Division of Molecular imaging, Institution of Biomedical Research and Innovation, 2-2 Minatojima-Minamimachi, Chuo-ku, Kobe 650-0047, Japan.
Eur J Nucl Med Mol Imaging. 2010 Apr;37(4):685-90. doi: 10.1007/s00259-009-1302-y. Epub 2009 Nov 14.
We retrospectively examined the clinical efficacy of (11)C-methionine positron emission tomography ((11)C-MET PET) in patients with brain neoplasm, especially whether the (11)C-MET PET changed the clinical management and whether the change was beneficial or detrimental.
This study reviewed 89 (11)C-MET PET scans for 80 patients (20 scans for initial diagnosis of brain tumor and 69 scans for differentiating tumor recurrence from radiation necrosis). Final diagnosis and the effect on the intended management were obtained from the questionnaire to the referring physicians or directly from the medical records. The diagnostic sensitivity, specificity, and accuracy for the (11)C-MET PET were evaluated. Regarding the management impact, the rate of scans that caused changes in intended management was also evaluated. Moreover, the occurrence of scans having detrimental diagnostic impact (DDI) and beneficial diagnostic impact (BDI) were evaluated.
Sensitivity, specificity, and accuracy of (11)C-MET PET was 87.8, 80.0, and 85.9%. The intended management was changed in 50.0% of the scans. DDI and BDI were observed in 4.3 and 36.2% of the total relevant scans, respectively.
(11)C-MET PET can provide useful information in initial diagnosis and differentiating tumor recurrence from radiation necrosis. The intended management was changed in half of the scans. Since a few cases did not receive the requisite treatment due to false-negative results of (11)C-MET PET, management decision should be made carefully, especially in the case of a negative scan.
我们回顾性地研究了（11）C-蛋氨酸正电子发射断层扫描（（11）C-MET PET）在脑肿瘤患者中的临床疗效，特别是（11）C-MET PET 是否改变了临床管理，以及这种改变是有益还是有害。
本研究回顾了 80 例患者的 89 次（11）C-MET PET 扫描（20 次用于脑肿瘤的初始诊断，69 次用于区分肿瘤复发与放射性坏死）。通过向转诊医生发送问卷或直接从病历中获得最终诊断和对预期管理的影响。评估了（11）C-MET PET 的诊断敏感性、特异性和准确性。关于管理影响，还评估了导致预期管理发生变化的扫描率。此外，还评估了扫描产生不利诊断影响（DDI）和有利诊断影响（BDI）的发生率。
（11）C-MET PET 的敏感性、特异性和准确性分别为 87.8%、80.0%和 85.9%。50.0%的扫描改变了预期的治疗方案。在所有相关扫描中，分别有 4.3%和 36.2%的扫描出现了不利诊断影响（DDI）和有利诊断影响（BDI）。
（11）C-MET PET 可在初始诊断和区分肿瘤复发与放射性坏死方面提供有用的信息。半数扫描改变了预期的治疗方案。由于（11）C-MET PET 的假阴性结果，一些患者未能接受必要的治疗，因此应谨慎做出管理决策，特别是在扫描结果为阴性的情况下。
