Abstract
To compare the contribution of the tracers [C-11]methionine (met) and [f-18]-fluorodeoxyglucose (fdg) in positron emission tomography (pet)-guided stereotactic brain biopsy. Forty-five patients underwent combined Met-Pet-, fdg-pet- associated with computerized tomography (ct)- or magnetic resonance (mr)-guided stereotactic biopsy. The patients presented a lesion that was in close relationship with the cortical or subcortical grey matter. Met-pet and fdg-pet images were analyzed to determine which tracer offers the best information to guide at least one stereotactic biopsy trajectory. Histological diagnosis was obtained in all patients (39 tumors / 6 non tumor lesions). All tumors were biopsied under pet-guidance. Fdg was used for target definition when tumor uptake was higher than in the grey matter (18 tumors). Met was used for target definition when fdg uptake was absent or equivalent to that of the grey matter (21 tumors). Parallel review of all histological and imaging data showed that all tumors had an area of abnormal Met uptake and 33 of them had an abnormal fdg uptake. All 6 non tumor lesions had no Met uptake and were biopsied under ct- or mr-guidance only. All tumor trajectories had an area of abnormal met uptake; all non-diagnostic trajectories in tumors had no abnormal met uptake. When fdg shows limitations for target selection, met is a good alternative, because of its high specificity in tumors. Moreover, in the perspective of a single-tracer procedure and regardless of fdg uptake, met is a better choice for the pet-guidance of neurosurgical procedures.
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Pirotte, B. (2011). Combined Use of [F-18]Fluorodeoxyglucose and [C-11]Methionine in 45 PET-Guided Stereotactic Brain Biopsies. In: Hayat, M. (eds) Methods of Cancer Diagnosis, Therapy, and Prognosis. Methods of Cancer Diagnosis, Therapy and Prognosis, vol 8. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-8665-5_16
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