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Usefulness of 11C-Methionine PET in differential diagnosis of epileptogenic brain neoplasms
Utilidad de la PET con 11C-metionina en el diagnóstico diferencial de los tumores epileptógenos
J.R. García
, M. Baquero, E. Llinares, M. Soler, M. Moragas, E. Riera
Corresponding author
Unidad PET/TC CETIR-ERESA,, Esplugues, Barcelona, Spain
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Mujer de 25 años que presentó crisis parcial simple. La PET con <span class="elsevierStyleSup">11</span>C-metionina mostró ausencia de actividad anómala de <span class="elsevierStyleSup">11</span>C-metionina de la lesión córtico-subcortical parieto-temporal derecha, características sugestivas de lesión benigna. La biopsia esteroatáxica confirmó la existencia de un DNET.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.R. García, M. Baquero, E. Llinares, M. Soler, M. Moragas, E. Riera" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.R." "apellidos" => "García" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Baquero" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Llinares" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Soler" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Moragas" ] 5 => array:2 [ "nombre" => "E." 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"apellidos" => "Mazican" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808915000877?idApp=UINPBA00004N" "url" => "/22538089/0000003400000005/v1_201508130058/S2253808915000877/v1_201508130058/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2253808915000865" "issn" => "22538089" "doi" => "10.1016/j.remnie.2015.07.012" "estado" => "S300" "fechaPublicacion" => "2015-09-01" "aid" => "673" "copyright" => "Elsevier España, S.L.U. and SEMNIM" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2015;34:329-30" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 56 "formatos" => array:2 [ "HTML" => 12 "PDF" => 44 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting image</span>" "titulo" => "<span class="elsevierStyleSup">99m</span>Tc-HDP SPECT/MRI in isolated xanthoma of the temporal bone" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "329" "paginaFinal" => "330" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "<span class="elsevierStyleSup">99m</span>Tc-HDP SPECT/RM en xantoma único del hueso temporal" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1491 "Ancho" => 3253 "Tamanyo" => 331021 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Whole body bone scintigraphy revealing an hypermetabolic focus in the right temporal region. 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"apellidos" => "García" "email" => array:1 [ 0 => "jrgarcia@cetir.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Baquero" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Llinares" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Soler" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Moragas" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Riera" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad PET/TC CETIR-ERESA,, Esplugues, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad de la PET con <span class="elsevierStyleSup">11</span>C-metionina en el diagnóstico diferencial de los tumores epileptógenos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 987 "Ancho" => 2500 "Tamanyo" => 159836 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Image PET, MRI and fusion PET/MRI. 25-year-old woman who presented a simple partial seizure. The <span class="elsevierStyleSup">11</span>C-methionine PET showed cortico-subcortical lesion on the right parieto-temporal lobe without abnormal activity of the tracer, features suggestive of benign lesion. The stereotactic biopsy confirmed the existence of a DNET.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Brain tumors are associated to more than 50% of patients with epilepsy, of which about 30% are drug-resistant. Epilepsy associated with brain tumors is multifactorial, but fundamentally depends on its location and histology. So, low-grade tumors are more epileptogenic than high-grade. In high-grade tumors and adult epilepsy is associated with increased frequency of neurological deficits. In low-grade tumors and infant-juvenile age, epilepsy presents clinically isolated.