title: Use of fractional anisotropy for determination of the cut-off value in 11C-methionine positron emission tomography for glioma.
abstract: Multimodal imaging is one of the necessary steps in the treatment of malignant brain tumors, and use of magnetic resonance imaging (MRI) and positron emission tomography (PET) are the current gold standard technique for the morphological and biological assessment of malignant brain tumors. In addition, fractional anisotropy (FA) obtained from diffusion tensor imaging (DTI) and 11C-methionine PET are useful to determine the tumor border at the tumor and white matter interface. Although there is no question of their value, a universally accepted cut-off value to discriminate normal and abnormal tissue has not been established. In this study we attempted to calculate and determine the cut-off values in FA and 11C-methionine PET that will allow delineation of the tumor border at the tumor and white matter interface by combining these two modalities. We were able to determine individual cut-off values for 11 patients, and then found an average cut-off value in the T/N ratio of 11C-methionine PET of 1.27 and in FA of 0.26, values similar to those previously confirmed by histological study. Moreover, reconstructing images delineating the tumor border was possible combining these two imaging modalities. We propose that the combined analysis of DTI and 11C-methionine PET has the potential to improve tumor border imaging in glioma patients, providing important information for establishing neurosurgical strategies.
authors.affiliation: Department of Neurosurgery, Osaka University Gradate School of Medicine, 2-2 Yamadoka, Suita, Osaka 565-0871, Japan. m-kinoshita@nsurg.med.osaka-u.ac.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Naoya
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Tetsu
authors.initials: T
authors.lastname: Goto
authors.forename: Takufumi
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Okita
authors.forename: Naoki
authors.initials: N
authors.lastname: Kagawa
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kishima
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Norihiko
authors.initials: N
authors.lastname: Fujita
authors.forename: Eku
authors.initials: E
authors.lastname: Shimosegawa
authors.forename: Jun
authors.initials: J
authors.lastname: Hatazawa
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D016880:Anisotropy; D001932:Brain Neoplasms / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008715:Methionine; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique
chemical_list: D019275:Radiopharmaceuticals; C086242:carbon-11 methionine; D008715:Methionine