Brain metastases: neuroimaging.
Brain metastases: neuroimaging.
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DOI：
10.1016/b978-0-12-811161-1.00007-4
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发表时间：
2018
影响因子：
--
通讯作者：
Pope WB
中科院分区：
文献类型：
--
作者：
Pope WB
磁共振成像（MRI）是评估原发性和转移性肿瘤等脑肿块患者的基石。在有效检测和诊断脑转移瘤以及准确表征其后续治疗反应方面仍然存在重要挑战。这些困难包括区分转移与潜在的模拟物，如原发性脑肿瘤和感染，检测小转移，以及区分治疗反应与肿瘤复发和进展。最佳的患者管理可以受益于改进和验证良好的预后和预测性成像标志物，以及早期反应标志物，以确定肿瘤大小变化之前的成功治疗。为了满足这些基本需求，较新的MRI技术，包括扩散和灌注成像，MR波谱，以及传统使用的18-氟脱氧葡萄糖以外的正电子发射断层扫描（PET）示踪剂是广泛正在进行的研究的主题，已经确定了几种有前途的增值途径。这些较新的技术提供了丰富的生理和代谢信息，可以补充标准MR评价，通过提供监测和表征细胞结构，血管生成，灌注，pH值，缺氧，代谢物浓度和其他恶性肿瘤的关键特征的能力。本章回顾了计算机断层扫描、MRI和氨基酸PET提供的脑转移瘤的标准和高级成像，重点关注可作为脑转移瘤患者临床管理中解决问题工具的潜在生物标志物。
Magnetic resonance imaging (MRI) is the cornerstone for evaluating patients with brain masses such as primary and metastatic tumors. Important challenges in effectively detecting and diagnosing brain metastases and in accurately characterizing their subsequent response to treatment remain. These difficulties include discriminating metastases from potential mimics such as primary brain tumors and infection, detecting small metastases, and differentiating treatment response from tumor recurrence and progression. Optimal patient management could be benefited by improved and well-validated prognostic and predictive imaging markers, as well as early response markers to identify successful treatment prior to changes in tumor size. To address these fundamental needs, newer MRI techniques including diffusion and perfusion imaging, MR spectroscopy, and positron emission tomography (PET) tracers beyond traditionally used 18-fluorodeoxyglucose are the subject of extensive ongoing investigations, with several promising avenues of added value already identified. These newer techniques provide a wealth of physiologic and metabolic information that may supplement standard MR evaluation, by providing the ability to monitor and characterize cellularity, angiogenesis, perfusion, pH, hypoxia, metabolite concentrations, and other critical features of malignancy. This chapter reviews standard and advanced imaging of brain metastases provided by computed tomography, MRI, and amino acid PET, focusing on potential biomarkers that can serve as problem-solving tools in the clinical management of patients with brain metastases.