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present two women of similar age (27 and 25 years, respectively) following focal seizure who underwent Magnetic Resonance Imaging (MRI) that revealed similar findings: hypointense on T1-weighted and high signal on T2-weighted and FLAIR images with areas of diffusion restriction and without contrast enhancement (left frontal and parietal-temporal right, respectively). These features can be presented in different tumor types and in our case not allow the differential diagnosis between a low-grade glioma or ganglioneuronal tumor (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The Dysembryoplastic Neuroepithelial Tumor (DNET) was described by Daumas-Duport et al. in 1988 as a mixed ganglioneuronal low-grade lesion (WHO grade I) containing oligodendrocytes, astrocytes and neurons, with colloid material, which may be multifocal and coexist with regions of cortical dysgenesis. It is manifested mainly by the presence of epilepsy with focal seizures with onset of symptoms between 1 and 30 years (mean 9 years), many times difficult to control, usually without associated neurological deficit. The DNET is mainly cortical, but may show subcortical extension and sits mainly in the temporal lobe (62%) and frontal (31%). MRI typically shows hypointense lesions on T1-weighted and hyperintense on T2-weighted images without peri-lesional edema, may submit gadolinium enhancement, no specific characteristics of these tumors.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) has a recognized role in the localization of the seizure focus. However, in tumor metabolic assessment is known absence of uptake in low-grade gliomas. However, <span class="elsevierStyleSup">11</span>C-Methionine PET shows tracer uptake in all glial tumors, although the degree of activity allows to differentiate between grades I–II of III–IV.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> There are few references, but has been described absence of abnormal uptake of <span class="elsevierStyleSup">11</span>C-Methionine in DNET, in contrast to the tracer uptake in glial tumors, even in low-grade gliomas.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">For these reasons we proceed to perform <span class="elsevierStyleSup">11</span>C-methionine PET in both cases. After intravenous injection of 185<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>18.5<span class="elsevierStyleHsp" style=""></span>MBq of <span class="elsevierStyleSup">11</span>C-methionine, patients were in 20<span class="elsevierStyleHsp" style=""></span>min resting sensory-motor period. After performing a CT for attenuation correction PET brain images were acquired for 10<span class="elsevierStyleHsp" style=""></span>min. At the same sesion, we proceeded to study conducting 3D T1-weighted MRI for software fusion purpose (SPM8).</p><p id="par0030" class="elsevierStylePara elsevierViewall">The first patient shows a pathological <span class="elsevierStyleSup">11</span>C-Methionine uptake in cortical lesion on the upper-left frontal lobe (ratio 1.7/0.9:1.89). However, in the second patient the cortico-subcortical right parieto-temporal lesion shows no abnormal uptake of <span class="elsevierStyleSup">11</span>C-Methionine. Quantifying more widely accepted in the evaluation of brain tumors with <span class="elsevierStyleSup">11</span>C-Methionine is the relationship between the degree of uptake of the lesion (SUV max) and the background calculating on gray matter of the healthy contralateral lobe (medium SUV).</p><p id="par0035" class="elsevierStylePara elsevierViewall">Given this different metabolic behavior differentiated therapeutic strategy is decided. In the first patient, due to suspected of glial tumor proceed to its removal, confirming grade II glioma. In the second patient, performing a stereotactic biopsy is decided and confirmed suspected metabolic DNET.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Treatment of DNET, even if it is a benign tumor, requiring surgery in the case of drug-resistant epilepsies with frequent evolution of these patients.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">2,3</span></a> In our case given the histological confirmation of DNET, since it was the first epileptogenic episode was decided to initiate anticonvulsant treatment. Due to medical control of seizures no tumor excision was performed, avoiding the possible neurological deficit secondary intervention, without new episodes epileptogenic.</p><p id="par0045" class="elsevierStylePara elsevierViewall">These results suggest that <span class="elsevierStyleSup">11</span>C-Methionine PET could be very useful in differentiating the various epileptogenic tumors, especially in the characterization of DNET, information that can influence the therapeutic decision of these patients.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García JR, Baquero M, Llinares E, Soler M, Moragas M, Riera E. Utilidad de la PET con <span class="elsevierStyleSup">11</span>C-metionina en el diagnóstico diferencial de los tumores epileptógenos. Rev Esp Med Nucl Imagen Mol. 2015;34:331–332.