Methionine PET/CT Studies In Patients With Cancer
Methionine PET/CT Studies In Patients With Cancer
The purpose of this study is to test the usefulness of imaging with radiolabeled methionine
 in the evaluation of children and young adults with tumor(s). Methionine is a naturally
 occurring essential amino acid. It is crucial for the formation of proteins. When labeled
 with carbon-11 (C-11), a radioactive isotope of the naturally occurring carbon-12, the
 distribution of methionine can be determined noninvasively using a PET (positron emission
 tomography) camera. C-11 methionine (MET) has been shown valuable in the monitoring of a
 large number of neoplasms. Since C-11 has a short half life (20 minutes), MET must be
 produced in a facility very close to its intended use. Thus, it is not widely available and
 is produced only at select institutions with access to a cyclotron and PET chemistry
 facility. With the new availability of short lived tracers produced by its PET chemistry
 unit, St. Jude Children's Research Hospital (St. Jude) is one of only a few facilities with
 the capabilities and interests to evaluate the utility of PET scanning in the detection of
 tumors, evaluation of response to therapy, and distinction of residual tumor from scar tissue
 in patients who have completed therapy. The investigators propose to examine the
 biodistribution of MET in patients with malignant solid neoplasms, with emphasis on central
 nervous system (CNS) tumors and sarcomas. This project introduces a new diagnostic test for
 the noninvasive evaluation of neoplasms in pediatric oncology. Although not the primary
 purpose of this proposal, the investigators anticipate that MET studies will provide useful
 clinical information for the management of patients with malignant neoplasms.
The study focuses on the following objectives:

 Primary objective:

 -  To estimate the success rate of Methionine (MET) for visualizing tumors at the time of
 diagnosis. The study hypothesizes that at least 70% of newly diagnosed tumors within
 each group will be studied and will be successfully visualized.

 Secondary objective:

 -  To compare uptake of MET in tumors with tumor grade in patients with newly diagnosed or
 relapsed, and/or persistent disease. Hypothesis: high grade tumors will concentrate
 higher amounts of MET than lower grade tumors measured both qualitatively and
 semi-quantitatively.

 -  To examine the bio-distribution of MET in organs that do not contain tumor, in
 particular the lungs, heart, mediastinum, liver, spleen, pancreas, muscle, brain, and
 bone marrow.

 Exploratory objectives:

 -  To compare the findings on MET PET scans with those of standard imaging modalities,
 principally MRI (magnetic resonance imaging) and FDG (fluorodeoxyglucose) PET CT
 (computed tomography) at diagnosis, or at study enrollment for patients with relapsed
 and or persistent disease, and for all patients over time.

 -  To compare the extent of abnormality on MRI with that of MET.

 -  To determine the presence or absence of elevated MET uptake beyond those of MRI defined
 abnormality.

 -  To explore the relationship between MET uptake and prognosis.
Inclusion Criteria:

 -  All participants under the care of St. Jude physicians with known or suspected
 neoplastic disease are eligible for participation.

 -  Participants will have had, or are scheduled to have clinical imaging evaluations
 which may include FDG PET CT, or CT, or MRI within 4 weeks of entry.

 -  No limit on age or gender.

 -  Female participants of childbearing age must not be lactating due to theoretical
 potential harm to the infant from exposure to radiation.

 -  Informed consent signed by participant, parent, or guardian according to the
 guidelines of the institutional review board.

 Exclusion Criteria:

 -  More than 6 MET PET scans within the previous 12 months.

 -  Inability or unwillingness of research participant, parent, or legal
 guardian/representative to give written informed consent.

 Inclusion Criteria for Open-Access

 -  All participants under the care of St. Jude physicians with known or suspected
 neoplastic disease are eligible for participation.

 -  No limit on age or gender

 -  Female participants of childbearing age must not be lactating due to theoretical
 potential harm to the infant from exposure to radiation.

 -  Informed consent signed by participant, parent, or guardian according to the
 guidelines of the institutional review board.

 Exclusion Criteria for Open-Access

 -  More than 6 MET PET scans within the previous 12 months.

 -  Inability or unwillingness of research participant, parent, or legal
 guardian/representative to give written informed consent.