Sonoda Y, Kumabe T, Takahashi T, Shirane R, Yoshimoto T
Department of Neurosurgery, Tohoku University School of Medicine, Sendai.
Neurol Med Chir (Tokyo). 1998 Jun;38(6):342-7; discussion 347-8. doi: 10.2176/nmc.38.342.
The clinical usefulness of L-methyl-11C-methionine positron emission tomography (11C-MET PET) and thallium-201 single photon emission computed tomography (201T1 SPECT) for distinguishing glioma recurrence from radiation-induced changes was evaluated. Ten patients with lesions highly suggestive of recurrent glioma on magnetic resonance imaging underwent 11C-MET PET and 201T1 SPECT studies. Two patients were examined twice, so a total of 12 studies were performed. The clinical diagnoses were five recurrent gliomas and seven radiation necrosis. The five recurrent gliomas appeared as increased uptakes on both 11C-MET PET and 201T1 SPECT scans. Four of the seven radiation necrosis lesions also appeared as increased uptakes on the 201T1 SPECT scans. In contrast, only one radiation necrosis appeared as increased uptake on the 11C-MET PET scans. There was no significant difference in 201T1 SPECT indices between radiation necrosis and tumor recurrence, but the ratio of the differential absorption ratio of tumor tissue to that of the homologous contralateral gray matter in PET of recurrent glioma was significantly higher than that of radiation necrosis. 11C-MET PET is superior to 201T1 SPECT for the differentiation of tumor recurrence from radiation necrosis and delineation of the extent of the tumor.
评估了L-甲基-11C-蛋氨酸正电子发射断层扫描（11C-MET PET）和铊-201单光子发射计算机断层扫描（201T1 SPECT）在鉴别胶质瘤复发与放射性改变方面的临床实用性。10例磁共振成像高度提示复发性胶质瘤的患者接受了11C-MET PET和201T1 SPECT检查。2例患者接受了两次检查，因此共进行了12次检查。临床诊断为5例复发性胶质瘤和7例放射性坏死。5例复发性胶质瘤在11C-MET PET和201T1 SPECT扫描上均表现为摄取增加。7例放射性坏死病变中有4例在201T1 SPECT扫描上也表现为摄取增加。相比之下，只有1例放射性坏死在11C-MET PET扫描上表现为摄取增加。放射性坏死与肿瘤复发之间的201T1 SPECT指数无显著差异，但复发性胶质瘤PET中肿瘤组织与对侧同源灰质的差异吸收比显著高于放射性坏死。11C-MET PET在鉴别肿瘤复发与放射性坏死以及描绘肿瘤范围方面优于201T1 SPECT。
