SpringerLink
Log in

Semi-quantification of methionine uptake and flair signal for the evaluation of chemotherapy in low-grade oligodendroglioma

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

11C-Methionine (MET) is a useful positron emission tomography (PET) tracer for the evaluation of low-grade gliomas. Among these tumors, a high percentage of low-grade oligodendrogliomas (ODG) are sensitive to chemotherapy with procarbazine, CCNU, and vincristine (PCV). We aimed at: (1) objectively assessing ODG response to PCV by a metabolic index (the Activity Volume Index or AVI) generated from an automated semi-quantification of PET with MET (PET-MET); (2) comparing AVI and quantitative magnetic resonance imaging (MRI) measurements of response to PCV.

Methods: seven patients with ODG were followed for a period of 19.9±6.6months after the completion of PCV chemotherapy. Regions of interest (ROI) were generated by covering all voxels with count values above a threshold level set at 120% of the mean cerebellar activity. On each slice, ROI volume and mean count values were calculated. AVI was calculated as the sum over all ROI of tumor volume×(tumor mean count/cerebellum count). Tumor volume measurements on MRI, were based on signal abnormalities visually detected on fluid-attenuated inversion recovery (FLAIR) sequences.

Results: PCV therapy was associated with a drastic decrease in AVI (mean±SD, cm3): AVI post-PCV=0.80±1.45 vs. AVI prior PCV=12.94±11.46 (P=0.03). Likewise, we observed a decrease in tumor volume estimated from the FLAIR signal (31.37±11.99 post-PCV vs. 67.95±39.96 prior PCV, P=0.03) although AVI decrease after PCV was significantly more pronounced (P=0.015).

Conclusion: This study, based on limited number of patients and follow-up period indicates that AVI may be a sensitive and observer-independent method applicable to the assessment of ODG responsiveness to PCV treatment and may offer a major added value to both clinical assessment and MRI evaluation of chemotherapeutic outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • VW Stieber (2001) ArticleTitleLow-grade gliomas Curr Treat Options Oncol 2 495–506

    Google Scholar 

  • JG Cairncross DR Macdonald (1991) ArticleTitleChemotherapy for oligodendroglioma. Progress report Arch Neurol 48 225–227

    Google Scholar 

  • J Glass FH Hochberg ML Gruber DN Louis D Smith B Rattner (1992) ArticleTitleThe treatment of oligodendrogliomas and mixed oligodendroglioma-astrocytomas with PCV chemotherapy J Neurosurg 76 741–745 Occurrence Handle1:STN:280:By2B38notFM%3D Occurrence Handle1564535

    CAS  PubMed  Google Scholar 

  • WP Mason GS Krol LM DeAngelis (1996) ArticleTitleLow-grade oligodendroglioma responds to chemotherapy Neurology 46 203–207

    Google Scholar 

  • MJ Bent Particlevan den JM Kros JJ Heimans LC Pronk CJ Groeningen Particlevan HG Krouwer MJ Taphoorn BA Zonnenberg CC Tijssen A Twijnstra CJ Punt W Boogerd (1998) ArticleTitleResponse rate and prognostic factors of recurrent oligodendroglioma treated with procarbazine, CCNU, and vincristine chemotherapy. Dutch Neuro-oncology Group Neurology 51 1140–1145 Occurrence Handle9781544

    PubMed  Google Scholar 

  • JC Buckner D Gesme ParticleJr JR O’Fallon JE Hammack S Stafford PD Brown R Hawkins BW Scheithauer BJ Erickson R Levitt EG Shaw R Jenkins (2003) ArticleTitlePhase II trial of procarbazine, lomustine, and vincristine as initial therapy for patients with low-grade oligodendroglioma or oligoastrocytoma: efficacy and associations with chromosomal abnormalities J Clin Oncol 21 251–255 Occurrence Handle10.1200/JCO.2003.06.023 Occurrence Handle12525516

