[Metabolic studies of gliomas with positron emission tomography and phosphorus 31 MR spectroscopy in diagnosis and treatment planning].
Glioma are often histologically heterogenous. As many of these tumors are not removable in toto, due to their localisation, the most malignant part of the tumor may be missed and information for optimum therapeutic management is incomplete. Furthermore, low grade gliomas tend to become more malignant in their development; additional surgical intervention is often not possible. Non-invasive measurement of tumor glucose metabolism with (F-18)-2-fluoro-2-deoxyglucose (FDG) and positron-emission-tomography (PET) may be used to evaluate tumor malignancy. Malignant gliomas (astrocytoma III degree and glioblastoma) frequently showed increased peak metabolic rates (in comparison with normal white matter) and uncoupling of FDG transport and phosphorylation. Preliminary experiences with image-guided localized phosphorus-31 MR spectroscopy (P-31 MRS) demonstrated a decrease of phosphodiesters in malignant gliomas, whereas the phosphomonoesters showed an increase in several cases. The phosphocreatine peak was often reduced. A more active therapy of low grade gliomas might be indicated when signs of hypermetabolism in FDG-PET and alteration of energy-rich phosphates or membrane-phosphates in P-31 MRS are found.
Jeske
J
J
Universitäts Nervenklinik, Köln.
Herholz
K
K
Heindel
W
W
Heiss
W D
WD
D000255:Adenosine Triphosphate / Q000378:metabolism; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D003847:Deoxyglucose / Q000378:metabolism; D004734:Energy Metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D005910:Glioma / Q000175:diagnosis / Q000378:metabolism*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D009682:Magnetic Resonance Spectroscopy; D010725:Phosphocreatine / Q000378:metabolism; D010758:Phosphorus / Q000378:metabolism*; D014055:Tomography, Emission-Computed
D001786:Blood Glucose; D010725:Phosphocreatine; D019788:Fluorodeoxyglucose F18; D010758:Phosphorus; D000255:Adenosine Triphosphate; D003847:Deoxyglucose
Stoffwechseluntersuchungen an Gliomen mit der Positronen-Emissions-Tomographie und der Phosphor-31-MR-Spektroskopie in Diagnostik und Therapieplanung.