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Long-term evaluation of the effect of hypofractionated high-energy proton treatment of benign meningiomas by means of 11C-l-methionine positron emission tomography

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Abstract

Purpose

To determine if 11C-l-methionine PET is a useful tool in the evaluation of the long-term effect of proton beam treatment in patients with meningioma remnant.

Methods

Included in the study were 19 patients (4 men, 15 women) with intracranial meningioma remnants who received hypofractionated high-energy proton beam treatment. Patients were examined with 11C-l-methionine PET and MRI prior to treatment and after 6 months, and 1, 2, 3, 5, 7 and 10 years. Temporal changes in methionine uptake ratio, meningioma volume, meningioma regrowth and clinical symptoms throughout the follow-up period were evaluated.

Results

In 17 patients the tumour volume was unchanged throughout the follow-up. The methionine uptake ratio on PET decreased over the years in most patients. In two patients the tumour remnant showed progression on MRI. In these patients, prior to the volume increase on MRI, the methionine uptake ratio increased. One patient experienced transient clinical symptoms and showed radiological evidence of a radiation-induced reaction close to the irradiated field.

Conclusion

Proton beam treatment is a safe and effective treatment for achieving long-term growth arrest in meningioma remnants. Follow-up with 11C-l-methionine PET may be a valuable adjunct to, but not a replacement for, standard radiological follow-up.

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Authors and Affiliations

  1. Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala University Hospital, 751 85, Uppsala, Sweden

    Mats Ryttlefors, Francesco Latini & Olafur Gudjonsson

  2. Department of Surgical Sciences, Radiology, Uppsala University, Uppsala University Hospital, 751 85, Uppsala, Sweden

    Torsten Danfors

  3. Department of Immunology, Genetics and Pathology, Medical Radiation Science, Uppsala University Hospital, 751 85, Uppsala, Sweden

    Anders Montelius

  4. Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Clinical oncology, Uppsala University, Uppsala University Hospital, 751 85, Uppsala, Sweden

    Erik Blomquist

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  1. Mats Ryttlefors
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Correspondence to Mats Ryttlefors.

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Ryttlefors, M., Danfors, T., Latini, F. et al. Long-term evaluation of the effect of hypofractionated high-energy proton treatment of benign meningiomas by means of 11C-l-methionine positron emission tomography. Eur J Nucl Med Mol Imaging 43, 1432–1443 (2016). https://doi.org/10.1007/s00259-016-3310-z

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