    Article  PubMed  Google Scholar 

  • S Diabira MC Rousselet E Gamelin P Soulier E Jadaud P Menei (2001) ArticleTitlePCV chemotherapy for oligodendroglioma: response analyzed on T2 weighted-MRI J Neurooncol 55 45–50

    Google Scholar 

  • C Daumas-Duport P Varlet ML Tucker F Beuvon P Cervera JP Chodkiewicz (1997) ArticleTitleOligodendrogliomas. Part I: Patterns of growth, histological diagnosis, clinical and imaging correlations: a study of 153 cases J Neurooncol 34 37–59

    Google Scholar 

  • JN Scott PM Brasher RJ Sevick NB Rewcastle PA Forsyth (2002) ArticleTitleHow often are nonenhancing supratentorial gliomas malignant. A population study Neurology 59 947–949 Occurrence Handle1:STN:280:DC%2BD38vovVWlsQ%3D%3D Occurrence Handle12297589

    CAS  PubMed  Google Scholar 

  • PJ Kelly (1993) ArticleTitleComputed tomography and histologic limits in glial neoplasms: tumor types and selection for volumetric resection Surg Neurol 39 458–465

    Google Scholar 

  • K Herholz T Holzer B Bauer R Schroder J Voges RI Ernestus G Mendoza G Weber-Luxenburger J Lottgen A Thiel K Wienhard WD Heiss (1998) ArticleTitle11C-methionine PET for differential diagnosis of low-grade gliomas Neurology 50 1316–1322 Occurrence Handle1:STN:280:DyaK1c3lsFCiuw%3D%3D Occurrence Handle9595980

    CAS  PubMed  Google Scholar 

  • K Ericson A Lilja M Bergstrom VP Collins L Eriksson E Ehrin H Holst Particlevon H Lundqvist BB Langsrom M Mosskin (1985) ArticleTitlePositron emission tomography with ([11C]methyl)-L-methionine, [11C]D-glucose, and [68Ga]EDTA in supratentorial tumors J Comput Assist Tomogr 9 683–689

    Google Scholar 

  • T Ogawa A Inugami J Hatazawa I Kanno M Murakami N Yasui K Mineura K Uemura (1996) ArticleTitleClinical positron emission tomography for brain tumors: comparison of fludeoxyglucose F 18 and L-methyl-11C-methionine Am J Neuroradiol 17 345–353 Occurrence Handle1:STN:280:ByiD1M3lvFU%3D Occurrence Handle8938309

    CAS  PubMed  Google Scholar 

  • JM Derlon MC Petit-Taboue F Chapon V Beaudouin MH Noel C Creveuil P Courtheoux JP Houtteville (1997) ArticleTitleThe in vivo metabolic pattern of low-grade brain gliomas: a positron emission tomographic study using 18F-fluorodeoxyglucose and 11C-L-methylmethionine Neurosurgery 40 276–287 Occurrence Handle1:STN:280:ByiC28%2FjsF0%3D Occurrence Handle9007859

    CAS  PubMed  Google Scholar 

  • S Goldman M Levivier B Pirotte JM Brucher D Wikler P Damhaut S Dethy J Brotchi J Hildebrand (1997) ArticleTitleRegional methionine and glucose uptake in high-grade gliomas: a comparative study on PET-guided stereotactic biopsy J Nucl Med 38 1459–1462 Occurrence Handle1:CAS:528:DyaK2sXmt1Sksro%3D Occurrence Handle9293808

    CAS  PubMed  Google Scholar 

  • N Massager (2002) ArticleTitle[Usefulness of PET scan guidance in stereotaxic radioneurosurgery using a gamma knife] Bull Mem Acad R Med Belg 157 355–362

    Google Scholar 

  • O Witte ParticleDe I Goldberg D Wikler S Rorive P Damhaut M Monclus I Salmon J Brotchi S Goldman (2001) ArticleTitlePositron emission tomography with injection of methionine as a prognostic factor in glioma J Neurosurg 95 746–750 Occurrence Handle11702862

