Sequential and Hybrid PET/MRI Acquisition in Follow-Up Examination of Glioblastoma Show Similar Diagnostic Performance.
Sequential and Hybrid PET/MRI Acquisition in Follow-Up Examination of Glioblastoma Show Similar Diagnostic Performance.
复制标题
胶质母细胞瘤随访检查中的连续和混合 PET/MRI 采集显示出相似的诊断性能。
DOI：
10.3390/cancers15010083
复制
发表时间：
2022-12-23
期刊：
影响因子：
5.2
通讯作者：
Metz, Marie-Christin
中科院分区：
文献类型：
--
作者：
Ziegenfeuter, Julian;Delbridge, Claire;Bernhardt, Denise;Gempt, Jens;Schmidt-Graf, Friederike;Griessmair, Michael;Thomas, Marie;Meyer, Hanno S.;Zimmer, Claus;Meyer, Bernhard;Combs, Stephanie E.;Yakushev, Igor;Wiestler, Benedikt;Metz, Marie-Christin
在胶质瘤患者的治疗中，可靠地区分真实的肿瘤进展和治疗相关的变化是一个具有挑战性的情况。氨基酸PET和核磁共振灌注成像，以及它们的组合，在这一决定中发挥着核心作用。在临床实践中，PET和MRI通常是在两个不同的时间点获得的，因此问题出现了，这是否以及如何影响他们的诊断性能。在我们的研究中，我们调查了38名胶质母细胞瘤患者(IDH野生型)的独特队列，他们在一个月内接受了PET-MRI(同时采集FET-PET和DSC灌注)以及MRI检查和DSC灌注。对于所有的全局和局部图像指标，重要的是诊断性能，我们发现同时采集和连续采集PET和MRI之间没有显著差异。这些结果为常规临床管理提供了保证，并支持进一步研究先进的多参数模型，以便在不同时获得PET和MRI的情况下改善神经肿瘤学的个性化决策。正电子发射断层扫描(PET)和磁共振成像(MRI)，包括动态磁化率对比灌注(DSC-PWI)，对于高级别胶质瘤患者的治疗监测至关重要。在临床实践中，它们通常在不同的时间点进行。这是否会影响他们的诊断性能目前尚不清楚。为此，我们回顾了38例经病理证实的胶质母细胞瘤(IDH野生型)，并怀疑肿瘤放疗后复发。只有同时接受PET-MRI(其中DSC灌注与FET-PET同时采集)和单独MRI检查(包括DSC灌注)的患者被包括在内。肿瘤被自动分割为对比剂增强的肿瘤(CET)、坏死和水肿区。为了比较DSC与FET-PET的同步和顺序灌注，我们计算了Dice重叠、全局互信息以及热点区域的体素Spearman相关性。对于PET和MRI的联合评估，我们使用同时或连续获取的图像作为输入数据，计算了区分真正进展(PD)和治疗相关变化(TRC)的Logistic回归模型。当比较同步的PET-MRI和顺序的PET/MRI采集时，我们没有观察到Dice重叠(p=0.17；配对t检验)、互信息(p=0.18；配对t检验)和Spearman相关(p=0.90；配对t检验)之间的显著差异。这也适用于两次检查间隔14天的患者。重要的是，对于诊断性能，ROC分析在区分PD和TRC方面显示相似的AUC(AUC同步PET：0.77；AUC序贯PET：0.78；p=0.83，DeLong‘s检验)。我们发现同时采集和顺序采集FET-PET和DSC灌注之间没有相关差异，也没有关于它们的诊断性能的差异。考虑到对胶质瘤治疗反应的多参数评估日益受到重视，我们的结果令人放心地表明，序贯采集在临床和科学上是可以接受的。
Reliable differentiation between true tumor progression and treatment-related changes is a challenging situation in the management of glioma patients. Both amino-acid PET and perfusion MRI, as well as their combination, play a central role in this decision. In clinical practice, PET and MRI are usually acquired at two separate time points, so the question arises if and how this affects their diagnostic performance. In our study, we investigated a unique cohort of 38 glioblastoma patients (IDH wild-type), who received both a PET–MRI (with simultaneous acquisition of FET-PET and DSC perfusion) as well as an MRI exam with DSC perfusion within a month of each other. For all global and local image metrics, and importantly also for the diagnostic performance, we found no significant difference between the simultaneous and sequential acquisition of PET and MRI. These results are reassuring for routine clinical management and support further investigation into advanced, multi-parametric models for improving personalized decision-making in neuro-oncology when PET and MRI are not acquired simultaneously. Both positron emission tomography (PET) and