The Study On The Clinical Applications And Correlative Factors Analysis Of Human Brain Tumors By PET-CT With ～(18)F-fluorodexyglucose And/or ～(11)C-methionine

Objective To investigate the value of clinical application of diagnosis and direction surgery of brain tumors with ¹⁸F-fluorodeoxyglucose (FDG) and ¹¹C-methionine (MET) positron emission tomography (PET); study the relation between ¹⁸F-FDG and ¹¹C-MET PET with proliferation, metabolism, growth characteristic and correlative cytokine of gliomas; design a method of combination of PET-CT and neuronavigation to improve gliomas surgery and investigation its clinical application.Methods (1) 71 patients with suspected brain tumor had performed ¹⁸F-FDG and ¹¹C-MET PET, analyzed the PET image in visual and semi-quantitative approach, compared the PET diagnosis with MRI, CT and pathologic results. (2) The relation between both tracers uptake and Ki67 LI, GLUT1 and 3, CD98, hLAT1, 4F2hc, â…§ factor, VEGF, HIF-1α was studied by immunohistochemistry, Western blot and RT-PCR. (3) The PET image of 2 patients with glioma was analyzed and was imputed into neuronavigation system to improve the operation.Results (1) The ¹⁸F-FDG and ¹¹C-MET uptake increases correspondingly to the ascending of brain tumor grade.The diagnostic sensitivity of brain tumor with ¹⁸F-FDG is 84.3%, the specificity is 68.7%, the vercity is 80.6%; ¹¹C-MET is 96.7%, 77.8% and 92.3%. ¹⁸F-FDG and ¹¹C-MET PET can differentiated between high and low grade tumor. The ¹⁸F-FDG and ¹¹C-MET uptake by tumors has significant relativity. Visual and semi-quantitative grading by ¹⁸F-FDG is better than ¹¹C-MET. ¹¹C-MET is better than ¹⁸F-FDG in finding and delineating tumor. T/MCU is the great grading and differential index. Combined two tracers can improve diagnosis and grading of brain tumors. (2) The ¹⁸F-FDG and ¹¹C-MET uptake by gliomas is corresponding with proliferation, expression of GLUT1, GLUT3 and CD98, relative cytokine (VEGF, HIF-1α), MVD, cell density, integrity of BBB. (3) The PET of glomas has special advantage in locating glioma. Combined PET and neuronavigation can help surgeon to confirm the operation target and range.