Radiotherapy treatment planning and long-term follow-up with [ 11C]methionine PET in patients with low-grade astrocytoma
Purpose: To evaluate the feasibility of [ 11C]-methionine positron emission tomography (MET PET) in radiotherapy (RT) treatment planning and long-term follow-up in patients with low-grade glioma. Patients: Thirteen patients with low-grade astrocytoma and 1 with anaplastic astrocytoma underwent seque...
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| creator | Nuutinen, Joanne Sonninen, Pirkko Lehikoinen, Pertti Sutinen, Eija Valavaara, Ritva Eronen, Esa Norrgård, Stefan Kulmala, Jarmo Teräs, Mika Minn, Heikki |
| description | Purpose: To evaluate the feasibility of [
11C]-methionine positron emission tomography (MET PET) in radiotherapy (RT) treatment planning and long-term follow-up in patients with low-grade glioma.
Patients: Thirteen patients with low-grade astrocytoma and 1 with anaplastic astrocytoma underwent sequential MET PET and magnetic resonance imaging (MRI) before and 3, 6, 12, and 21–39 months after RT, respectively. Ten patients were studied after initial debulking surgery or biopsy and 4 in the recurrence phase.
Methods: A total of 58 PET scans were performed. After transmission scanning, a median dose of 425 MBq of MET was injected intravenously and emission data was acquired 20 min after injection for 20 min. The uptake of MET in tumor area was measured as standardized uptake value (SUV) and tumor-to-contralateral brain SUV ratios were generated to assess irradiation effects on tumor metabolism. Functional imaging with PET was compared with concurrent MRI in designing the RT planning volumes and in assessment of response to RT during a median follow-up time of 33 months.
Results: In 12 patients (86%), tumor area was clearly discernible in the baseline PET study. In the remaining 2 patients with a suspected residual tumor in MRI, PET showed only a diffuse uptake of MET interpreted as negative in the original tumor area. In the dose planning of RT, MET PET was helpful in outlining the gross tumor volume in 3 of 11 cases (27%), whereas PET findings either coincided with MRI (46%) or were less distinctive (27%) in other cases. In quantitative evaluation, patients with a low tumor SUV initially had significantly better prognosis than those with a high SUV. Tumor-to-contralateral brain uptake ratios of MET discriminated well patients remaining clinically stable from those who have since relapsed or died of disease.
Conclusion: Quantitative MET PET has prognostic value at the time of initial treatment planning of low-grade glioma. Some patients may benefit of RT volume definition with MET PET, which seems to disclose residual tumor better than MRI in selected cases. Stable or decreasing uptake of MET in tumor area after RT during follow-up seems to be a favorable sign. |
| doi_str_mv | 10.1016/S0360-3016(00)00604-0 |
| format | Article |
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11C]-methionine positron emission tomography (MET PET) in radiotherapy (RT) treatment planning and long-term follow-up in patients with low-grade glioma.
Patients: Thirteen patients with low-grade astrocytoma and 1 with anaplastic astrocytoma underwent sequential MET PET and magnetic resonance imaging (MRI) before and 3, 6, 12, and 21–39 months after RT, respectively. Ten patients were studied after initial debulking surgery or biopsy and 4 in the recurrence phase.
Methods: A total of 58 PET scans were performed. After transmission scanning, a median dose of 425 MBq of MET was injected intravenously and emission data was acquired 20 min after injection for 20 min. The uptake of MET in tumor area was measured as standardized uptake value (SUV) and tumor-to-contralateral brain SUV ratios were generated to assess irradiation effects on tumor metabolism. Functional imaging with PET was compared with concurrent MRI in designing the RT planning volumes and in assessment of response to RT during a median follow-up time of 33 months.
Results: In 12 patients (86%), tumor area was clearly discernible in the baseline PET study. In the remaining 2 patients with a suspected residual tumor in MRI, PET showed only a diffuse uptake of MET interpreted as negative in the original tumor area. In the dose planning of RT, MET PET was helpful in outlining the gross tumor volume in 3 of 11 cases (27%), whereas PET findings either coincided with MRI (46%) or were less distinctive (27%) in other cases. In quantitative evaluation, patients with a low tumor SUV initially had significantly better prognosis than those with a high SUV. Tumor-to-contralateral brain uptake ratios of MET discriminated well patients remaining clinically stable from those who have since relapsed or died of disease.
