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Meningioma Treated with Interferon-, Evaluated with [¹¹C]-L-Methionine Positron Emission Tomography¹

Departments of Neurology [C. M., Z-J. Z.], Neurosurgery [O. G.], Radiology [A. L.], and Pathology [M. H.], and PET Center [B. L.], University Hospital, SE-75185 Uppsala, Sweden

Purpose: In meningioma patients with postoperative residual masses, recurrent or primarily inoperable tumors, positron emission tomography (PET) with [¹¹C]-L-methionine was used to evaluate treatment efficacy of IFN-.

Experimental Design: Twelve patients were treated with IFN- at a dose of 1.5–5 million IU s.c. daily. PET, computed tomography, and/or magnetic resonance imaging were performed in all patients before and, at regular intervals, during IFN- treatment. The ratio of tumor hot-spot uptake to cerebellar uptake or to cortex uptake was calculated. This ratio estimates the relative methionine accumulation in the tumor and presumably the proliferative activity in the tumor.

Results: During IFN- treatment, PET demonstrated a mean relative percentage of reduction in the uptake ratio (MRelR) of 22.3% in the meningiomas. In nine patients who were considered responders, defined as patients with a positive MRelR, the MRelR was 30.4%. For the three nonresponders, defined as patients with a negative MRelR, the MRelR was -1.8%. Three patients were followed for a long time: two patients for 8 years and one patient for 4 years and 6 months; the two patients followed for 8 years are still on IFN. The volumes of these tumors were constant or showed a slight decrease. No correlation was found between histopathological diagnosis (PAD) WHO grading I–III of meningiomas and response to IFN- treatment.

Conclusions: PET was judged a useful method to predict which patients are suitable for long-term treatment with IFN- and also for dose finding. In five patients treated from 9 months to 8 years, IFN- seemed to be an effective oncostatic drug. The clinical usefulness of IFN-, taking adverse reactions into account, must be evaluated in a larger series of patients.

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