Related Experiment Video
Updated: Jul 7, 2026
PET and MRI Guided Irradiation of a Glioblastoma Rat Model Using a Micro-irradiator
Published on: December 28, 2017
Targeting optimal biopsy location in basal ganglia germinoma using (11)C-methionine positron emission tomography
Nobuyuki Kawai1, Keisuke Miyake, Yoshihiro Nishiyama
1Department of Neurological Surgery, Kagawa University School of Medicine, Kita-gun, Kagawa 761-0793, Japan. nobu@med.kagawa-u.ac.jp
Background:
Approximately 5% to 10% of intracranial germinomas arise from the basal ganglia or thalamus. Diagnosis is usually made by stereotactic biopsy, and precise location of the biopsy target is crucial because germinoma in these sites is potentially curable. We herein describe a case with germinoma in the basal ganglia that showed nonspecific clinical and radiological findings. The usefulness of MET-PET in locating an optimal biopsy target and monitoring treatment efficacy in this case is presented.
Case Description:
A 9-year-old boy presented with a 4-month history of dystonia in his left upper extremity. Magnetic resonance imaging of the brain showed abnormal signal intensity in the right basal ganglia, internal capsule, and corona radiata without mass formation and enhancement effect. He had been treated as having multiple sclerosis without improvements on clinical and radiological findings. The MET-PET study showed increased tracer uptake in the areas of abnormal signal intensity on the MR images, and the MRI-PET co-registered images exhibited the highest tracer uptake in the anterior limb of the internal capsule. A stereotactic biopsy targeting the highest tracer uptake lesion was performed with histologic verification of germinoma. He was intensively treated with combined chemotherapy and radiotherapy according to the MR images and MET-PET findings. After the treatment, the area of abnormal signal intensity significantly reduced in size on the follow-up MRI and lesional tracer uptake was also decreased on MET-PET images.
Conclusion:
The MET-PET study is very useful for locating a precise biopsy target and provides useful information in monitoring treatment efficacy in the basal ganglia germinoma that showed nonspecific radiological findings.
Insights
Metabolic positron emission tomography (MET-PET) aids in precisely locating biopsy targets for basal ganglia germinoma. This imaging technique also proves valuable for monitoring treatment effectiveness in challenging cases.
Area of Science:
- Neuro-oncology
- Diagnostic Imaging
- Nuclear Medicine
Background:
- Intracranial germinomas can occur in the basal ganglia or thalamus (5-10% of cases).
- Accurate biopsy targeting is critical for potentially curable basal ganglia germinomas.
- Nonspecific clinical and radiological findings can complicate diagnosis.
Observation:
- A 9-year-old boy presented with dystonia and nonspecific MRI findings suggestive of multiple sclerosis.
- MET-PET revealed increased tracer uptake in abnormal signal areas on MRI.
- Co-registered MRI-PET identified the highest uptake in the anterior limb of the internal capsule, guiding stereotactic biopsy.
Findings:
- Histologic verification confirmed germinoma.
- Combined chemotherapy and radiotherapy were administered based on imaging findings.
- Follow-up MRI and MET-PET showed significant reduction in lesion size and tracer uptake, indicating treatment efficacy.
Implications:
- MET-PET is highly effective for precise biopsy targeting in basal ganglia germinoma.
- MET-PET provides valuable data for monitoring treatment response in these tumors.
- This approach improves diagnostic accuracy and therapeutic management for rare germinomas.