    PubMed  Google Scholar 

  • P Bustany M Chatel JM Derlon F Darcel P Sgouropoulos F Soussaline A Syrota (1986) ArticleTitleBrain tumor protein synthesis and histological grades: a study by positron emission tomography (PET) with C11-L-Methionine J Neurooncol 3 397–404

    Google Scholar 

  • J Voges K Herholz T Holzer M Wurker B Bauer U Pietrzyk H Treuer R Schroder V Sturm WD Heiss (1997) ArticleTitle11C-methionine and 18F-2-fluorodeoxyglucose positron emission tomography: a tool for diagnosis of cerebral glioma and monitoring after brachytherapy with 125I seeds Stereotact Funct Neurosurg 69 129–135 Occurrence Handle1:STN:280:DyaK1cznslKhtg%3D%3D Occurrence Handle9711745

    CAS  PubMed  Google Scholar 

  • B Kaschten A Stevenaert B Sadzot M Deprez C Degueldre G Del Fiore A Luxen M Reznik (1998) ArticleTitlePreoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine J Nucl Med 39 778–785 Occurrence Handle1:CAS:528:DyaK1cXjsVShtbY%3D Occurrence Handle9591574

    CAS  PubMed  Google Scholar 

  • D Comar J Cartron M Maziere C Marazano (1976) ArticleTitleLabelling and metabolism of methionine-methyl-11 C Eur J Nucl Med 1 11–4

    Google Scholar 

  • M Bynevelt J Britton H Seymour E MacSweeney N Thomas K Sandhu (2001) ArticleTitleFLAIR imaging in the follow-up of low-grade gliomas: time to dispense with the dual-echo Neuroradiology 43 129–133 Occurrence Handle10.1007/s002340000389 Occurrence Handle1:STN:280:DC%2BD3MzlsVagsw%3D%3D Occurrence Handle11326557

    Article  CAS  PubMed  Google Scholar 

  • J Reifenberger G Reifenberger L Liu CD James W Wechsler VP Collins (1994) ArticleTitleMolecular genetic analysis of oligodendroglial tumors shows preferential allelic deletions on 19q and 1p Am J Pathol 145 1175–1190 Occurrence Handle1:CAS:528:DyaK2M**t1Wksb8%3D Occurrence Handle7977648

    CAS  PubMed  Google Scholar 

  • N Hashimoto M Murakami Y Takahashi M Fujimoto J Inazawa K Mineura (2003) ArticleTitleCorrelation between genetic alteration and long-term clinical outcome of patients with oligodendroglial tumors, with identification of a consistent region of deletion on chromosome arm 1p Cancer 97 2254–2261 Occurrence Handle10.1002/cncr.11322 Occurrence Handle1:CAS:528:DC%2BD3sXjvVSjs7Y%3D Occurrence Handle12712480

    Article  CAS  PubMed  Google Scholar 

  • JS Smith A Perry TJ Borell HK Lee J O’Fallon SM Hosek D Kimmel A Yates PC Burger BW Scheithauer RB Jenkins (2000) ArticleTitleAlterations of chromosome arms 1p and 19q as predictors of survival in oligodendrogliomas, astrocytomas, and mixed oligoastrocytomas J Clin Oncol 18 636–645 Occurrence Handle1:STN:280:DC%2BD3c7itVyrsA%3D%3D Occurrence Handle10653879

    CAS  PubMed  Google Scholar 

  • JG Cairncross K Ueki MC Zlatescu DK Lisle DM Finkelstein RR Hammond JS Silver PC Stark DR Macdonald Y Ino DA Ramsay DN Louis (1998) ArticleTitleSpecific genetic predictors of chemotherapeutic response and survival in patients with anaplastic oligodendrogliomas J Natl Cancer Inst 90 1473–1479 Occurrence Handle10.1093/jnci/90.19.1473 Occurrence Handle1:STN:280:DyaK1cvkslejug%3D%3D Occurrence Handle9776413

