ldtЛучевая диагностика и терапияDiagnostic radiology and radiotherapy2079-5343Baltic Medical Education Center10.22328/2079-5343-2025-16-1-57-65ldt-1066Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHМетаболическая характеристика глиом ствола мозга у детей по результатам ПЭТ/КТ с 11С-метионином: ретроспективное исследованиеMetabolic characterization of brainstem glioma in children according to 11C-methionine PET/CT data: a retrospective studyСкворцоваТ. Ю.SkvortsovaT. Yu.

Скворцова Татьяна Юрьевна — кандидат медицинских наук, доцент, ведущий эксперт лаборатории нейровизуализации, врач-радиолог

197376, Санкт-Петербург, ул. Акад. Павлова, д. 9

Tatiana Yu. Skvortsova — Cand. of Sci. (Med.), docent, senior expert of neuroimaging laboratory, nucler medicine physician

197376, St. Petersburg, Acad. Pavlov st., 9

tanya@ihb.spb.ruhttps://orcid.org/0000-0001-9306-2101СавинцеваЖ. И.SavintsevaZh. I.

Савинцева Жанна Игоревна — кандидат медицинских наук, доцент, научный сотрудник лаборатории нейровизуализации, врач-рентгенолог, заведующий кабинетом МРТ 

197376, Санкт-Петербург, ул. Акад. Павлова, д. 9

Zhanna I. Savintseva — Cand. of Sci. (Med.), docent, researcher of neuroimaging laboratory, IHB RAS, Head of MRI cabinet of the radiology department, radiologist

197376, St. Petersburg, Acad. Pavlov st., 9

zhanna@ihb.spb.ruhttps://orcid.org/0000-0002-8607-3635ЖелудковаО. Г.ZheludkovaO. G.

Желудкова Ольга Григорьевна — доктор медицинских наук, профессор, главный научный сотрудник, детский онколог, эксперт ВАК по детской нейроонкологии

119620, Москва, ул. Авиаторов, д. 38

Olga G. Zheludkova — Dr. of Sci. (Med.), professor, senior  researcher, pediatric oncologist

119619, Moscow, Aviatorov st., 38

Институт мозга человека имени Н. П. Бехтеревой Российской академии наукРоссияN. P. Bechtereva Institute of the human brain of Russian academy of sciencesRussian FederationНаучно-практический центр специализированной медицинской помощи детям имени В. Ф. Войно-Ясенецкого Департамента здравоохранения города МосквыРоссияV. F. Voyko-Yasenetsky Scientific and practical center of specialized medical care for childrenRussian Federation2025130420251615765Copyright © Скворцова Т.Ю., Савинцева Ж.И., Желудкова О.Г., 20252025Скворцова Т.Ю., Савинцева Ж.И., Желудкова О.Г.Skvortsova T.Y., Savintseva Z.I., Zheludkova O.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://radiag.bmoc-spb.ru/jour/article/view/1066ВВЕДЕНИЕ

ВВЕДЕНИЕ: Одной из главных трудностей в прогнозировании и планировании лечения детей с глиомой ствола мозга считается нечастая гистологическая верификация диагноза, что побуждают усилить внимание к неинвазивной диагностике при помощи различных методов нейровизуализации.

ЦЕЛЬ

ЦЕЛЬ: Изучение метаболической характеристики опухолей ствола головного мозга и  таламусов у  детей при помощи ПЭТ/КТ с 11С-метионином (Мет) в сочетании с результатами МРТ.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ: В исследование включены результаты ПЭТ/КТ с Мет 63 детей в возрасте от 3 до 18 с глиомами ствола мозга и таламусов, которым до лечения были выполнены МРТ с контрастным усилением (КУ) и ПЭТ/КТ с Мет. Анализ проводился на совмещенных данных ПЭТ и МРТ и состоял из визуальной оценки и определении индексов накопления (ИН) Мет и метаболического объема опухоли.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ: Опухоли разделены на две группы — злокачественные диффузные глиомы ствола мозга (ДГСМ) и другие глиомы ствола мозга. Значимые различия между ДГСМ и другими глиомами найдены в размерах поражения и исходной структуре опухолевого роста. Различий в частоте опухолевого контрастирования не обнаружено (р=0,21). Гиперфиксация Мет наблюдалась в 72% злокачественных 

INTRODUCTION

INTRODUCTION: One of the main difficulties in prognosis and treatment planning in children with brainstem glioma is rare histological verification of the diagnosis, which prompts increased attention to non-invasive diagnostics using neuroimaging.

OBJECTIVE

OBJECTIVE: To study the metabolic characteristics of brainstem and thalamic tumors in children using PET/CT with 11Cmethionine (Met) in association with MRI results.

MATERIALS AND METHODS

MATERIALS AND METHODS: The study included the results of Met PET/CT in 63 children aged 3 to 18 with brainstem gliomas who underwent contrast-enhanced MRI (CE) and 11C-methionine PET/CT before treatment. The analysis was performed on fused PET and MRI images and consisted of visual assessment and calculation of Met tumor-to-brain ratio (TBR) and the metabolic tumor volume.

RESULTS

RESULTS: Tumors were divided into two groups: diffuse intrinsic pontine gliomas (DIPG) and other gliomas (OG). Significant differences between DIPG and OG were found in lesion size and initial tumor bed. No differences were found in the frequency of tumor contrast enhancement (p=0.21). Met high uptake was observed in 72% of DIPG and in 58% of other gliomas without significant differences (p=0.25), but TBR depended on the reference structure: cerebellum or frontal cortex (p=0.00001). Positive or negative Met tumor uptake, as well as TBR, were not associated with either the tumor type or its localization. The relationship between tumor enhancement and Met uptake pattern was found in DIPG.

DISCUSSION

DISCUSSION: Variability in amino acid transport and metabolism in brainstem tumors did not allow a reliable discrimination between tumor types, which may be due to the similar phenotypic features in DIPG and OG affecting Met uptake. The data obtained are consistent with the results of studies by other groups of authors, which showed that the greatest prognostic value for brainstem tumors is not the histological structure, but the glioma genotype.

CONCLUSION

CONCLUSION: The absence of a specific pattern of methionine transport and metabolism disorders for diffuse midline glioma limits the significance of metabolic biomarkers in the diagnosis and differential diagnosis of brainstem tumors.

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The authors declare that there are no conflicts of interest present.