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 987 "Ancho" => 2500 "Tamanyo" => 139366 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Image PET, MRI and fusion PET/MRI. 27-year-old woman who presented complex partial seizure. The <span class="elsevierStyleSup">11</span>C-methionine PET showed cortical lesion on the upper-left frontal lobe with increased uptake of the tracer (ratio SUV lesion/background 1.7/0.9:1.89) suggestive of glial tumor. The excision of the lesion confirmed the existence of a grade II glioma.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 987 "Ancho" => 2500 "Tamanyo" => 159836 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Image PET, MRI and fusion PET/MRI. 25-year-old woman who presented a simple partial seizure. The <span class="elsevierStyleSup">11</span>C-methionine PET showed cortico-subcortical lesion on the right parieto-temporal lobe without abnormal activity of the tracer, features suggestive of benign lesion. The stereotactic biopsy confirmed the existence of a DNET.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neuroimaging in brain tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Arbizu" 1 => "P.D. Domínguez" 2 => "R. Díez-Valle" 3 => "C. Vigil" 4 => "R. García-Eulate" 5 => "J.L. Zubieta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2010.11.001" "Revista" => array:7 [ "tituloSerie" => "Rev Esp Med Nucl" "fecha" => "2011" "volumen" => "30" "paginaInicial" => "47" "paginaFinal" => "65" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21211868" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0015028208001787" "estado" => "S300" "issn" => "00150282" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accuracy of distinguishing between dysembryoplastic neuroepithelial tumors and other epileptogenic brain neoplasms with [<span class="elsevierStyleSup">11</span>C]methionine PET" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Rheims" 1 => "S. Rubi" 2 => "S. Bouvard" 3 => "E. Bernard" 4 => "N. Streichenberger" 5 => "M. Guenot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/neuonc/nou022" "Revista" => array:6 [ "tituloSerie" => "Neuro Oncol" "fecha" => "2014" "volumen" => "16" "paginaInicial" => "1417" "paginaFinal" => "1426" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24598358" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dysembryoplastic neuroepithelial tumor: a surgically curable tumor of young patients with intractable partial seizures. Report of thirty-nine cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Daumas-Duport" 1 => "B.W. Scheithauer" 2 => "J.P. Chodkiewicz" 3 => "E.R. Laws Jr." 4 => "C. Vedrenne" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1988" "volumen" => "23" "paginaInicial" => "545" "paginaFinal" => "556" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3143922" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003400000005/v1_201508130058/S2253808915000762/v1_201508130058/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003400000005/v1_201508130058/S2253808915000762/v1_201508130058/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808915000762?idApp=UINPBA00004N" ]
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| 2024 May | 0 | 4 | 4 |
| 2024 March | 0 | 6 | 6 |
| 2024 February | 0 | 2 | 2 |
| 2024 January | 0 | 3 | 3 |
| 2023 December | 0 | 9 | 9 |
| 2023 November | 0 | 5 | 5 |
| 2023 October | 0 | 9 | 9 |
| 2023 September | 0 | 2 | 2 |
| 2023 August | 0 | 6 | 6 |
| 2023 July | 0 | 1 | 1 |
| 2023 June | 0 | 3 | 3 |
| 2023 May | 0 | 7 | 7 |
| 2023 April | 0 | 3 | 3 |
| 2023 March | 0 | 1 | 1 |
| 2023 February | 0 | 4 | 4 |
| 2023 January | 0 | 5 | 5 |
| 2022 December | 0 | 5 | 5 |
| 2022 November | 0 | 4 | 4 |
| 2022 October | 0 | 2 | 2 |
| 2022 August | 0 | 15 | 15 |
| 2022 July | 0 | 2 | 2 |
| 2022 June | 0 | 2 | 2 |
| 2022 May | 0 | 2 | 2 |
| 2022 April | 0 | 5 | 5 |
| 2022 March | 0 | 10 | 10 |
| 2022 February | 0 | 2 | 2 |
| 2022 January | 0 | 8 | 8 |
| 2021 December | 0 | 4 | 4 |
| 2021 November | 0 | 11 | 11 |
| 2021 October | 0 | 13 | 13 |
| 2021 September | 0 | 3 | 3 |
| 2021 August | 0 | 11 | 11 |
| 2021 July | 0 | 1 | 1 |
| 2021 June | 0 | 5 | 5 |
| 2021 May | 0 | 1 | 1 |
| 2021 April | 0 | 3 | 3 |
| 2021 March | 0 | 7 | 7 |
| 2021 February | 0 | 2 | 2 |
| 2021 January | 0 | 1 | 1 |
| 2020 November | 0 | 1 | 1 |
| 2020 August | 0 | 2 | 2 |
| 2020 June | 0 | 1 | 1 |
| 2020 May | 0 | 3 | 3 |
| 2020 April | 0 | 1 | 1 |
| 2020 February | 0 | 1 | 1 |
| 2020 January | 0 | 1 | 1 |
| 2019 December | 0 | 1 | 1 |
| 2019 September | 0 | 2 | 2 |
| 2019 August | 0 | 1 | 1 |
| 2019 July | 0 | 4 | 4 |
| 2019 June | 0 | 8 | 8 |
| 2019 May | 0 | 29 | 29 |
| 2019 April | 0 | 8 | 8 |
| 2019 March | 0 | 3 | 3 |
| 2019 January | 0 | 2 | 2 |
| 2018 December | 0 | 1 | 1 |
| 2018 October | 0 | 2 | 2 |
| 2018 February | 1 | 0 | 1 |
| 2018 January | 5 | 0 | 5 |
| 2017 December | 5 | 1 | 6 |
| 2017 November | 4 | 0 | 4 |
| 2017 October | 2 | 1 | 3 |
| 2017 September | 5 | 0 | 5 |
| 2016 February | 0 | 1 | 1 |
| 2015 November | 0 | 1 | 1 |
| 2015 October | 0 | 2 | 2 |
Show all
