Multiparametric evaluation of low grade gliomas at follow-up: comparison between diffusion and perfusion MR with 18F-FDOPA PET
Multiparametric evaluation of low grade gliomas at follow-up: comparison between diffusion and perfusion MR with 18F-FDOPA PET
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DOI：
10.1259/bjr.20160476
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发表时间：
2016-01-01
影响因子：
2.6
通讯作者：
Bozzao, Alessandro
中科院分区：
文献类型：
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作者：
Espagnet, Maria C. Rossi;Romano, Andrea;Bozzao, Alessandro
目的：比较6-[F-18]-氟-L-3，4-二羟基苯丙氨酸(F-18-FDOPA)正电子发射断层扫描(PET)在低度恶性脑胶质瘤(LGG)中的随访效果，寻找鉴别不同预后的最佳成像参数。方法：回顾分析2010-2015年间12例经病理证实的LGG和MR(灌注和扩散序列)患者的临床资料。使用基于感兴趣区的方法评估MR检查和PET图像上的脑血容量(CBV)和表观扩散系数(ADC)图。所有患者在1年的随访中被归类为稳定或进展性疾病。采用皮尔逊相关检验和多元方差分析进行统计学分析(p，0.05)。结果：PET参数[最大肿瘤/健侧正常脑比值(T/N-max)和肿瘤/纹状体比值]与PET热点区域和最大信号改变区域的ADC值或相对CBV值均无显著相关性。T/Nmax对1年随访结果不同的两组患者具有较好的敏感性(83%)和特异度(100%)(p，0.05)。结论：与F-18-FDOPA PET相比，灌注和弥散成像在LGGs中提供了不同的信息，因此，它们可以作为评估这两种肿瘤的补充工具。F-18-FDOPA PET在LGG的随访中显示出显著的预后作用，似乎是一种比MR高级技术更好的结果预测工具。这些结果需要在更大人群中的纵向研究中得到证实。知识进展：这是第一项在随访期间将F-18-FDOPA PET与LGG的灌注和扩散MR进行比较的研究。这些初步结果强调了多模式方法在这一领域的重要性，并证明了F-18-FDOPA PET在预测肿瘤进展风险患者方面的潜在作用。
Objective: To compare MRI using perfusion and diffusion techniques with 6-[F-18]-fluoro-L-3,4-dihydroxyphenylalanine (F-18-FDOPA) positron emission tomography (PET) in the follow-up of low-grade gliomas (LGGs) and to identify the best imaging parameter to differentiate patients with different prognosis.Methods: Between 2010 and 2015, 12 patients with a pathology-proven diagnosis of LGG and MR (with perfusion and diffusion sequences) and a PET study during their follow-up were retrospectively included in our study. Cerebral blood volume (CBV) and apparent diffusion coefficient (ADC) maps on MR studies and PET images were evaluated using a region of interest-based method. All patients were categorized as stable or as having progressive disease at 1-year follow-up. Statistical analysis was performed using Pearson's correlation test and multivariate analysis of variance (p, 0.05).Results: No significant correlations were found between PET parameters [maximum tumour-to-controlateral normal brain ratio (T/N-max) and tumour-to-striatum ratio] and ADC or relative CBV values measured in both PET hotspot regions and areas of maximum signal alterations. T/Nmax demonstrated a good sensitivity (83%) and specificity (100%) for differentiating two subgroups of patients with different outcomes at 1-year-follow-up (p, 0.05).Conclusion: Perfusion and diffusion MR images provide different information compared with F-18-FDOPA PET in LGGs during follow-up and therefore, they should be considered as complementary tools in the evaluation of these tumours. F-18-FDOPA PET showed a significant prognostic role in the follow-up of LGGs and appeared to be a better tool than MR advanced techniques for outcome prediction. These results need to be confirmed with longitudinal studies on a larger population.Advances in knowledge: This is the first study that compared F-18-FDOPA PET with perfusion and diffusion MR in LGGs during follow-up. These preliminary results highlight the importance of a multimodality approach in this field and evidence a potential role for F-18-FDOPA PET to predict patients at risk for tumour progression.