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CORRESPONDENCE
Year : 2013  |  Volume : 9  |  Issue : 4  |  Page : 715-717

The demonstration of extension of high-grade glioma beyond magnetic resonance imaging defined edema by the use of 11 C-methionine positron emission tomography


1 Department of Radiation Oncology, Health Care Global-Bangalore Institute of Oncology, Karnataka, India
2 Department of Orthopedics, Bhagwan Mahaveer Jain Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Swaroop Revannasiddaiah
Department of Radiation Oncology, Health Care Global-Bangalore Institute of Oncology, #8 P. Kalinga Rao Road, Sampangiramnagar, Bengaluru - 560 027
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.126464

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The use of magnetic resonance imaging (MRI) is the current standard for the delineation of target volumes for high-grade gliomas (HGG). While the peritumoral edema as per T2-weighted (T2W) imaging is utilized as basis to delineate the initial borders of the clinical target volume (CTV), those areas enhancing on T1-weighted (T1W) images with gadolinium contrast (T1-Gd) are considered for treatment with further boost. However, recent data has emerged concerning the use of positron emission tomography (PET) with 11 C-methionine, which seemingly provides additional information beyond MRI. We present the case of a gentleman with an inoperable HGG which was imaged with 11 C-methionine-PET ( 11 C-MET-PET)/CT as well as MRI as part of the radiotherapy treatment planning (RTP) process. The differences noted between the MRI and the PET defined volumes are presented. This being a patient who was not operated, the potentially confounding issue of surgery-induced PET-avidity is absent.


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