title: Use of positron emission tomography (PET) in stereotactic conditions for brain biopsy.
abstract: In order to take advantage of the metabolic information provided by positron emission tomography (PET) in cases of brain tumour, we have developed a technique to integrate PET images routinely in the planning of stereotactic brain biopsy. We used stereotactic PET with [18F]-labelled fluorodeoxyglucose (PET-FDG) in 38 patients undergoing brain biopsy. To evaluate the contribution of PET-FDG in guiding brain biopsy, we analyzed the diagnosis provided by the 78 stereotactic trajectories obtained in these patients. We found that stereotactic PET-FDG seemed to provide more information in cases of anaplastic astrocytomas and glioblastomas than in low-grade gliomas. Our results also show that biopsy trajectories performed in areas where increased FDG uptake is found within the lesion boundaries always provide interpretable specimens; this was not the case for trajectories guided by CT only. Therefore, the routine integration PET-FDG in the planning of stereotactic brain biopsy may lead to a reduction in sampling. Recently, we also tested consecutive stereotactic PET with [11C]-labelled methionine (PET-Met) and PET-FDG. This technique allowed us to compare accurately the tumoural glucose metabolism and protein synthesis. Our results suggest that stereotactic PET may increase the diagnostic yield of brain biopsy and may improve the understanding of PET in neuro-oncology.
authors.affiliation: Department of Neurosurgery, PET/Biomedical Cyclotron Unit, Université Libre de Bruxelles, Erasme Hospital, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Pirotte
authors.forename: S
authors.initials: S
authors.lastname: Goldman
authors.forename: L M
authors.initials: LM
authors.lastname: Bidaut
authors.forename: A
authors.initials: A
authors.lastname: Luxen
authors.forename: E
authors.initials: E
authors.lastname: Stanus
authors.forename: J M
authors.initials: JM
authors.lastname: Brucher
authors.forename: D
authors.initials: D
authors.lastname: Balériaux
authors.forename: J
authors.initials: J
authors.lastname: Brotchi
authors.forename: M
authors.initials: M
authors.lastname: Levivier
mesh_terms: D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000000981:diagnostic imaging / Q000473:pathology; D001706:Biopsy / Q000295:instrumentation*; D001786:Blood Glucose / Q000378:metabolism*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D003847:Deoxyglucose / Q000031:analogs & derivatives / Q000378:metabolism; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000473:pathology; D005910:Glioma / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008715:Methionine / Q000378:metabolism; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D014055:Tomography, Emission-Computed / Q000295:instrumentation*
chemical_list: D001786:Blood Glucose; D009363:Neoplasm Proteins; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; D008715:Methionine