@article{66dfe320569c4017b0be60dd6e751b90,
title = "Determination of brain tumor recurrence using 11C-methionine positron emission tomography after radiotherapy",
abstract = "We conducted a prospective multicenter trial to compare the usefulness of 11C-methionine (MET) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for identifying tumor recurrence. Patients with clinically suspected tumor recurrence after radiotherapy underwent both 11C-MET and 18F-FDG PET. When a lesion showed a visually detected uptake of either tracer, it was surgically resected for histopathological analysis. Patients with a lesion negative to both tracers were revaluated by magnetic resonance imaging (MRI) at 3 months after the PET studies. The primary outcome measure was the sensitivity of each tracer in cases with histopathologically confirmed recurrence, as determined by the McNemar test. Sixty-one cases were enrolled, and 56 cases could be evaluated. The 38 cases where the lesions showed uptake of either 11C-MET or 18F-FDG underwent surgery; 32 of these cases were confirmed to be subject to recurrence. Eighteen cases where the lesions showed uptake of neither tracer received follow-up MRI; the lesion size increased in one of these cases. Among the cases with histologically confirmed recurrence, the sensitivities of 11C-MET PET and 18F-FDG PET were 0.97 (32/33, 95% confidence interval [CI]: 0.85-0.99) and 0.48 (16/33, 95% CI: 0.33-0.65), respectively, and the difference was statistically significant (P <.0001). The diagnostic accuracy of 11C-MET PET was significantly better than that of 18F-FDG PET (87.5% vs. 69.6%, P =.033). No examination-related adverse events were observed. The results of the study demonstrated that 11C-MET PET was superior to 18F-FDG PET for discriminating between tumor recurrence and radiation-induced necrosis.",
keywords = "brain tumors, methionine, positron emission tomography, radiation injuries, recurrences",
author = "Shigeru Yamaguchi and Kenji Hirata and Michinari Okamoto and Eku Shimosegawa and Jun Hatazawa and Ryuichi Hirayama and Naoki Kagawa and Haruhiko Kishima and Noboru Oriuchi and Masazumi Fujii and Kentaro Kobayashi and Hiroyuki Kobayashi and Shunsuke Terasaka and Nishijima, {Ken ichi} and Yuji Kuge and Ito, {Yoichi M.} and Hiroshi Nishihara and Nagara Tamaki and Tohru Shiga",
note = "Funding Information: This research was supported by MEXT under Grant Number JP15lm0103004 and by AMED under Grant Numbers JP16lk0201033, JP16lm0103004, and JP19ck0106290. We specially thank Chietsugu Katoh (Hokkaido University Graduate School of Health Services, Sapporo, Japan), Eriko Tsukamoto (Central CI clinic, Sapporo, Japan) and Tomohiko Kaji (Hakodate Goryokaku Hospital, Hakodate, Japan) for the central radiological assessment of this study. We thank Sumitomo Heavy Industries for providing the synthesis apparatus (C-MET100). We thank Eriko Suzuki (Central Institute of Isotope Science, Hokkaido University, Sapporo, Japan) for special assistance to this study. We thank Shigeo Omagari (SHI Accelerator Service Ltd., Tokyo, Japan) for operating the cyclotron and synthesizing the 11C-methionine. We also wish to thank the staff at Hokkaido University Hospital Clinical Research and Medical Innovation Center for assistance with the conduct of this project. Funding Information: Kenji Hirata received lecture fees from Medical Image Lab. Haruhiko Kishima received lecture fees from Daiichi‐Sankyo. Yuji Kuge reports research funding from Sumitomo Heavy Industries. The other authors have no conflict of interest to report. Funding Information: This research was supported by MEXT under Grant Number JP15lm0103004 and by AMED under Grant Numbers JP16lk0201033, JP16lm0103004, and JP19ck0106290. We specially thank Chietsugu Katoh (Hokkaido University Graduate School of Health Services, Sapporo, Japan), Eriko Tsukamoto (Central CI clinic, Sapporo, Japan) and Tomohiko Kaji (Hakodate Goryokaku Hospital, Hakodate, Japan) for the central radiological assessment of this study. We thank Sumitomo Heavy Industries for providing the synthesis apparatus (C‐MET100). We thank Eriko Suzuki (Central Institute of Isotope Science, Hokkaido University, Sapporo, Japan) for special assistance to this study. We thank Shigeo Omagari (SHI Accelerator Service Ltd., Tokyo, Japan) for operating the cyclotron and synthesizing the C‐methionine. We also wish to thank the staff at Hokkaido University Hospital Clinical Research and Medical Innovation Center for assistance with the conduct of this project. 11 Publisher Copyright: {\textcopyright} 2021 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.",
year = "2021",
month = oct,
doi = "10.1111/cas.15001",
language = "English",
volume = "112",
pages = "4246--4256",
journal = "Cancer Science",
issn = "1347-9032",
publisher = "Wiley-Blackwell",
number = "10",
}