title: A study of vestibular schwannomas using positron emission tomography and monoclonal antibody Ki-67.
abstract: OBJECTIVE
  This study aimed to evaluate the role of positron emission tomography (PET) as an in vivo determinant of tumor aggressiveness and growth.
  
  
  METHODS
  The study design was a prospective pilot study.
  
  
  METHODS
  Positron emission tomography was performed at the Clarke Institute of Psychiatry. All patients were treated at the Sunnybrook Health Science Centre. Both institutions are affiliated with the University of Toronto, Toronto, Canada.
  
  
  METHODS
  The study consisted of five consecutive patients with vestibular schwannomas with tumor size of 1 cm or larger within the cerebellopontine angle. One was a recurrent tumor and four were primary tumors.
  
  
  METHODS
  Preoperative PET studies were conducted using 18-fluorodeoxyglucose (FDG) as a radionuclide tracer to measure glucose metabolism within tumors. Tumors were processed and immunostained against Ki-67 nuclear antigen; their proliferative potentials were quantified based on immunoreactivity of tumor cells.
  
  
  METHODS
  Tumor metabolic activity on PET was compared with that of contralateral cerebellum to arrive at an FDG index. This number was compared with clinical parameters and Ki-67 reactivity.
  
  
  RESULTS
  On PET, all tumors showed less metabolic activity than the cerebellum. The FDG uptake varied greatly between tumors independent of clinical parameters. All the tumors had a low proliferative index (<5%) with immunohistochemistry; there were quite a bit of intralesional variations in proliferative activities.
  
  
  CONCLUSIONS
  Large tumor size and recurrent disease did not correlate well with increased FDG uptake on PET. Similarly, they did not show increased cellular activities as expressed by Ki-67 immunostaining.
authors.affiliation: Department of Otolaryngology, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
authors.forename: J M
authors.initials: JM
authors.lastname: Chen
authors.forename: S
authors.initials: S
authors.lastname: Houle
authors.forename: L C
authors.initials: LC
authors.lastname: Ang
authors.forename: D
authors.initials: D
authors.lastname: Commins
authors.forename: K
authors.initials: K
authors.lastname: Allan
authors.forename: J
authors.initials: J
authors.lastname: Nedzelski
authors.forename: D
authors.initials: D
authors.lastname: Rowed
mesh_terms: D000328:Adult; D000368:Aged; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D008940:Mitotic Index; D009464:Neuroma, Acoustic / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism* / Q000601:surgery; D010865:Pilot Projects; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed
chemical_list: D019394:Ki-67 Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18