title: The demonstration of extension of high-grade glioma beyond magnetic resonance imaging defined edema by the use of (11) C-methionine positron emission tomography.
abstract: The use of magnetic resonance imaging (MRI) is the current standard for the delineation of target volumes for high-grade gliomas (HGG). While the peritumoral edema as per T2-weighted (T2W) imaging is utilized as basis to delineate the initial borders of the clinical target volume (CTV), those areas enhancing on T1-weighted (T1W) images with gadolinium contrast (T1-Gd) are considered for treatment with further boost. However, recent data has emerged concerning the use of positron emission tomography (PET) with 11 C-methionine, which seemingly provides additional information beyond MRI. We present the case of a gentleman with an inoperable HGG which was imaged with 11 C-methionine-PET ( 11 C-MET-PET)/CT as well as MRI as part of the radiotherapy treatment planning (RTP) process. The differences noted between the MRI and the PET defined volumes are presented. This being a patient who was not operated, the potentially confounding issue of surgery-induced PET-avidity is absent.
authors: Sridhar P
authors: SP
authors: Susheela
authors: Department of Radiation Oncology, Health Care Global-Bangalore Institute of Oncology, Karnataka, India.
authors: Swaroop
authors: S
authors: Revannasiddaiah
authors: N
authors: N
authors: Madhusudhan
authors: Mahesh
authors: M
authors: Bijjawara
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy; D059248:Chemoradiotherapy; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004487:Edema / Q000473:pathology; D005910:Glioma / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008715:Methionine; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011859:Radiography; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; C086242:carbon-11 methionine; D003606:Dacarbazine; D008715:Methionine; D000077204:Temozolomide