Dataset Information

Value of C-11 methionine PET/CT in patients with intracranial germinoma.

ABSTRACT:

Purpose

The purpose of this study was to investigate the value of C-11 methionine (MET) positron emission tomography (PET)/computed tomography (CT) in patients with intracranial germinoma (IG).

Material and methods

We conducted a retrospective analysis of 21 consecutive patients with pathologically confirmed IGs and eight patients with intracranial non-germinomas (INGs) located in a similar region. Clinical characteristics, imaging findings, and tumor markers such as α-fetoprotein (AFP) and β-human chorionic gonadotropin (HCG) were used as clinical variables. Maximum standardized uptake value (SUVmax), tumor-to-normal tissue (T/N) ratio, and visual scoring of tumor were used as MET PET parameters.

Results

All IGs were well visualized on MET PET with a three-grade visual scoring system. In addition, SUVmax of IGs was higher than that of INGs (P = 0.005). Pre-treatment (Pre-Tx) T/N ratio was significantly correlated with pre-Tx serum HCG (P = 0.031). Moreover, MET PET parameters showed significant associations with tumor location, sex, KRAS variant, and symptoms.

Conclusion

MET PET/CT could be a useful diagnostic tool in patients suspected of having IGs. In addition, the MET avidity of tumor is a potential surrogate biomarker of HCG, which has been used as a diagnostic marker for IGs. Tumor MET parameters also had significant differences according to tumor locations, sex, symptoms, and KRAS mutation. However, MET avidity of tumors had no significant prognostic value.

SUBMITTER: Park YJ

PROVIDER: S-EPMC8820606 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Value of C-11 methionine PET/CT in patients with intracranial germinoma.

Park Yong-Jin YJ Lee Ji Won JW Cho Hee Won HW Choe Yearn Seong YS Lee Kyung-Han KH Choi Joon Young JY Sung Ki Woong KW Moon Seung Hwan SH

PloS one 20220207 2

<h4>Purpose</h4>The purpose of this study was to investigate the value of C-11 methionine (MET) positron emission tomography (PET)/computed tomography (CT) in patients with intracranial germinoma (IG).<h4>Material and methods</h4>We conducted a retrospective analysis of 21 consecutive patients with pathologically confirmed IGs and eight patients with intracranial non-germinomas (INGs) located in a similar region. Clinical characteristics, imaging findings, and tumor markers such as α-fetoprotein ...[more]

PMID: 35130327

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Project description:BackgroundIt is well known that primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders. Precise preoperative adenoma localization is essential for increasing PHPT cure rate. Conventional localization techniques include neck ultrasound, 99m-Tc-sestamibi scintigraphy, and computed tomography (CT). However, all of these methods have limitations. 11C-methionine positron emission tomography/computed tomography (PET/CT) combines both anatomical and functional modalities; it may be useful in terms of lowering the imaging procedures number and improving accuracy.MethodsA retrospective diagnostic accuracy study with sensitivity and specificity evaluation was conducted. We studied the data of 91 patients with PHPT, who were hospitalized at Almazov National Medical Research Centre. Medical records, lab results, and CT imaging of all patients were analyzed. All of them underwent ultrasound. 99m-Tc-sestamibi/99m-Tc-pertechnetate subtraction scintigraphy and CT were performed on 56 and 86 patients, respectively. Since 2020 11C-methionine PET/CT has been performed on 45 patients. Then, minimally invasive parathyroidectomy (PTX) was carried out in all patients. Histological results were used as a benchmark in order to evaluate diagnostic accuracy of studied methods. Parathyroid adenoma or hyperplasia was confirmed in all patients. Multiple lesions were found in 5 patients. Nineteen lesions were ectopic. All patients with multiple lesions required at least 3 localization techniques, and 2 of them required 4.ResultsThe sensitivity of 11C-methionine PET/CT was 98%, CT, 99m-Tc-sestamibi scintigraphy, and ultrasound showed sensitivity at 75%, 79%, and 67%, respectively. The estimated specificities of 11C-methionine PET/CT, CT, 99m-Tc-sestamibi scintigraphy and ultrasound were 93%, 73%, 75%, and 70%, respectively.ConclusionsOur study showed that 11C-methionine PET/CT has higher sensitivity and specificity than conventional techniques in a group of 19 patients. 11C-methionine PET/CT may take a place in the imaging of parathyroid adenomas, it may replace CT and 99m-Tc-sestamibi scintigraphy while simultaneously providing information about lesion topography and function.

Project description:PurposeAccurate preoperative localization is imperative to guide surgery in primary hyperparathyroidism (pHPT). It remains unclear which second-line imaging technique is most effective after negative first-line imaging. In this study, we compare the diagnostic effectiveness of [11C]methionine PET/CT, [11C]choline PET/CT, and four dimensional (4D)-CT head-to-head in patients with pHPT, to explore which of these imaging techniques to use as a second-line scan.MethodsWe conducted a powered, prospective, blinded cohort study in patients with biochemically proven pHPT and prior negative or discordant first-line imaging consisting of ultrasonography and 99mTc-sestamibi. All patients underwent [11C]methionine PET/CT, [11C]choline PET/CT, and 4D-CT. At first, all scans were interpreted by a nuclear medicine physician, and a radiologist who were blinded from patient data and all imaging results. Next, a non-blinded scan reading was performed. The scan results were correlated with surgical and histopathological findings. Serum calcium values at least 6 months after surgery were used as gold standard for curation of HPT.ResultsA total of 32 patients were included in the study. With blinded evaluation, [11C]choline PET/CT was positive in 28 patients (88%), [11C]methionine PET/CT in 23 (72%), and 4D-CT in 15 patients (47%), respectively. In total, 30 patients have undergone surgery and 32 parathyroid lesions were histologically confirmed as parathyroid adenomas. Based on the blinded evaluation, lesion-based sensitivity of [11C]choline PET/CT, [11C]methionine PET/CT, and 4D-CT was respectively 85%, 67%, and 39%. The sensitivity of [11C]choline PET/CT differed significantly from that of [11C]methionine PET/CT and 4D-CT (p = 0.031 and p < 0.0005, respectively).ConclusionIn the setting of pHPT with negative first-line imaging, [11C]choline PET/CT is superior to [11C]methionine PET/CT and 4D-CT in localizing parathyroid adenomas, allowing correct localization in 85% of adenomas. Further studies are needed to determine cost-benefit and efficacy of these scans, including the timing of these scans as first- or second-line imaging techniques.

Dataset Information

Value of C-11 methionine PET/CT in patients with intracranial germinoma.

Purpose

Material and methods

Results

Conclusion

Publications

Value of C-11 methionine PET/CT in patients with intracranial germinoma.

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