Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, North-15, West-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
J Neurooncol. 2011 Jan;101(2):335-41. doi: 10.1007/s11060-010-0262-1. Epub 2010 Jun 15.
Gliomas are regionally heterogeneous tumors. Positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) and (11)C-methionine (MET) evaluates the heterogeneity of histological malignancy within the tumor. We present two patients with oligodendrocytic tumors that showed discrepancies in the highest uptake areas with these two tracers. PET studies with MET and FDG were performed on the same day, 2 weeks before surgery. In both cases, biopsy specimens were separately obtained from the highest MET and FDG uptake areas guided by intraoperative neuronavigation. Histological examinations demonstrated that the specimens from the highest MET uptake area revealed low-grade oligoastrocytoma or oligodendroglioma, whereas histological anaplasias were contained in the specimens from the highest FDG uptake area. With gliomas with oligodendroglial components, the MET uptake ratio does not always correspond to histological anaplasia, which can be detected only by FDG PET. Sole application of MET PET for preoperative evaluation may lead to misunderstanding of histological heterogeneity in gliomas, especially those with oligodendroglial components. FDG and MET tracers play complementary roles in preoperative evaluation of gliomas.
脑胶质瘤是区域性异质性肿瘤。正电子发射断层扫描（PET）结合氟脱氧葡萄糖（FDG）和（11）C-蛋氨酸（MET）可评估肿瘤内组织学恶性程度的异质性。我们介绍了两例少突胶质细胞瘤患者，这两种示踪剂在肿瘤内最高摄取区域存在差异。在手术前 2 周的同一天，对患者进行了 MET 和 FDG 的 PET 研究。在这两种情况下，通过术中神经导航，分别从 MET 和 FDG 摄取最高的区域获取活检标本。组织学检查显示，来自 MET 摄取最高区域的标本显示低级别少突星形细胞瘤或少突胶质细胞瘤，而来自 FDG 摄取最高区域的标本则包含组织学间变。对于含有少突胶质细胞成分的脑胶质瘤，MET 摄取率并不总是对应于组织学间变，这只能通过 FDG PET 检测到。仅应用 MET PET 进行术前评估可能会导致对脑胶质瘤组织学异质性的误解，尤其是那些含有少突胶质细胞成分的脑胶质瘤。FDG 和 MET 示踪剂在脑胶质瘤的术前评估中发挥互补作用。
