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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Artikel

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Correlation of an integrated Methionine-PET/MRI and ALA-derived tissue fluorescence indicates heterogeneity in low-grade glioma: a technical innovation

Meeting Abstract

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  • Oliver Gembruch - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany
  • Marc Schlamann - Abteilung für Neuroradiologie, Universitätsklinikum Giessen, Universität Gießen, Germany
  • Lale Umutlu - Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany
  • Ulrich Sure - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany
  • Oliver Marcus Müller - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany
  • Nicolai El Hindy - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.13.04

doi: 10.3205/16dgnc308, urn:nbn:de:0183-16dgnc3087

Veröffentlicht: 8. Juni 2016

© 2016 Gembruch et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Low-grade gliomas (LGG) are slowly growing, diffusely infiltrating tumors, typically not presenting histological features of malignancy. Yet, according to recent findings there is evidence for an uncertain heterogeneity within these LGG. We present a technical innovation comprising preoperative utilization of an integrated Methionine-PET/MRI and its intraoperative association with 5-ALA fluorescence to detect areas of heterogeneity in LGG with a presumable higher malignancy.

Method: Preoperative integrated PET/MRI was performed in 3 patients with brain tumors, suggestive of LGG, without contrast enhancement. Intraoperatively the integrated Methionine-PET/MRI data were co-registered and neuronavigation was used to identify different areas of Methionine-PET tracer enhancement. 5-ALA at a routine dose of 20mg/kg body weight was administered 2 hours preoperatively. Areas of methionine-uptake according to neuronavigation were compared to intraoperative 5-ALA fluorescence.

Results: Integrated PET/MRI revealed areas of different methionine-uptake, which matched strikingly to 5-ALA fluorescence in LGG. Nevertheless, standard histopathology result revealed no difference in the biological grading according to the recent WHO classification.

Conclusions: According to integrated Methionine-PET/MRI LGG are heterogeneous tumors. The striking association between 5-ALA fluorescence and Methionine-PET uptake seems to be a powerful tool to distinguish intraoperative subgroups for further prospective molecular subclassification.