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J Korean Neurosurg Soc. 2006 Mar;39(3):176-182. English. Original Article.
Cho WS , Kim CH , Kim JE , Chung JK , Paek SH , Jung HW .
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Clinical Research Institute, Seoul National University College of Medicine, Seoul, Korea.

OBJECTIVE: This study concernes the usefulness of 11C-methyl-L-and D-methionine(Met)-positron emission tomography(PET) for gliomagrading and detection of recurrence in gliomas, compared with fluorine-18, 2-fluoro-deoxyglucose(FDG)-PET. METHODS: Eighty patients underwent Met-PET study for evaluation of glioma: 37 astrocytomas (WHO grade II, 3; III, 8; IV, 26), 27 oligodendrogliomas (WHO grade II, 16; III, 11), and 12 suspicious recurrent gliomas. All images were taken within 2 weeks before operation. For suspicious recurrent cases on magnetic resonance images, both FDG-PET and Met-PET were performed. RESULTS: In astrocytoma, Mean maximum standard uptake value(SUV) of region of interest(ROI) was not different between WHO grades (p=0.108), but ROI/normal contralateral tissue SUV (T/N) ratio was statistically different between WHO grades (p=0.002). T/N ratio was more closely related to visual scale than maximum SUV of ROI (p<0.001 and p=0.107 respectively). In oligodendroglioma, there was no statistical difference between WHO grades in view of maximum SUV and T/N ratio. For recurrent gliomas, sensitivity of FDG-PET and Met-PET was 25% and 100%, while specificity of FDG-PET and Met-PET were 100% and 80%, respectively. CONCLUSION: Met-PET might be an appropriate tool for tumor grading in astrocytom a and be more sensitive for detection of recurrence in gliomas than FDG-PET.

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