magnetic resonance imaging (MRI), including dynamic susceptibility contrast perfusion (DSC-PWI), are crucial for treatment monitoring of patients with high-grade gliomas. In clinical practice, they are usually conducted at separate time points. Whether this affects their diagnostic performance is presently unclear. To this end, we retrospectively reviewed 38 patients with pathologically confirmed glioblastoma (IDH wild-type) and suspected tumor recurrence after radiotherapy. Only patients who received both a PET–MRI (where DSC perfusion was acquired simultaneously with a FET-PET) and a separate MRI exam (including DSC perfusion) were included. Tumors were automatically segmented into contrast-enhancing tumor (CET), necrosis, and edema. To compare the simultaneous as well as the sequential DSC perfusion to the FET-PET, we calculated Dice overlap, global mutual information as well as voxel-wise Spearman correlation of hotspot areas. For the joint assessment of PET and MRI, we computed logistic regression models for the differentiation between true progression (PD) and treatment-related changes (TRC) using simultaneously or sequentially acquired images as input data. We observed no significant differences between Dice overlap (p = 0.17; paired t-test), mutual information (p = 0.18; paired t-test) and Spearman correlation (p = 0.90; paired t-test) when comparing simultaneous PET–MRI and sequential PET/MRI acquisition. This also held true for the subgroup of patients with >14 days between exams. Importantly, for the diagnostic performance, ROC analysis showed similar AUCs for differentiation of PD and TRC (AUC simultaneous PET: 0.77; AUC sequential PET: 0.78; p = 0.83, DeLong’s test). We found no relevant differences between simultaneous and sequential acquisition of FET-PET and DSC perfusion, also regarding their diagnostic performance. Given the increasing attention to multi-parametric assessment of glioma treatment response, our results reassuringly suggest that sequential acquisition is clinically and scientifically acceptable.
登录
查看更多内容
影响因子：
158.5
作者：
Stupp, R;Mason, WP;Ryan, G
通讯作者：
Ryan, G
影响因子：
4.7
作者：
Arzanforoosh F;Croal PL;van Garderen KA;Smits M;Chappell MA;Warnert EAH
通讯作者：
Warnert EAH
影响因子：
4.8
作者：
Rohlfing, Torsten;Zahr, Natalie M.;Sullivan, Edith V.;Pfefferbaum, Adolf
通讯作者：
Pfefferbaum, Adolf
DOI：
10.1007/s00259-020-05114-0
发表时间：
2021-06
影响因子：
9.1
作者：
Steidl E;Langen KJ;Hmeidan SA;Polomac N;Filss CP;Galldiks N;Lohmann P;Keil F;Filipski K;Mottaghy FM;Shah NJ;Steinbach JP;Hattingen E;Maurer GD
通讯作者：
Maurer GD
（18）F-FET PET/MRI对脑肿瘤患者临床管理的影响。
DOI：
10.2967/jnumed.121.262051
发表时间：
2022-04
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
--
作者：
Brendle C;Maier C;Bender B;Schittenhelm J;Paulsen F;Renovanz M;Roder C;Castaneda-Vega S;Tabatabai G;Ernemann U;Fougère C
通讯作者：
Fougère C