Multimodality Assessment of Brain Tumors and Tumor Recurrence
Multimodality Assessment of Brain Tumors and Tumor Recurrence
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DOI：
10.2967/jnumed.110.084210
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发表时间：
2011-10-01
影响因子：
9.3
通讯作者：
Lanfermann, Heinrich
中科院分区：
文献类型：
--
作者：
Heiss, Wolf-Dieter;Raab, Peter;Lanfermann, Heinrich
神经影像学在颅内肿瘤（尤其是脑胶质瘤）的诊断中发挥着重要作用，并且必须包括对肿瘤的位置和范围及其生物活性的评估。因此，形态学成像方式和功能、代谢或分子成像方式应结合起来进行初步诊断、跟踪病程和评估治疗效果。 MRI 是提供详细形态学信息的黄金标准，可以为代谢（MR 波谱）和灌注（灌注加权成像）提供一些额外的见解，但在识别肿瘤分级、邻近组织的侵袭性生长、治疗引起的变化以及复发方面仍然存在局限性。这些见解可以通过各种 PET 模式获得，包括葡萄糖代谢、氨基酸摄取、核苷摄取和缺氧的成像。 PET 结果和 MRI 的联合配准，将高分辨率形态学图像与生物信息相结合，可以提高诊断准确性。这些程序通过新开发的 PET 和 MRI 模式组合进行了优化，可以同时评估人脑的形态、功能、代谢和分子信息。
Neuroimaging plays a significant role in the diagnosis of intracranial tumors, especially brain gliomas, and must consist of an assessment of location and extent of the tumor and of its biologic activity. Therefore, morphologic imaging modalities and functional, metabolic, or molecular imaging modalities should be combined for primary diagnosis and for following the course and evaluating therapeutic effects. MRI is the gold standard for providing detailed morphologic information and can supply some additional insights into metabolism (MR spectroscopy) and perfusion (perfusion-weighted imaging) but still has limitations in identifying tumor grade, invasive growth into neighboring tissue, and treatment-induced changes, as well as recurrences. These insights can be obtained by various PET modalities, including imaging of glucose metabolism, amino acid uptake, nucleoside uptake, and hypoxia. Diagnostic accuracy can benefit from coregistration of PET results and MRI, combining the high-resolution morphologic images with the biologic information. These procedures are optimized by the newly developed combination of PET and MRI modalities, permitting the simultaneous assessment of morphologic, functional, metabolic, and molecular information on the human brain.