Carbon-11-methionine PET in focal cortical dysplasia: a comparison with fluorine-18-FDG PET and technetium-99m-ECD SPECT.
Focal cortical dysplasia is one of the known neuronal migration disorders and has recently been recognized as a cause of intractable epilepsy. In this study, we assessed the 11C-methionine (MET) uptake in focal cortical dysplasia by PET, and then compared the results with that of 18F-fluoro-2-deoxy-D-glucose (FDG) PET and 99mTc-ethyl cysteinate dimer (ECD) SPECT.


METHODS
Four patients (3 men, 1 woman; age range 16-68 yr) were examined by PET and SPECT for a presurgical examination of medically intractable seizures. In all 4 patients, 11C-MET PET was performed for 15 min, started 15 min after the administration of 511-662 MBq MET. In 3 of 4 patients, FDG PET was performed for 15 min, and started 20 min after the administration of 185-370 MBq FDG. In all 4 patients, the cerebral blood flow was also evaluated by 99mTc-ECD SPECT for 15 min after the administration of 600 MBq ECD.


RESULTS
In MET PET, all 4 lesions were visually recognized to have high MET uptake areas. The MET uptake of the lesions was 1.44 +/- 0.30 for the standardized uptake value (SUV) (ranging from 0.99-1.61). In FDG PET, 2 lesions were demonstrated to have low uptake areas (3.82 in SUV) while 1 had an ictal high uptake (4.74 in SUV). In ECD SPECT, 1 lesion demonstrated hypoperfusion and 1 ictal hyperperfusion while 2 showed no abnormalities. All 4 patients underwent a cortical resection and the microscopic examinations were consistent with those of focal cortical dysplasia but no evidence of a tumor was found.


CONCLUSIONS
MET PET is useful for identifying focal cortical dysplasia as a high uptake area.
Sasaki
M
M
Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Kuwabara
Y
Y
Yoshida
T
T
Fukumura
T
T
Morioka
T
T
Nishio
S
S
Fukui
M
M
Masuda
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000473:pathology; D002560:Cerebrovascular Circulation; D003545:Cysteine / Q000031:analogs & derivatives; D004827:Epilepsy / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008715:Methionine; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012640:Seizures / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C086242:carbon-11 methionine; D008715:Methionine; C059659:technetium Tc 99m bicisate; D003545:Cysteine