carbon-11-methionine and Lymphoma--Large-B-Cell--Diffuse

A 79-year-old man presenting with gait disturbance and cognitive decline was diagnosed with intravascular large B-cell lymphoma (IVLBCL) by random skin biopsy. Some IVLBCL lesions were identified by PET examinations using 11 C-methionine, 18 F-FDG, and 18 F-THK5351. 11 C-methionine and 18 F-FDG uptake, which likely reflects the presence of the lymphoma cells themselves, increased clearly in the left putamen but weakly in the left deep white matter. 18 F-THK5351 uptake increased in all lesions, likely reflecting perivascular astrogliosis caused by IVLBCL. Hence, 18 F-THK5351 PET can evaluate tumor extension in IVLBCL lesions where 11 C-methionine and 18 F-FDG PET may fail in its visualization.

Topics: Aged; Carbon Radioisotopes; Fluorodeoxyglucose F18; Humans; Lymphoma, Large B-Cell, Diffuse; Male; Methionine; Positron-Emission Tomography; Radiopharmaceuticals

The aim of our study was to examine the usefulness of PET with C-methionine (MET) and F-fluorodeoxyglucose (FDG) in the differentiation of glioblastoma multiforme (GBM) and intracranial diffuse large B-cell lymphoma (DLBCL).. We evaluated 22 patients retrospectively with an enhancing brain tumor on MRI, including 15 GBM and 7 DLBCL, which was confirmed by histopathology. Dynamic PET scans with MET and FDG were performed for preoperative differential diagnosis. We assessed the images qualitatively and quantitatively. In quantitative assessment, the SUVmax was used on FDG PET and both late and early phases on MET PET. In addition, the ratio of SUVmax in the late and early phases on MET-PET was evaluated (ΔSUVmax).. SUVmax on FDG PET of DLBCL was significantly higher than that of GBM. Setting an SUVmax of 12.0 as the cutoff for differentiating DLBCL from GBM, 1 GBM and 1 DLBCL were found to be false-positive and false-negative, respectively.SUVmax in the late and early phases of MET-PET was not significantly different between DLBCL and GBM; however, we also found significant differences in ΔSUVmax on MET-PET. Using ΔSUVmax 1.17 as the cutoff, we could differentiate DLBCL from GBM completely. In the present study, ΔSUVmax on MET-PET was slightly superior to SUVmax on FDG PET.. Both SUVmax on FDG PET and ΔSUVmax on MET-PET were considered to be good diagnostic tests when encountering difficulties in this differential diagnosis.

Topics: Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Female; Fluorodeoxyglucose F18; Glioblastoma; Humans; Lymphoma, Large B-Cell, Diffuse; Male; Methionine; Middle Aged; Positron-Emission Tomography; Quality Control; Retrospective Studies; Young Adult

Although the optimum treatment of primary central nervous system lymphoma (PCNSL) remains a challenge, there is increasing interest in methotrexate-based chemotherapy as an effective strategy. Here, we report evidence supporting the utility of methionine PET/CT for evaluating PCNSL disease extent and response to high-dose methotrexate therapy.. Four patients newly diagnosed with diffuse large B-cell PCNSL underwent methionine PET/CT and MRI of the brain at baseline and again after completion of high-dose methotrexate combination chemotherapy. Three patients also received pretreatment FDG PET/CT, and the intervals between MRI and both PET/CTs were within 3 weeks. The results of methionine PET/CT were compared with MRI and clinical findings.. Pretreatment methionine PET/CT demonstrated clear demarcation of PCNSL tumors with high contrast in 3 patients and only faint uptake in the remaining patient, which also showed low FDG uptake. In 1 patient, methionine PET/CT displayed more tumor lesions than FDG PET/CT did. After high-dose methotrexate chemotherapy, methionine images displayed complete disappearance of abnormal uptake in all 4 patients. In 3 of the patients, posttreatment MRI and clinical follow-up corroborated findings of complete remission. In the remaining patient, MRI showed nonenhancing T2 hyperintensities in the periventricular white matter, for which the significance was inconclusive.. Methionine PET/CT may provide clinically useful information complementary to MRI for monitoring the response to systemic chemotherapy in patients with PCNSL.

Topics: Antineoplastic Agents; Brain; Dose-Response Relationship, Drug; Female; Humans; Lymphoma, Large B-Cell, Diffuse; Magnetic Resonance Imaging; Male; Methionine; Methotrexate; Middle Aged; Multimodal Imaging; Positron-Emission Tomography; Tomography, X-Ray Computed; Treatment Outcome