, Zhang Y, Fan D, Yu T, Shen H, Chen Q, Ai L. Utility of dynamic susceptibility contrast perfusion-weighted MR imaging and 11C-methionine PET/CT for differentiation of tumor recurrence from radiation injury in patients with high-grade gliomas. AJNR Am J Neuroradiol. 2019;40(2):253–9.CrossRefGoogle Scholar
  17. 17.
    Ito K, Matsuda H, Kubota K. Imaging spectrum and pitfalls of 11C-methionine positron emission tomography in a series of patients with intracranial lesions. Korean J Radiol. 2016;17(3):424–34.CrossRefGoogle Scholar
  18. 18.
    Thackeray JT, Bankstahl JP, Wang Y, et al. Targeting amino acid metabolism for molecular imaging of inflammation early after myocardial infarction. Theranostics. 2016;6(11):1768–79.CrossRefGoogle Scholar
  19. 19.
    Phitayakorn R, McHenry CR. Incidence and location of ectopic abnormal parathyroid glands. Am J Surg. 2006;191:418–23.CrossRefGoogle Scholar
  20. 20.
    Wei WJ, Shen CT, Song HJ, et al. Comparison of SPET/CT, SPET and planar imaging using 11mTc-MIBI as independenttechniques to support minimally invasive parathyroidectomy in primary hyperparathyroidism: a meta-analysis. Hell J Nucl Med. 2015;18:127–35.Google Scholar
  21. 21.
    In KC, Gi JC, et al. Detection and characterization of parathyroid adenoma/hyperplasia for preoperative localization: comparison between 11C-methionine PET/CT and 99mTc-sestamibi scintigraphy. Nucl Med Mol Imaging. 2013;47(3):166–72.CrossRefGoogle Scholar
  22. 22.
    Leskinen-Kallio S, Lindholm P, Lapela M, et al. Imaging of head and neck tumors with positron emission tomography and 11C-methionine. Int J Radiat Oncol Biol Phys. 1994;30(5):1195–9.CrossRefGoogle Scholar
  23. 23.
    Chesnay E, Babin E, Constans JM, et al. Early response to chemotherapy in hypopharyngeal cancer: assessment with 11C-methionine PET, correlation with morphologic response, and clinical outcome. J Nucl Med. 2003;44(4):526–32.PubMedGoogle Scholar
  24. 24.
    Lapa C, Knop S, Schreder M, et al. 11C-methionine-PET in multiple myeloma: correlation with clinical parameters and bone marrow involvement. Theranostics. 2016;6(2):254–61.CrossRefGoogle Scholar
  25. 25.
    Kaste SC, Snyder SE, Metzger ML, et al. Comparison of 11C-methionine and 18F-FDG PET-CT for staging and follow-up of pediatric lymphoma. J Nucl Med. 2017;58(3):419–24.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Sebastiano Cosentino
    • 1
  • Fabrizio Scopelliti
    • 1
  • Gabriella Murè
    • 1
  • Sara Baldari
    • 1
  • Massimo Ippolito
    • 1
  1. 1.Division of Nuclear MedicineCannizzaro HospitalCataniaItaly

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