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

• DOI: 10.1007/s11060-018-2834-4
• Publication Date: 2018-03-21T09:48:49Z
• Authors: Yuichi Nomura; Yoshitaka Asano; Jun Shinoda; Hirohito Yano; Yuka Ikegame; Tomohiro Kawasaki; Noriyuki Nakayama; Takashi Maruyama; Yoshihiro Muragaki; Toru Iwama
• Keywords: Adult; Male; Lymphoma; Brain Neoplasms; Brain; Glioma; Middle Aged; Sensitivity and Specificity; Hemangioblastoma; 03 medical and health sciences; Imaging, Three-Dimensional; Methionine; 0302 clinical medicine; Positron-Emission Tomography; Meningeal Neoplasms; Humans; Female; Carbon Radioisotopes; Radiopharmaceuticals; Meningioma; Aged; Retrospective Studies

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.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).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.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.