    Article  CAS  PubMed  Google Scholar 

  • T Brismar S Anderson VP Collins (1995) ArticleTitleMechanism of high K+ and Tl+ uptake in cultured human glioma cells Cell Mol Neurobiol 15 351–360

    Google Scholar 

  • MF Roesdi TJ Postma OS Hoekstra CJ Groeningen Particlevan JG Wolbers JJ Heimans (1998) ArticleTitleThallium-201 SPECT as response parameter for PCV chemotherapy in recurrent glioma J Neurooncol 40 251–255

    Google Scholar 

  • K Herholz LW Kracht WD Heiss (2003) ArticleTitleMonitoring the effect of chemotherapy in a mixed glioma by C-11-methionine PET J Neuroimag 13 269–271

    Google Scholar 

  • M Levivier D Wikler ParticleJr N Massager P David D Devriendt J Lorenzoni B Pirotte F Desmedt S Simon ParticleJr S Goldman P Houtte ParticleVan J Brotchi (2002) ArticleTitleThe integration of metabolic imaging in stereotactic procedures including radiosurgery: a review J Neurosurg 97 542–550

    Google Scholar 

  • WM Pardridge (1983) ArticleTitleBrain metabolism: a perspective from the blood-brain barrier Physiol Rev 63 1481–535

    Google Scholar 

  • KJ Langen H Muhlensiepen M Holschbach H Hautzel P Jansen HH Coenen (2000) ArticleTitleTransport mechanisms of 3-[123I]iodo-alpha-methyl-L-tyrosine in a human glioma cell line: comparison with [3H]methyl]-L-methionine J Nucl Med 41 1250–1255 Occurrence Handle1:CAS:528:DC%2BD3cXlsFWjs7Y%3D Occurrence Handle10914918

    CAS  PubMed  Google Scholar 

  • K Tsuchiya Y Mizutani J Hachiya (1996) ArticleTitlePreliminary evaluation of fluid-attenuated inversion-recovery MR in the diagnosis of intracranial tumors Am J Neuroradiol 17 1081–1086 Occurrence Handle1:STN:280:BymA1cvgtVA%3D Occurrence Handle8791919

    CAS  PubMed  Google Scholar 

  • M Essig R Metzner M Bonsanto H Hawighorst J Debus V Tronnier MV Knopp G Kaick Particlevan (2001) ArticleTitlePostoperative fluid-attenuated inversion recovery MR imaging of cerebral gliomas: initial results Eur Radiol 11 2004–2010 Occurrence Handle10.1007/s003300100856 Occurrence Handle1:STN:280:DC%2BD3MnkvValtQ%3D%3D Occurrence Handle11702135

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine and PET/Biomedical-Cyclotron Unit, Université Libre de Bruxelles-Hôpital Erasme, Brussels, Belgium

    Bich-Ngoc-Thanh Tang, David Wikler & Serge Goldman

  2. Department of Radiology, Université Libre de Bruxelles-Hôpital Erasme, Brussels, Belgium

    Niloufar Sadeghi

  3. Department of Oncology, Université Libre de Bruxelles-Hôpital Erasme, Brussels, Belgium

    Fabrice Branle

  4. Department of Neurosurgery, Université Libre de Bruxelles-Hôpital Erasme, Brussels, Belgium

    Olivier De Witte

  5. Hospital Erasme, route de Lennik 808, 1070, Brussels, Belgium

    Bich-Ngoc-Thanh Tang

Authors
  1. Bich-Ngoc-Thanh Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Niloufar Sadeghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fabrice Branle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Olivier De Witte
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Wikler
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Serge Goldman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bich-Ngoc-Thanh Tang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tang, BNT., Sadeghi, N., Branle, F. et al. Semi-quantification of methionine uptake and flair signal for the evaluation of chemotherapy in low-grade oligodendroglioma. J Neurooncol 71, 161–168 (2005). https://doi.org/10.1007/s11060-004-9654-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-004-9654-4

Keywords

Search

Navigation