title: C-11 choline versus F-18 fluorodeoxyglucose for imaging meningiomas: an initial experience.
abstract: OBJECTIVE
  Positron emission tomography/computed tomography (PET/CT) with C-11 choline has been used for staging, restaging, and follow-up of various tumors, whereas its role for imaging meningiomas has only been preliminarily explored. The aim of this study was to compare C-11 choline and F-18 fluorodeoxyglucose (F-18 FDG) uptake in meningiomas and relate these findings to the histopathological analysis.
  
  
  METHODS
  Two sequential three-dimensional PET/CT scans with 370 MBq (10 mCi) of C-11 choline and 370 MBq (10 mCi) of F-18 FDG were performed 2 hours apart in 7 patients with histologically confirmed meningiomas. Five patients had WHO grade I and 2 had WHO grade II meningioma. For each scan, two-dimensional regions of interest were drawn on tumor boundaries and on the contralateral side on CT images and copied to the corresponding PET images. SUVmax and tumor-to-background ratio were calculated.
  
  
  RESULTS
  Relative to the contralateral side, C-11 choline uptake was increased in all meningiomas, whereas F-18 FDG uptake was decreased in 6 patients and increased in 1 of the 2 patients with grade II meningiomas. In the whole group, SUVmax of C-11 choline and F-18 FDG were 3.6 +/- 1.3 and 5.7 +/- 1.3, respectively. The tumor-to-background ratio for C-11 choline was much higher than that for F-18 FDG (5.3 +/- 0.8 vs. 0.9 +/- 0.2, respectively) (P < 0.001). The uptake of C-11 choline was higher in patients with grade II than in grade I meningiomas.
  
  
  CONCLUSIONS
  These preliminary results suggest that C-11 choline may better image meningiomas in comparison with F-18 FDG. Clinical applications of C-11 choline PET/CT for grading and follow-up of meningiomas need to be assessed in further studies.
authors.affiliation: Center for Molecular Bioimaging, University of Milano-Bicocca, Milan, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Giovacchini
authors.forename: Federico
authors.initials: F
authors.lastname: Fallanca
authors.forename: Claudio
authors.initials: C
authors.lastname: Landoni
authors.forename: Luigi
authors.initials: L
authors.lastname: Gianolli
authors.forename: Piero
authors.initials: P
authors.lastname: Picozzi
authors.forename: Luca
authors.initials: L
authors.lastname: Attuati
authors.forename: Mariarosa
authors.initials: M
authors.lastname: Terreni
authors.forename: Maria
authors.initials: M
authors.lastname: Picchio
authors.forename: Cristina
authors.initials: C
authors.lastname: Messa
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Fazio
mesh_terms: D000368:Aged; D002250:Carbon Radioisotopes / Q000737:chemistry; D002794:Choline / Q000737:chemistry* / Q000493:pharmacokinetics; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008579:Meningioma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D002250:Carbon Radioisotopes; D019788:Fluorodeoxyglucose F18; D002794:Choline