Conclusion: Quantitative MET PET has prognostic value at the time of initial treatment planning of low-grade glioma. Some patients may benefit of RT volume definition with MET PET, which seems to disclose residual tumor better than MRI in selected cases. Stable or decreasing uptake of MET in tumor area after RT during follow-up seems to be a favorable sign.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/S0360-3016(00)00604-0</identifier><identifier>PMID: 10924970</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Astrocytoma - diagnostic imaging ; Astrocytoma - metabolism ; Astrocytoma - radiotherapy ; Biological and medical sciences ; Brain Neoplasms - diagnostic imaging ; Brain Neoplasms - metabolism ; Brain Neoplasms - radiotherapy ; Brain tumors ; Carbon Radioisotopes ; Diseases of the nervous system ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Methionine ; Methionine - pharmacokinetics ; Middle Aged ; Nervous system ; PET ; Radionuclide investigations ; Radiotherapy Dosage ; Radiotherapy planning ; Radiotherapy Planning, Computer-Assisted - methods ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Tomography, Emission-Computed - methods</subject><ispartof>International journal of radiation oncology, biology, physics, 2000-08, Vol.48 (1), p.43-52</ispartof><rights>2000 Elsevier Science Inc.</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-19607d6025e2e2c8582c49bad631dd484b15763f6b52eaeeebd3320ec67163683</citedby><cites>FETCH-LOGICAL-c390t-19607d6025e2e2c8582c49bad631dd484b15763f6b52eaeeebd3320ec67163683</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0360-3016(00)00604-0$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1450142$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10924970$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nuutinen, Joanne</creatorcontrib><creatorcontrib>Sonninen, Pirkko</creatorcontrib><creatorcontrib>Lehikoinen, Pertti</creatorcontrib><creatorcontrib>Sutinen, Eija</creatorcontrib><creatorcontrib>Valavaara, Ritva</creatorcontrib><creatorcontrib>Eronen, Esa</creatorcontrib><creatorcontrib>Norrgård, Stefan</creatorcontrib><creatorcontrib>Kulmala, Jarmo</creatorcontrib><creatorcontrib>Teräs, Mika</creatorcontrib><creatorcontrib>Minn, Heikki</creatorcontrib><title>Radiotherapy treatment planning and long-term follow-up with [ 11C]methionine PET in patients with low-grade astrocytoma</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose: To evaluate the feasibility of [
11C]-methionine positron emission tomography (MET PET) in radiotherapy (RT) treatment planning and long-term follow-up in patients with low-grade glioma.
Patients: Thirteen patients with low-grade astrocytoma and 1 with anaplastic astrocytoma underwent sequential MET PET and magnetic resonance imaging (MRI) before and 3, 6, 12, and 21–39 months after RT, respectively. Ten patients were studied after initial debulking surgery or biopsy and 4 in the recurrence phase.
Methods: A total of 58 PET scans were performed. After transmission scanning, a median dose of 425 MBq of MET was injected intravenously and emission data was acquired 20 min after injection for 20 min. The uptake of MET in tumor area was measured as standardized uptake value (SUV) and tumor-to-contralateral brain SUV ratios were generated to assess irradiation effects on tumor metabolism. Functional imaging with PET was compared with concurrent MRI in designing the RT planning volumes and in assessment of response to RT during a median follow-up time of 33 months.
Results: In 12 patients (86%), tumor area was clearly discernible in the baseline PET study. In the remaining 2 patients with a suspected residual tumor in MRI, PET showed only a diffuse uptake of MET interpreted as negative in the original tumor area. In the dose planning of RT, MET PET was helpful in outlining the gross tumor volume in 3 of 11 cases (27%), whereas PET findings either coincided with MRI (46%) or were less distinctive (27%) in other cases. In quantitative evaluation, patients with a low tumor SUV initially had significantly better prognosis than those with a high SUV. Tumor-to-contralateral brain uptake ratios of MET discriminated well patients remaining clinically stable from those who have since relapsed or died of disease.
