18F-FACBC PET/MRI in Diagnostic Assessment and Neurosurgery of Gliomas

Clinical Nuclear Medicine - Tập 44 Số 7 - Trang 550-559 - 2019
Anna Karlberg, Erik Magnus Berntsen, Håkon Johansen1, Anne Jarstein Skjulsvik, Ingerid Reinertsen2, Hong Dai3, Yiming Xiao4, Hassan Rivaz, Per Borghammer5, Ole Solheim, Live Eikenes6
1Department of Radiology and Nuclear Medicine, St Olavs Hospital;
2Department of Health Research, SINTEF, Trondheim, Norway
3Department of Pathology and Medical Genetics, St Olavs Hospital;
4Robarts Research Institute, Western University, London, Ontario, Canada
5Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark
6Department of Circulation and Medical Imaging, Norwegian University of Science and Technology

Tóm tắt

Purpose

This pilot study aimed to evaluate the amino acid tracer 18F-FACBC with simultaneous PET/MRI in diagnostic assessment and neurosurgery of gliomas.

Materials and Methods

Eleven patients with suspected primary or recurrent low- or high-grade glioma received an 18F-FACBC PET/MRI examination before surgery. PET and MRI were used for diagnostic assessment, and for guiding tumor resection and histopathological tissue sampling. PET uptake, tumor-to-background ratios (TBRs), time-activity curves, as well as PET and MRI tumor volumes were evaluated. The sensitivities of lesion detection and to detect glioma tissue were calculated for PET, MRI, and combined PET/MRI with histopathology (biopsies for final diagnosis and additional image-localized biopsies) as reference.

Results

Overall sensitivity for lesion detection was 54.5% (95% confidence interval [CI], 23.4–83.3) for PET, 45.5% (95% CI, 16.7–76.6) for contrast-enhanced MRI (MRICE), and 100% (95% CI, 71.5–100.0) for combined PET/MRI, with a significant difference between MRICE and combined PET/MRI (P = 0.031). TBRs increased with tumor grade (P = 0.004) and were stable from 10 minutes post injection. PET tumor volumes enclosed most of the MRICE volumes (>98%) and were generally larger (1.5–2.8 times) than the MRICE volumes. Based on image-localized biopsies, combined PET/MRI demonstrated higher concurrence with malignant findings at histopathology (89.5%) than MRICE (26.3%).

Conclusions

Low- versus high-grade glioma differentiation may be possible with 18F-FACBC using TBR. 18F-FACBC PET/MRI outperformed MRICE in lesion detection and in detection of glioma tissue. More research is required to evaluate 18F-FACBC properties, especially in grade II and III tumors, and for different subtypes of gliomas.

Từ khóa


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