IMAGING CHALLENGES IN THE ASSESSMENT OF POSTTREATMENT GLIOMAS AND OPPORTUNITIES TO IMPROVE THE ACCURACY OF DIAGNOSIS USING PET WITH [¹¹C]METHIONINE

Authors, including specialists in nuclear medicine, radiologist and neurosurgeon, offer a comprehensive approach to the challenges of brain tumor imaging in assessment of treatment response. Analysis of the vast raw material - PET with [¹¹C] methionine, MRI conducted in dynamics from 1038 patients with cerebral gliomas - allowed to divide the treatment control into 3 main tasks: control of tumor removal after surgery, assessment of the response to therapy and differential diagnosis of recurrent brain tumor and radiation-induced brain changes. The critical meaningful Macdonald criteria, recently proposed RANO criteria (2010) and basic principle that the metabolic changes in tumors revealed by PET using [¹¹C] methionine precede structural changes on MRI were the basis for solving the each problem. The article reviews the advantages and features of using PET in the assessment of glioma surgery and in early detection of glioma progression. Authors paid attention to the relatively new concept of «pseudoprogression» and «pseudoresponse» and formulated metabolic characteristics of these phenomena. Comparison of structural and metabolic parameters provides objective criteria for evaluating the effectiveness of individual treatment.

церебральные глиомы, эффективность лечения, продолженный рост опухоли, псевдопрогрессия, псевдоответ, cerebral glioma, response assessment, recurrent glioma, pseudoprogression, pseudoresponse

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