Conclusion: Quantitative MET PET has prognostic value at the time of initial treatment planning of low-grade glioma. Some patients may benefit of RT volume definition with MET PET, which seems to disclose residual tumor better than MRI in selected cases. Stable or decreasing uptake of MET in tumor area after RT during follow-up seems to be a favorable sign.</description><subject>Adult</subject><subject>Astrocytoma - diagnostic imaging</subject><subject>Astrocytoma - metabolism</subject><subject>Astrocytoma - radiotherapy</subject><subject>Biological and medical sciences</subject><subject>Brain Neoplasms - diagnostic imaging</subject><subject>Brain Neoplasms - metabolism</subject><subject>Brain Neoplasms - radiotherapy</subject><subject>Brain tumors</subject><subject>Carbon Radioisotopes</subject><subject>Diseases of the nervous system</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methionine</subject><subject>Methionine - pharmacokinetics</subject><subject>Middle Aged</subject><subject>Nervous system</subject><subject>PET</subject><subject>Radionuclide investigations</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy planning</subject><subject>Radiotherapy Planning, Computer-Assisted - methods</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Tomography, Emission-Computed - methods</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkF2L1DAUhoMo7rj6E5RciOhF9SRp0_ZKZFjdhYUVXUEQCWlyOhNpm5pk3J1_b2Y7qHdenXPxvOfjIeQpg9cMmHzzGYSEQuT2JcArAAllAffIijV1W4iq-nqfrP4gJ-RRjD8AgLG6fEhOGLS8bGtYkdtP2jqfthj0vKcpoE4jTonOg54mN22oniwd_LQpEoaR9n4Y_E2xm-mNS1v6jTK2_j5i2jqfaaQfz66pm-isk8tT4kIdEpugLVIdU_Bmn_yoH5MHvR4iPjnWU_Ll_dn1-ry4vPpwsX53WRjRQipYK6G2EniFHLlpqoabsu20lYJZWzZlx6pail52FUeNiJ0VggMaWTMpZCNOyYtl7hz8zx3GpEYXDQ75P_S7qGrGpaybOoPVAprgYwzYqzm4UYe9YqAOytWdcnXwqQDUnXIFOffsuGDXjWj_SS2OM_D8COho9NAHPRkX_3JlBazkGXu7YJht_HIYVDRZokHrApqkrHf_ueQ3Cf-eGQ</recordid><startdate>20000801</startdate><enddate>20000801</enddate><creator>Nuutinen, Joanne</creator><creator>Sonninen, Pirkko</creator><creator>Lehikoinen, Pertti</creator><creator>Sutinen, Eija</creator><creator>Valavaara, Ritva</creator><creator>Eronen, Esa</creator><creator>Norrgård, Stefan</creator><creator>Kulmala, Jarmo</creator><creator>Teräs, Mika</creator><creator>Minn, Heikki</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000801</creationdate><title>Radiotherapy treatment planning and long-term follow-up with [ 11C]methionine PET in patients with low-grade astrocytoma</title><author>Nuutinen, Joanne ; Sonninen, Pirkko ; Lehikoinen, Pertti ; Sutinen, Eija ; Valavaara, Ritva ; Eronen, Esa ; Norrgård, Stefan ; Kulmala, Jarmo ; Teräs, Mika ; Minn, Heikki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-19607d6025e2e2c8582c49bad631dd484b15763f6b52eaeeebd3320ec67163683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Astrocytoma - diagnostic imaging</topic><topic>Astrocytoma - metabolism</topic><topic>Astrocytoma - radiotherapy</topic><topic>Biological and medical sciences</topic><topic>Brain Neoplasms - diagnostic imaging</topic><topic>Brain Neoplasms - metabolism</topic><topic>Brain Neoplasms - radiotherapy</topic><topic>Brain tumors</topic><topic>Carbon Radioisotopes</topic><topic>Diseases of the nervous system</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methionine</topic><topic>Methionine - pharmacokinetics</topic><topic>Middle Aged</topic><topic>Nervous system</topic><topic>PET</topic><topic>Radionuclide investigations</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy planning</topic><topic>Radiotherapy Planning, Computer-Assisted - methods</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Tomography, Emission-Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nuutinen, Joanne</creatorcontrib><creatorcontrib>Sonninen, Pirkko</creatorcontrib><creatorcontrib>Lehikoinen, Pertti</creatorcontrib><creatorcontrib>Sutinen, Eija</creatorcontrib><creatorcontrib>Valavaara, Ritva</creatorcontrib><creatorcontrib>Eronen, Esa</creatorcontrib><creatorcontrib>Norrgård, Stefan</creatorcontrib><creatorcontrib>Kulmala, Jarmo</creatorcontrib><creatorcontrib>Teräs, Mika</creatorcontrib><creatorcontrib>Minn, Heikki</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nuutinen, Joanne</au><au>Sonninen, Pirkko</au><au>Lehikoinen, Pertti</au><au>Sutinen, Eija</au><au>Valavaara, Ritva</au><au>Eronen, Esa</au><au>Norrgård, Stefan</au><au>Kulmala, Jarmo</au><au>Teräs, Mika</au><au>Minn, Heikki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiotherapy