Document Detail

Differentiation of glioblastomas from metastatic brain tumors by tryptophan uptake and kinetic analysis: a positron emission tomographic study with magnetic resonance imaging comparison.
MedLine Citation:
PMID:  23759373     Owner:  NLM     Status:  MEDLINE    
Differentiating high-grade gliomas from solitary brain metastases is often difficult by conventional magnetic resonance imaging (MRI); molecular imaging may facilitate such discrimination. We tested the accuracy of α[11C]methyl-l-tryptophan (AMT)-positron emission tomography (PET) to differentiate newly diagnosed glioblastomas from brain metastases. AMT-PET was performed in 36 adults with suspected brain malignancy. Tumoral AMT accumulation was measured by standardized uptake values (SUVs). Tracer kinetic analysis was also performed to separate tumoral net tryptophan transport (by AMT volume of distribution [VD]) from unidirectional uptake rates using dynamic PET and blood input function. Differentiating the accuracy of these PET variables was evaluated and compared to conventional MRI. For glioblastoma/metastasis differentiation, tumoral AMT SUV showed the highest accuracy (74%) and the tumor/cortex VD ratio had the highest positive predictive value (82%). The combined accuracy of MRI (size of contrast-enhancing lesion) and AMT-PET reached up to 93%. For ring-enhancing lesions, tumor/cortex SUV ratios were higher in glioblastomas than in metastatic tumors and could differentiate these two tumor types with > 90% accuracy. These results demonstrate that evaluation of tryptophan accumulation by PET can enhance pretreatment differentiation of glioblastomas and metastatic brain tumors. This approach may be particularly useful in patients with a newly diagnosed solitary ring-enhancing mass.
David O Kamson; Sandeep Mittal; Amy Buth; Otto Muzik; William J Kupsky; Natasha L Robinette; Geoffrey R Barger; Csaba Juhász
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Molecular imaging     Volume:  12     ISSN:  1536-0121     ISO Abbreviation:  Mol Imaging     Publication Date:    2013 Jul-Aug
Date Detail:
Created Date:  2013-06-13     Completed Date:  2014-04-28     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  101120118     Medline TA:  Mol Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327-37     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Brain Neoplasms / pathology*,  radionuclide imaging*
Breast Neoplasms / radionuclide imaging,  secondary
Diagnosis, Differential
Glioblastoma / pathology*,  radionuclide imaging*
Lung Neoplasms / radionuclide imaging,  secondary
Magnetic Resonance Imaging*
Middle Aged
Multimodal Imaging
Neoplasm Metastasis
Positron-Emission Tomography*
Tryptophan / analogs & derivatives*,  pharmacokinetics
Grant Support
P30 CA022453/CA/NCI NIH HHS; R01 CA123451/CA/NCI NIH HHS; R01 CA123451/CA/NCI NIH HHS
Reg. No./Substance:
13510-08-2/alpha-methyltryptophan; 8DUH1N11BX/Tryptophan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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