Usefulness of FMISO-PET for glioma analysis

Neurol Med Chir (Tokyo). 2013;53(11):773-8. doi: 10.2176/nmc.ra2013-0256. Epub 2013 Oct 29.

Abstract

Glioma is one of the most common brain tumors in adults. Its diagnosis and management have been determined by histological classifications. It is difficult to establish new paradigms because the pathology has matured and a great deal of knowledge has accumulated. On the other hand, we understand that there are limitations to this gold-standard because of the heterogeneity of glioma. Thus, it is necessary to find new criteria independent of conventional morphological diagnosis. Molecular imaging such as positron emission tomography (PET) is one of the most promising approaches to this challenge. PET provides live information of metabolism through the behavior of single molecules. The advantage of PET is that its noninvasive analysis does not require tissue sample, therefore examination can be performed repeatedly. This is very useful for capturing changes in the biological nature of tumor without biopsy. In the present clinical practice for glioma, (18)F-fluorodeoxyglucose (FDG) PET is the most common tracer for predicting prognosis and differentiating other malignant brain tumors. Amino acid tracers such as (11)C-methionine (MET) are the most useful for detecting distribution of glioma, including low-grade. Tracers to image hypoxia are under investigation for potential clinical use, and recently, (18)F-fluoromisonidazole (FMISO) has been suggested as an effective tracer to distinguish glioblastoma multiforme from others.

Publication types

  • Review

MeSH terms

  • Adult
  • Animals
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / metabolism
  • Diagnosis, Differential
  • Fluorine Radioisotopes* / pharmacokinetics
  • Glioblastoma / diagnostic imaging
  • Glioblastoma / metabolism
  • Glioma / diagnostic imaging*
  • Glioma / metabolism
  • Humans
  • Misonidazole / analogs & derivatives*
  • Misonidazole / pharmacokinetics
  • Oxygen / metabolism
  • Positron-Emission Tomography*
  • Prognosis
  • Radiopharmaceuticals* / pharmacokinetics
  • Reproducibility of Results

Substances

  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • fluoromisonidazole
  • Misonidazole
  • Oxygen