Chinese Journal of Contemporary Neurology and Neurosurgery (Apr 2013)

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

  • Zhi-tie HAN,
  • Shao-bo SU,
  • Liang XUE,
  • Chuan ZHANG,
  • Jun MA,
  • Jia-shi WANG,
  • Shu-yuan YUE

Journal volume & issue
Vol. 13, no. 4
pp. 324 – 329

Abstract

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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.

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