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Usefulness of [(11)C] Methionine PET in the Differentiation of Tumefactive Multiple Sclerosis from High Grade Astrocytoma

Tumefactive multiple sclerosis (tumefactive MS) is an atypical variant of MS characterized by a large isolated demyelinating lesion. Because tumefactive MS mimics high grade astrocytoma clinically and radiologically, it is difficult to distinguish between the two using only traditional diagnostic mo...

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Autores principales: HASHIMOTO, Satoka, INAJI, Motoki, NARIAI, Tadashi, KOBAYASHI, Daisuke, SANJO, Nobuo, YOKOTA, Takanori, ISHII, Kenji, TAKETOSHI, Maehara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527963/
https://www.ncbi.nlm.nih.gov/pubmed/30996153
http://dx.doi.org/10.2176/nmc.oa.2018-0287
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author HASHIMOTO, Satoka
INAJI, Motoki
NARIAI, Tadashi
KOBAYASHI, Daisuke
SANJO, Nobuo
YOKOTA, Takanori
ISHII, Kenji
TAKETOSHI, Maehara
author_facet HASHIMOTO, Satoka
INAJI, Motoki
NARIAI, Tadashi
KOBAYASHI, Daisuke
SANJO, Nobuo
YOKOTA, Takanori
ISHII, Kenji
TAKETOSHI, Maehara
author_sort HASHIMOTO, Satoka
collection PubMed
description Tumefactive multiple sclerosis (tumefactive MS) is an atypical variant of MS characterized by a large isolated demyelinating lesion. Because tumefactive MS mimics high grade astrocytoma clinically and radiologically, it is difficult to distinguish between the two using only traditional diagnostic modalities, such as routine magnetic resonance imaging. [(11)C] methionine positron emission tomography (MET PET) has been known as a useful diagnostic tool for glioma. However, it has not been established as a diagnostic tool for tumefactive MS yet. Therefore, the objective of this study was to evaluate the performance of MET PET in differentiating tumefactive MS from high grade astrocytoma. We studied patients with tumefactive MS [six patients (three men, three women), 7 lesions] and 77 patients with astrocytoma (World Health Organization grade II: 13 patients, grade III: 28 patients, and grade IV: 36 patients), and we compared MET uptake of tumefactive demyelinating lesions and astrocytoma. For MET PET analysis, Lesion/Normal region ratios (L/N ratios) were calculated and compared between tumefactive demyelinating lesions and astrocytoma. On MET PET, the L mean/N ratio of tumefactive MS was 1.18 ± 0.50, which was significantly lower than that of high-grade glioma (astrocytoma grade III: 1.95 ± 0.62, P = 0.006; grade IV: 2.35 ± 0.54, P <0.0001). The L maximum (L max)/N ratio of tumefactive demyelinating lesion was also significantly lower than that of high grade astrocytoma (tumefactive MS: 1.89 ± 0.55; astrocytoma grade III: 3.37 ± 1.36, P = 0.0232; astrocytoma grade IV: 4.35 ± 1.30, P <0.0001). In conclusion, MET PET can help differentiate tumefactive MS from high grade astrocytoma.
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spelling pubmed-65279632019-05-21 Usefulness of [(11)C] Methionine PET in the Differentiation of Tumefactive Multiple Sclerosis from High Grade Astrocytoma HASHIMOTO, Satoka INAJI, Motoki NARIAI, Tadashi KOBAYASHI, Daisuke SANJO, Nobuo YOKOTA, Takanori ISHII, Kenji TAKETOSHI, Maehara Neurol Med Chir (Tokyo) Original Article Tumefactive multiple sclerosis (tumefactive MS) is an atypical variant of MS characterized by a large isolated demyelinating lesion. Because tumefactive MS mimics high grade astrocytoma clinically and radiologically, it is difficult to distinguish between the two using only traditional diagnostic modalities, such as routine magnetic resonance imaging. [(11)C] methionine positron emission tomography (MET PET) has been known as a useful diagnostic tool for glioma. However, it has not been established as a diagnostic tool for tumefactive MS yet. Therefore, the objective of this study was to evaluate the performance of MET PET in differentiating tumefactive MS from high grade astrocytoma. We studied patients with tumefactive MS [six patients (three men, three women), 7 lesions] and 77 patients with astrocytoma (World Health Organization grade II: 13 patients, grade III: 28 patients, and grade IV: 36 patients), and we compared MET uptake of tumefactive demyelinating lesions and astrocytoma. For MET PET analysis, Lesion/Normal region ratios (L/N ratios) were calculated and compared between tumefactive demyelinating lesions and astrocytoma. On MET PET, the L mean/N ratio of tumefactive MS was 1.18 ± 0.50, which was significantly lower than that of high-grade glioma (astrocytoma grade III: 1.95 ± 0.62, P = 0.006; grade IV: 2.35 ± 0.54, P <0.0001). The L maximum (L max)/N ratio of tumefactive demyelinating lesion was also significantly lower than that of high grade astrocytoma (tumefactive MS: 1.89 ± 0.55; astrocytoma grade III: 3.37 ± 1.36, P = 0.0232; astrocytoma grade IV: 4.35 ± 1.30, P <0.0001). In conclusion, MET PET can help differentiate tumefactive MS from high grade astrocytoma. The Japan Neurosurgical Society 2019-05 2019-04-17 /pmc/articles/PMC6527963/ /pubmed/30996153 http://dx.doi.org/10.2176/nmc.oa.2018-0287 Text en © 2019 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Article
HASHIMOTO, Satoka
INAJI, Motoki
NARIAI, Tadashi
KOBAYASHI, Daisuke
SANJO, Nobuo
YOKOTA, Takanori
ISHII, Kenji
TAKETOSHI, Maehara
Usefulness of [(11)C] Methionine PET in the Differentiation of Tumefactive Multiple Sclerosis from High Grade Astrocytoma
title Usefulness of [(11)C] Methionine PET in the Differentiation of Tumefactive Multiple Sclerosis from High Grade Astrocytoma
title_full Usefulness of [(11)C] Methionine PET in the Differentiation of Tumefactive Multiple Sclerosis from High Grade Astrocytoma
title_fullStr Usefulness of [(11)C] Methionine PET in the Differentiation of Tumefactive Multiple Sclerosis from High Grade Astrocytoma
title_full_unstemmed Usefulness of [(11)C] Methionine PET in the Differentiation of Tumefactive Multiple Sclerosis from High Grade Astrocytoma
title_short Usefulness of [(11)C] Methionine PET in the Differentiation of Tumefactive Multiple Sclerosis from High Grade Astrocytoma
title_sort usefulness of [(11)c] methionine pet in the differentiation of tumefactive multiple sclerosis from high grade astrocytoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527963/
https://www.ncbi.nlm.nih.gov/pubmed/30996153
http://dx.doi.org/10.2176/nmc.oa.2018-0287
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