treatment planning and long-term follow-up with [ 11C]methionine PET in patients with low-grade astrocytoma</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2000-08-01</date><risdate>2000</risdate><volume>48</volume><issue>1</issue><spage>43</spage><epage>52</epage><pages>43-52</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose: To evaluate the feasibility of [
11C]-methionine positron emission tomography (MET PET) in radiotherapy (RT) treatment planning and long-term follow-up in patients with low-grade glioma.
Patients: Thirteen patients with low-grade astrocytoma and 1 with anaplastic astrocytoma underwent sequential MET PET and magnetic resonance imaging (MRI) before and 3, 6, 12, and 21–39 months after RT, respectively. Ten patients were studied after initial debulking surgery or biopsy and 4 in the recurrence phase.
Methods: A total of 58 PET scans were performed. After transmission scanning, a median dose of 425 MBq of MET was injected intravenously and emission data was acquired 20 min after injection for 20 min. The uptake of MET in tumor area was measured as standardized uptake value (SUV) and tumor-to-contralateral brain SUV ratios were generated to assess irradiation effects on tumor metabolism. Functional imaging with PET was compared with concurrent MRI in designing the RT planning volumes and in assessment of response to RT during a median follow-up time of 33 months.
Results: In 12 patients (86%), tumor area was clearly discernible in the baseline PET study. In the remaining 2 patients with a suspected residual tumor in MRI, PET showed only a diffuse uptake of MET interpreted as negative in the original tumor area. In the dose planning of RT, MET PET was helpful in outlining the gross tumor volume in 3 of 11 cases (27%), whereas PET findings either coincided with MRI (46%) or were less distinctive (27%) in other cases. In quantitative evaluation, patients with a low tumor SUV initially had significantly better prognosis than those with a high SUV. Tumor-to-contralateral brain uptake ratios of MET discriminated well patients remaining clinically stable from those who have since relapsed or died of disease.
Conclusion: Quantitative MET PET has prognostic value at the time of initial treatment planning of low-grade glioma. Some patients may benefit of RT volume definition with MET PET, which seems to disclose residual tumor better than MRI in selected cases. Stable or decreasing uptake of MET in tumor area after RT during follow-up seems to be a favorable sign.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10924970</pmid><doi>10.1016/S0360-3016(00)00604-0</doi><tpages>10</tpages></addata></record> |
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| ispartof | International journal of radiation oncology, biology, physics, 2000-08, Vol.48 (1), p.43-52 |
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| subjects | Adult Astrocytoma - diagnostic imaging Astrocytoma - metabolism Astrocytoma - radiotherapy Biological and medical sciences Brain Neoplasms - diagnostic imaging Brain Neoplasms - metabolism Brain Neoplasms - radiotherapy Brain tumors Carbon Radioisotopes Diseases of the nervous system Feasibility Studies Female Follow-Up Studies Humans Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging Male Medical sciences Methionine Methionine - pharmacokinetics Middle Aged Nervous system PET Radionuclide investigations Radiotherapy Dosage Radiotherapy planning Radiotherapy Planning, Computer-Assisted - methods Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Tomography, Emission-Computed - methods |
| title | Radiotherapy treatment planning and long-term follow-up with [ 11C]methionine PET in patients with low-grade astrocytoma |
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