title: Detection of histological anaplasia in gliomas with oligodendroglial components using positron emission tomography with (18)F-FDG and (11)C-methionine: report of two cases.
abstract: Gliomas are regionally heterogeneous tumors. Positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) and (11)C-methionine (MET) evaluates the heterogeneity of histological malignancy within the tumor. We present two patients with oligodendrocytic tumors that showed discrepancies in the highest uptake areas with these two tracers. PET studies with MET and FDG were performed on the same day, 2 weeks before surgery. In both cases, biopsy specimens were separately obtained from the highest MET and FDG uptake areas guided by intraoperative neuronavigation. Histological examinations demonstrated that the specimens from the highest MET uptake area revealed low-grade oligoastrocytoma or oligodendroglioma, whereas histological anaplasias were contained in the specimens from the highest FDG uptake area. With gliomas with oligodendroglial components, the MET uptake ratio does not always correspond to histological anaplasia, which can be detected only by FDG PET. Sole application of MET PET for preoperative evaluation may lead to misunderstanding of histological heterogeneity in gliomas, especially those with oligodendroglial components. FDG and MET tracers play complementary roles in preoperative evaluation of gliomas.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, North-15, West-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirata
authors.forename: Tohru
authors.initials: T
authors.lastname: Shiga
authors.forename: Shinya
authors.initials: S
authors.lastname: Tanaka
authors.forename: Junichi
authors.initials: J
authors.lastname: Murata
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Terasaka
mesh_terms: D000328:Adult; D000708:Anaplasia / Q000000981:diagnostic imaging / Q000209:etiology; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D002250:Carbon Radioisotopes; D005260:Female; D019788:Fluorodeoxyglucose F18; D005910:Glioma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008715:Methionine; D009836:Oligodendroglia / Q000473:pathology*; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D002250:Carbon Radioisotopes; D019788:Fluorodeoxyglucose F18; D008715:Methionine