Substitution of 11C-methionine PET by perfusion MRI during the follow-up of treated high-grade gliomas: preliminary results in clinical practice

J Neuroradiol. 2010 May;37(2):89-97. doi: 10.1016/j.neurad.2009.04.005. Epub 2009 Jun 30.


Purpose: Our aim was to compare perfusion magnetic resonance imaging (MRI) and positron emission tomography (PET) using carbon-11 labelled methionine (MET) in gliomas and their value in differentiating tumour recurrence from necrosis.

Materials and methods: We retrospectively reviewed 28 patients with a high-grade glioma. A total of 33MR perfusions and MET-PET were ultimately analysable for comparison between the relative cerebral blood volume (rCBV) and MET-PET examinations. Intra- and interobserver reproducibility was assessed and diagnostic value of rCBV compared to MET-PET and histology was assessed by the area under the receiver operating characteristic (ROC) curve.

Results: ROC curve analysis showed that rCBV had at least equal performances in differentiating tumour recurrence and necrosis than MET-PET. Cut-off value of rCBV for differentiating tumour from necrosis was 182% with a sensitivity of 81.5% and a specificity of 100%.

Conclusion: In clinical practice, perfusion MRI could replace MET-PET for differentiating necrosis from tumour recurrence.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Blood Volume
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / pathology
  • Carbon Radioisotopes*
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Glioma / diagnosis*
  • Glioma / diagnostic imaging
  • Glioma / pathology
  • Humans
  • Magnetic Resonance Angiography / methods*
  • Male
  • Methionine*
  • Middle Aged
  • Necrosis / diagnosis
  • Necrosis / diagnostic imaging
  • Necrosis / pathology
  • Observer Variation
  • Positron-Emission Tomography / methods*
  • Retrospective Studies
  • Sensitivity and Specificity


  • Carbon Radioisotopes
  • Methionine