11C methionine positron emission tomography for meningioma

• Revealing subependymal giant cell astrocytoma with multimodal positron emission tomography: illustrative cases
• (11)C-Methionine uptake in meningiomas after stereotactic radiotherapy
• Meningioma grading based on positron emission tomography: A systematic review and meta-analysis
• Study on intracranial meningioma using PET ligand investigation during follow-up over years (SIMPLIFY)
• Correlation of (18)F-FDG and (11)C-methionine uptake on PET/CT with Ki-67 immunohistochemistry in newly diagnosed intracranial meningiomas
• 11C-Methionine Positron Emission Tomography/Computed Tomography Versus 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Evaluation of Residual or Recurrent World Health Organization Grades II and III Meningioma After Treatment
• Diagnostic accuracy of ¹¹C-methionine PET in detecting neuropathologically confirmed recurrent brain tumor after radiation therapy
• Analysis of progression and recurrence of meningioma using (11)C-methionine PET

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Mitamura et al., evaluated the uptake of 2-deoxy-18F-Fludeoxyglucose (FDG) and L-[methyl-11C]-methionine (MET) in patients with newly diagnosed intracranial meningiomas and correlated the results with tumor proliferation.

Data from 22 patients with newly diagnosed intracranial meningioma (12 grade I and 10 grade II) who underwent both FDG and MET brain PET/CT studies were retrospectively analyzed. The PET images were evaluated by a qualitative method and semiquantitative analysis using standardized uptake value (SUV) (SUVmax and SUVpeak) and tumor-to-reference tissue ratio (Tmax/N ratio and Tpeak/N ratio). Proliferative activity as indicated by the Ki-67 index was estimated in tissue specimens.

MET PET/CT showed a higher detection rate of meningioma than did FDG PET/CT (100 vs. 46%, respectively). The Tmax/N ratio and Tpeak/N ratio on MET PET/CT were significantly higher than those on FDG PET/CT (p < 0.001 and p < 0.001, respectively). There was a significant difference between grades I and II with respect to FDG SUVmax (p = 0.003), FDG SUVpeak (p = 0.003), FDG Tmax/N ratio (p = 0.02), FDG Tpeak/N ratio (p = 0.006), MET SUVmax (p = 0.002), MET SUVpeak (p = 0.002), MET Tmax/N ratio (p = 0.002), and MET Tpeak/N ratio (p = 0.002). There was a significant correlation between Ki-67 index and FDG PET/CT for SUVmax (p = 0.02), SUVpeak (p = 0.005), and Tpeak/N ratio (p = 0.05) and between Ki-67 index and MET PET/CT for SUVmax (p = 0.004), SUVpeak (p = 0.007), Tmax/N ratio (p = 0.002), and Tpeak/N ratio (p = 0.004).

MET PET/CT showed a high sensitivity compared with FDG PET/CT for detection of newly diagnosed WHO grades I and II intracranial meningiomas. Both FDG and MET uptake were found to be useful for evaluating tumor proliferation in meningiomas ¹⁾.