MURAGAKI Yoshihiro    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Visiting Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Usefulness of 11C-methionine positron emission tomography for treatment-decision making in cases of non-enhancing glioma-like brain lesions.
Journal	Formal name：Journal of neuro-oncology Abbreviation：J Neurooncol ISSN code：0167594X
Domestic / Foregin	Foregin
Volume, Issue, Page	126(3),pp.577-583
Author and coauthor	WATANABE Atsushi, MURAGAKI Yoshihiro, MARUYAMA Takashi, SHINODA Jun, OKADA Yoshikazu
Publication date	2016/02
Summary	he present study evaluated usefulness of the positron emission tomography with 11C-methionine for prediction of the clinical course and treatment decision-making in adult patients with newly diagnosed non-enhancing brain lesions mimicking low-grade gliomas. Retrospective analysis was done in 163 cases. In overall, 131 tumors underwent surgical resection, which in 34 cases was done after initial period of observation. Among the latter 5 patients were operated on after significant clinical deterioration. In overall, 3 resected neoplasms corresponded to WHO histopathological grade I, 87 to grade II, 39 to grade III, and 2 to grade IV. In all 163 cases the tumor/normal brain uptake ratio (T/N ratio) of 11C-methionine ranged from 0.68 to 8.02 (mean 2.21 +/- 1.16, median 1.81). Mean T/N ratios of non-operated lesions, low-grade and high-grade tumors were 1.60 +/- 0.85, 2.27 +/- 1.22, and 2.54 +/- 1.09, respectively (P < 0.0001), but overlap between 3 groups was prominent. In patients who had clinical deterioration during the period of observation T/N ratios of the lesion varied from 1.49 to 3.38 (mean 2.23 +/- 0.70, median 2.15). Comparison of the deterioration-free survival of patients with T/N ratios of the lesion above and below 1.90 revealed statistically significant difference (P < 0.0001). In conclusion, "wait-and-scan" strategy with delay of surgical treatment does not seem reasonable option if T/N ratio of 11C-methionine in the non-enhancing glioma-like brain lesion constitutes >/=1.90, since it may be associated with significant risk of tumor progression and clinical deterioration during follow-up.
DOI	10.1007/s11060-015-2004-x