Evaluation of Focal Cortical Dysplasia and Mixed Neuronal and Glial Tumors in Pediatric Epilepsy Patients Using18F-FDG and11C-Methionine PET
- 15 April 2010
- journal article
- Published by Society of Nuclear Medicine in Journal of Nuclear Medicine
- Vol. 51 (5), 728-734
- https://doi.org/10.2967/jnumed.109.070920
Abstract
Focal cortical dysplasia (FCD) and mixed neuronal and glial tumors share many clinical characteristics; therefore, the presurgical differential diagnosis of these diseases using MRI is difficult in some cases. The aim of this study was to determine whether 11C-methionine PET, compared with 18F-FDG PET, was useful for the evaluation of these diseases. Methods: The clinical and imaging data of 30 pediatric lesional epilepsy patients pathologically diagnosed with FCD, dysembryoplastic neuroepithelial tumor (DNT), or ganglioglioma were reviewed. Eleven patients had FCD, 8 patients had a DNT, and 11 patients had a ganglioglioma. 18F-FDG and 11C-methinine PET scans were obtained from 25 patients and 15 patients, respectively. Visual grading analysis and quantitative assessment of 18F-FDG and 11C-methionine PET, represented as a lesion–to–gray matter ratio (LGR), were performed. Results: In the visual grading analysis, both 18F-FDG PET and 11C-methionine PET detected a significant difference among the 3 disease groups (P = 0.033 and P = 0.016, respectively), but discrimination of FCD from mixed neuronal and glial tumors was possible only with 11C-methionine PET. The mean LGR of 18F-FDG PET was 0.502 ± 0.119 for FCD, 0.631 ± 0.107 for DNTs, and 0.620 ± 0.196 for gangliogliomas; there was no significant difference in LGR among the groups (P = 0.111). However, the mean LGR of 11C-methionine PET was 1.078 ± 0.182 for FCD, 1.564 ± 0.368 for DNT, and 2.114 ± 0.723 for gangliogliomas; there was a significant difference in LGR among the groups (P = 0.014). Post hoc analysis revealed that the LGR of FCD was significantly different from that of DNTs and gangliogliomas. The mean LGR value of DNTs fell between those of FCD and gangliogliomas. Conclusion: Although 18F-FDG plays a major role in the preoperative work-up of epilepsy surgery patients, it appears from this study that 18F-FDG does not contribute to the differential diagnosis and that another tracer such as 11C-methinine is required. 11C-methinine PET results correlated well with the pathologic spectrum in pediatric lesional epilepsy patients.Keywords
This publication has 19 references indexed in Scilit:
- Long‐term surgical outcomes of temporal lobe epilepsy associated with low‐grade brain tumorsCancer, 2009
- Predictors of tumor progression among children with gangliogliomasJournal of Neurosurgery: Pediatrics, 2009
- Predictors of surgical outcome and pathologic considerations in focal cortical dysplasiaNeurology, 2009
- Tumor recurrence and malignant progression of gangliogliomasCancer, 2008
- Neuronuclear Assessment of Patients With EpilepsySeminars in Nuclear Medicine, 2008
- The 2007 WHO classification of tumours of the central nervous systemActa Neuropathologica, 2007
- A developmental and genetic classification for malformations of cortical developmentNeurology, 2005
- Positron emission tomography imaging of brain tumorsNeuroimaging Clinics Of North America, 2002
- Dysembryoplastic Neuroepithelial Tumor: A Surgically Curable Tumor of Young Patients with Intractable Partial SeizuresNeurosurgery, 1988
- Focal dysplasia of the cerebral cortex in epilepsyJournal of Neurology, Neurosurgery & Psychiatry, 1971