Premium
11 C‐methionine uptake and intraoperative 5‐aminolevulinic acid‐induced fluorescence as separate index markers of cell density in glioma
Author(s) -
Arita Hideyuki,
Kinoshita Manabu,
Kagawa Naoki,
Fujimoto Yasunori,
Kishima Haruhiko,
Hashimoto Naoya,
Yoshimine Toshiki
Publication year - 2011
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.26445
Subject(s) - methionine , glioma , fluorescence , positron emission tomography , cell , medicine , microbiology and biotechnology , amino acid , nuclear medicine , chemistry , pathology , biochemistry , cancer research , biology , physics , quantum mechanics
BACKGROUND: The extent of tumor resection is acknowledged as 1 of the prognostic factors for glioma. 5‐Aminolevulinic acid (5‐ALA)‐induced fluorescence guidance and neuronavigation integrated with 11 C‐methionine positron emission tomography (PET) are widely utilized under the expectation of improving the extent of resection. These 2 novel approaches are beneficial for glioma resections, and the combination of these approaches appears rational. However, biological characteristics reflecting 5‐ALA‐induced fluorescence and 11 C‐methionine uptake have not been clearly elucidated, and studies about the relationship between 5‐ALA‐induced fluorescence and 11 C‐methionine uptake have been limited. The present study aimed to clarify this issue. METHODS: Data from 11 consecutive patients harboring astrocytic tumors were analyzed: 2 grade II and 2 grade III, and 7 grade IV tumors were included. Thirty samples from these patients were obtained from the relative periphery of each tumor. Relationships among histology, 5‐ALA‐induced fluorescence and 11 C‐methionine uptake were analyzed by stereotactic sampling and image analysis. RESULTS: Uptake of 11 C‐methionine correlated with cell density ( R 2 = 0.322, P = .0059). Cell density was higher in fluorescence‐positive areas than in negative areas (2760 ± 1080 vs 1450 ± 1380/mm 2 , P = .0132). Although both 11 C‐methionine uptake and fluorescence seemed to correlate with cell density, no significant difference in 11 C‐methionine uptake was seen between fluorescence‐positive and ‐negative areas ( P = .367). Multiple linear regression analysis revealed 11 C‐methionine uptake and 5‐ALA‐induced fluorescence as independent indices for tumor cell density. CONCLUSIONS: These results indicate that 5‐ALA fluorescence and 11 C‐methionine PET image are separate index markers for cytoreduction surgery of gliomas. Cancer 2011;. © 2011 American Cancer Society.