[18F]氟代-L-胸腺嘧啶正电子发射断层扫描（PET）与先进的磁共振成像（MRI）用于胶质瘤术前分级
[(18)F]-fluoro-L-thymidine PET and advanced MRI for preoperative grading of gliomas.
作者信息
Collet S, Valable S, Constans J M, Lechapt-Zalcman E, Roussel S, Delcroix N, Abbas A, Ibazizene M, Bernaudin M, Barré L, Derlon J M, Guillamo J S
机构信息
CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France.
CNRS, UMR 6301 ISTCT, CERVOxy ou LDM-TEP ou ISTS group, GIP CYCERON, Caen F-14074, France ; CEA, DSV/I2BM, UMR 6301 ISTCT, Caen F-14074, France ; Université de Caen Basse-Normandie, UMR 6301 ISTCT, Caen F-14074, France ; Normandie Univ, France ; CHU de Caen, Service de Neuroradiologie, Caen F-14000, France.
出版信息
Neuroimage Clin. 2015 May 29;8:448-54. doi: 10.1016/j.nicl.2015.05.012. eCollection 2015.
PURPOSE
Conventional MRI based on contrast enhancement is often not sufficient in differentiating grade II from grade III and grade III from grade IV diffuse gliomas. We assessed advanced MRI, MR spectroscopy and [(18)F]-fluoro-l-thymidine ([(18)F]-FLT) PET as tools to overcome these limitations.
METHODS
In this prospective study, thirty-nine patients with diffuse gliomas of grades II, III or IV underwent conventional MRI, perfusion, diffusion, proton MR spectroscopy ((1)H-MRS) and [(18)F]-FLT-PET imaging before surgery. Relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC), Cho/Cr, NAA/Cr, Cho/NAA and FLT-SUV were compared between grades.
RESULTS
Cho/Cr showed significant differences between grade II and grade III gliomas (p = 0.03). To discriminate grade II from grade IV and grade III from grade IV gliomas, the most relevant parameter was the maximum value of [(18)F]-FLT uptake FLTmax (respectively, p < 0.001 and p < 0.0001). The parameter showing the best correlation with the grade was the mean value of [(18)F]-FLT uptake FLTmean (R(2) = 0.36, p < 0.0001) and FLTmax (R(2) = 0.5, p < 0.0001).
CONCLUSION
Whereas advanced MRI parameters give indications for the grading of gliomas, the addition of [(18)F]-FLT-PET could be of interest for the accurate preoperative classification of diffuse gliomas, particularly for identification of doubtful grade III and IV gliomas.
目的
基于对比增强的传统磁共振成像（MRI）在鉴别II级与III级以及III级与IV级弥漫性胶质瘤时往往并不充分。我们评估了先进的MRI、磁共振波谱（MRS）以及[（18）F] - 氟 - L - 胸腺嘧啶核苷（[（18）F] - FLT）正电子发射断层显像（PET）作为克服这些局限性的工具。
方法
在这项前瞻性研究中，39例II级。III级或IV级弥漫性胶质瘤患者在手术前行传统MRI、灌注成像、扩散成像、质子磁共振波谱（（1）H - MRS）以及[（18）F] - FLT - PET成像。比较不同级别之间的相对脑血容量（rCBV）、表观扩散系数（ADC）、胆碱/肌酸（Cho/Cr）、N - 乙酰天门冬氨酸/肌酸（NAA/Cr）、胆碱/N - 乙酰天门冬氨酸（Cho/NAA）以及FLT标准化摄取值（FLT - SUV）。
结果
Cho/Cr在II级与III级胶质瘤之间显示出显著差异（p = 0.03）。为了鉴别II级与IV级以及III级与IV级胶质瘤，最相关的参数是[（18）F] - FLT摄取最大值FLTmax（分别为p < 0.001和p < 0.0001）。与级别相关性最佳的参数是[（18）F] - FLT摄取平均值FLTmean（R（2） = 0.36，p < 0.0001）和FLTmax（R（2） = 0.5，p < 0.0001）。
结论
尽管先进的MRI参数可为胶质瘤分级提供线索，但添加[（18）F] - FLT - PET对于弥漫性胶质瘤的准确术前分类可能是有意义的，特别是对于鉴别可疑的III级和IV级胶质瘤。
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