Derlon J M, Bourdet C, Bustany P, Chatel M, Theron J, Darcel F, Syrota A
Department of Neurosurgery, C.H.U. Caen, France.
Neurosurgery. 1989 Nov;25(5):720-8. doi: 10.1097/00006123-198911000-00006.
Treatment of gliomas remains disappointing in spite of a great number of experimental biological data and of randomized therapeutic studies. This could be partly explained by the inefficiency of our conventional methods to assess the regional metabolism of these tumors. The use of positron emission tomography (PET) brings encouraging possibilities in this field. We report our preliminary experience of measuring regional cerebral methionine uptake with PET after intravenous injection of [11C]L-methionine. Twenty-two patients with histologically confirmed gliomas were studied. An ECAT II positron emission tomograph was used for scanning. The position of the plane was chosen to include a major section of the tumor in the reconstructed brain slice. The protocol required a two-step examination: 1) after injection of 15 to 25 mCi of [11C]L-methionine, 12 scans were performed over a period of 46 minutes; and 2) 18 hours later, regional cerebral blood volume was measured in the same slice after intravenous injection of 2 to 4 mCi of 68GaCl3. The tumoral region of interest was determined as being the area of maximum activity. For each patient we calculated the ratio, R, between the activity in this tumor region of interest and the activity in the contralateral healthy symmetric region of interest which was used as an "internal standard" for the same patient. We correlated the ratio R with the histological grading. In 22 patients, mean values of R were calculated for each tumor: Grade II (n = 5): R = 1.04 +/- 0.27; Grade III (n = 5): R = 1.68 +/- 0.22; and Grade IV (n = 12): R = 2.33 +/- 0.86.(ABSTRACT TRUNCATED AT 250 WORDS)
尽管有大量的实验生物学数据和随机治疗研究,但胶质瘤的治疗效果仍然令人失望。这部分可以通过我们传统方法评估这些肿瘤区域代谢的低效性来解释。正电子发射断层扫描(PET)的使用在该领域带来了令人鼓舞的可能性。我们报告了静脉注射[11C]L-蛋氨酸后用PET测量局部脑蛋氨酸摄取的初步经验。研究了22例经组织学证实的胶质瘤患者。使用ECAT II正电子发射断层扫描仪进行扫描。选择平面位置以在重建的脑切片中包括肿瘤的主要部分。该方案需要分两步进行检查:1)注射15至25 mCi的[11C]L-蛋氨酸后,在46分钟内进行12次扫描;2)18小时后,静脉注射2至4 mCi的68GaCl3后,在同一切片中测量局部脑血容量。感兴趣的肿瘤区域被确定为最大活性区域。对于每位患者,我们计算了该肿瘤感兴趣区域的活性与对侧健康对称感兴趣区域的活性之间的比率R,该对侧区域用作同一患者的“内标”。我们将比率R与组织学分级相关联。在22例患者中,计算了每个肿瘤的R平均值:二级(n = 5):R = 1.04±0.27;三级(n = 5):R = 1.68±0.22;四级(n = 12):R = 2.33±0.86。(摘要截断于250字)