Multiparametric MR and PET Imaging of Intratumoral Biological Heterogeneity in Patients with Metastatic Lung Cancer Using Voxel-by-Voxel Analysis.
Multiparametric MR and PET Imaging of Intratumoral Biological Heterogeneity in Patients with Metastatic Lung Cancer Using Voxel-by-Voxel Analysis.
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DOI：
10.1371/journal.pone.0132386
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Beer AJ
中科院分区：
文献类型：
--
作者：
Metz S;Ganter C;Lorenzen S;van Marwick S;Holzapfel K;Herrmann K;Rummeny EJ;Wester HJ;Schwaiger M;Nekolla SG;Beer AJ
扩散加权磁共振成像(DW-MRI)和正电子发射断层扫描(FDG-PET)葡萄糖代谢成像(FDG-PET)提供了组织特征的定量信息。将这两种方法结合起来，可能会对肿瘤的异质性和生物学提供新的见解。在这里，我们提出了一种解决方案，以分析和可视化之间的表观扩散系数(ADC)和葡萄糖代谢之间的关系在空间分辨率逐个体素的基础上使用专用的定量软件。对12例非小细胞肺癌(NSCLC)的原发灶或转移灶进行了DW-MRI和18F-脱氧葡萄糖(FDG)PET检查。使用定制软件(Anima M3P)逐个体素地将来自DW-MRI的ADC与标准摄取值相关联。对于聚类分析，我们使用前瞻性定义的18F-FDG和ADC阈值来定义不同生物活性的肿瘤区域。ADC图和PET数据的联合分析和可视化在所有患者中都是可行的。空间分析显示整个肿瘤区域的ADC值相对均匀，而FDG显示向肿瘤中心的摄取减少。正如预期的那样，限制水的扩散率在葡萄糖代谢较高的地区显著，但也在葡萄糖代谢较低的地区发现。详细地说，72%的体素表现出低ADC值(<；1.5×10-3mm2/S)和高摄取18F-FDG(SUV>；3.6)。然而，83%的FDG摄取率低的体素也显示出低ADC值，逐渐向肿瘤中心靠拢。DW-MRI和FDG-PET的多参数分析和可视化是可行的，分别使用专用成像软件在逐个体素的空间分辨基础上进行。我们的初步数据表明，在转移性非小细胞肺癌中，水的扩散率和葡萄糖代谢并不一定在所有的肿瘤区域都相关。
Diffusion-weighted magnetic resonance imaging (DW-MRI) and imaging of glucose metabolism by positron emission tomography (FDG-PET) provide quantitative information on tissue characteristics. Combining the two methods might provide novel insights into tumor heterogeneity and biology. Here, we present a solution to analyze and visualize the relationship between the apparent diffusion coefficient (ADC) and glucose metabolism on a spatially resolved voxel-by-voxel basis using dedicated quantitative software. In 12 patients with non small cell lung cancer (NSCLC), the primary tumor or metastases were examined with DW-MRI and PET using 18F-fluorodeoxyglucose (FDG). The ADC’s from DW-MRI were correlated with standardized-uptake-values on a voxel-by-voxel basis using custom made software (Anima M3P). For cluster analysis, we used prospectively defined thresholds for 18F-FDG and ADC to define tumor areas of different biological activity. Combined analysis and visualization of ADC maps and PET data was feasible in all patients. Spatial analysis showed relatively homogeneous ADC values over the entire tumor area, whereas FDG showed a decreasing uptake towards the tumor center. As expected, restricted water diffusivity was notable in areas with high glucose metabolism but was also found in areas with lower glucose metabolism. In detail, 72% of all voxels showed low ADC values (<1.5x10-3 mm2/s) and high tracer uptake of 18F-FDG (SUV>3.6). However, 83% of the voxels with low FDG uptake also showed low ADC values, increasingly towards the tumor center. Multiparametric analysis and visualization of DW-MRI and FDG-PET is feasible on a spatially resolved voxel-by-voxel respectively cluster basis using dedicated imaging software. Our preliminary data suggest that water diffusivity and glucose metabolism in metastatic NSCLC are not necessarily correlated in all tumor areas.