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A patient with an anaplastic (malignant) astrocytoma was examined with computed tomography (CT) and with positron emission tomography (PET), in the latter case using 68GaEDTA, 11Cglucose, and 11Cmethionine. The CT examination as well as the 68GaEDTA study showed a small tumor located in the region of the head of the left caudate nucleus. The 11Cglucose examination showed increased uptake on the same region, as did the 11Cmethionine examination, but the latter also showed a considerable uptake in the entire left thalamic region. The patient died 15 days after the 11Cmethionine study and a histologic evaluation of thin sections obtained at autopsy showed excellent agreement between tumor extent and activity distribution after 11Cmethionine administration. The tumor tissue seen only with 11Cmethionine was histologically different from that part of the tumor observed with the other tracers. Although cytologically similar, the latter showed large necrotic areas and an ability to induce marked endothelial proliferation, whereas in the former neither necroses nor notable endothelial proliferation was seen. In this case more than 50% of the tumor would have remained radiologically imperceptible without the 11Cmethionine PET examination.
Bergström et al. (Thu,) studied this question.