Application of intergration of MRI and 11C-methionine PET in preoperative assessment and intraoperative neuronavigation of glioma surgery

Abstract

Background With the development of image fusion technology in clinical application, the fusion of 11C-methionine (11C-Met) PET and MRI is also used in clinic. Based on different image results in 11C-Met PET and MRI of gliomas, this article aims to evaluate the application value of integration of MRI and 11C-Met PET in preoperative assessment, intraoperative neuronavigation and tumor resection of glioma surgery. Methods Twenty-five patients with gliomas were examined with both MRI and 11C-Met PET before operation. Based on the integrated 11C-Met PET/MRI images, the neuronavigation workstation performed tumor delineation and calculated the tumor volume. Histological classification of tumors was performed according to WHO grades. The percentages of discrepancy-PET (vPET not included in vMRI) and discrepancy-MRI (vMRI not included in vPET) were evaluated on the fusion images. Results Therewere 3 11C-Met PET/MRI integration patterns emerged after analysis of volumetric data. One group included 15 cases (one was WHO Ⅱ, six were WHO Ⅲ and eight were WHO Ⅳ) with vMRI included in vPET with a low discrepancy-MRI. The second one included 2 patients with WHOⅢ gliomas with vPET included in vMRI with a low discrepancy-PET. The third group included 8 cases (six were WHOⅡ and two were WHO Ⅲ) with vMRI-different-from-vPET. Conclusion 11C-Met PET is able to accurately delineate tumor boundary and sensitively target the region of high proliferation or metabolism. Different 11C-Met PET/MRI integration patterns can be assigned in tumor classfication and are favorable for making surgery plans.

Keywords

• Positron-emission tomography
• Magnetic resonance imaging
• Glioma
• Monitoring, intraoperation