Effect of interstitial irradiation and glucose metabolism and methionine uptake in glioma patients
- Neurologische und Neurochirurgische Universitaesklinik, Koeln (Germany); and others
Interstitial radiation by stereotactic I-125 seed implants is an established therapy for brain glioma. We studied its effect on tissue glucose metabolism and methionine uptake because of its relevance for therapy planning and monitoring. Six patients with gliomas of histological grade 2 or 3 received permanent CT-guided stereotactic implants of 100 to 490 MBq I-125. FDG PET, and in 3 subjects also C-11-methionine PET, was performed before and one year after seed implantation on a Siemens ECAT EXACT. All scans were 3-D matched to CT, isodose volumes were determined, and changes of glucose metabolism and methionine uptake were evaluated in tumor and brain tissue as a function of radiation dose. There was a consistent dose-dependent decrease of methionine uptake after one year: less than 20% change for cumulated doses {<=}60 Gy, then a decline down to a reduction by 30-70% for doses {>=}150 Gy. Glucose metabolism showed a much more variable response without clear dose dependency. Average maximum reduction was 23% (S.D. 24%), and an increase of glucose metabolic rates in irradiated tissue up to 43% was noted in 5 patients. In one case recurrent tumor outside of the 170 Gy isodose was most clearly seen by increased methionin uptake. In conclusion, C-11-methionine appears suited for monitoring of therapeutic radiation effects, whereas FDG shows a more variable response and often increased glycolysis in irradiated tissue.
- OSTI ID:
- 198096
- Report Number(s):
- CONF-940605--
- Journal Information:
- Journal of Nuclear Medicine, Journal Name: Journal of Nuclear Medicine Journal Issue: Suppl.5 Vol. 35; ISSN JNMEAQ; ISSN 0161-5505
- Country of Publication:
- United States
- Language:
- English
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