非强化脑肿瘤的 FDOPA PET-CT。

FDOPA PET-CT of Nonenhancing Brain Tumors.

机构信息

From the *Service de Biophysique et Médecine Nucléaire, Hôpitaux Universitaires de Strasbourg; †ICube, Université de Strasbourg/CNRS (UMR 7357), Strasbourg; ‡Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de Médecine, Strasbourg; and §Service d'Anatomie Pathologique, ∥Service de Méthodologie et Biostatistiques, ¶IService de Radiologie, and #Service de Neurochirurgie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

出版信息

Clin Nucl Med. 2017 Apr;42(4):250-257. doi: 10.1097/RLU.0000000000001540.

DOI:10.1097/RLU.0000000000001540

PMID:28114224

Abstract

BACKGROUND

Primary brain tumor grading is crucial to rapidly determine the therapeutic impact and prognosis of a brain tumor as well as the tumors' aggressiveness profile. On magnetic resonance imaging, high-grade tumors are usually responsible for blood -brain barrier breakdowns, which result in tumor enhancement. However, this is not always the case. The main objective of this study was to evaluate the diagnostic value of FDOPA PET in the assessment of primary brain tumor aggressiveness with no contrast enhancement on MRI.

METHODS

Fifty-three patients were prospectively included: 35 low-grade and 18 high-grade histologically proven gliomas, with no contrast enhancement. Each patient underwent static PET acquisitions at 30 minutes. All patients had MRSI with measurements of different metabolites ratio.

RESULTS

FDOPA was useful in the subgroup of low-grade gliomas, discriminating between dysembryoplastic neuroepithelial tumor and grade II oligodendroglioma (P < 0.01). An optimal threshold of the maximum standardized uptake value at 30 minutes (SUVmax (T/N)30) = 2.16 to discriminated low- from high-grade gliomas with a sensitivity of 60%, specificity of 100%, PPV of 100%, and NPV of 83.33% (P < 0.01). The nCho/Cr and nCho/NAA ratios were significantly higher in high- than in low-grade gliomas (P < 0.03 and P < 0.04, respectively). A significant positive correlation between MRSI ratios and SUVmax was found.

CONCLUSION

Including data from amino acid metabolism used alone or in association with MRSI allows us to discriminate between dysembryoplastic neuroepithelial tumor and grade II oligodendroglioma and between low- and high-grade gliomas with no contrast enhancement on MRI.

摘要

背景

原发性脑肿瘤分级对于快速确定脑肿瘤的治疗效果和预后以及肿瘤的侵袭性特征至关重要。在磁共振成像（MRI）上，高级别肿瘤通常会导致血脑屏障破裂，从而导致肿瘤增强。然而，情况并非总是如此。本研究的主要目的是评估 FDOPA PET 在评估无 MRI 对比增强的原发性脑肿瘤侵袭性方面的诊断价值。

方法

53 例患者前瞻性纳入：35 例低级别和 18 例高级别组织学证实的胶质瘤，无对比增强。每位患者均进行 30 分钟的静态 PET 采集。所有患者均进行 MRSI 检查，测量不同代谢物比值。

结果

FDOPA 在低级别胶质瘤亚组中有用，可区分发育不良性神经上皮肿瘤和 II 级少突胶质细胞瘤（P<0.01）。30 分钟最大标准化摄取值（SUVmax（T/N）30）的最佳阈值=2.16，可区分低级别和高级别胶质瘤，其敏感性为 60%，特异性为 100%，阳性预测值为 100%，阴性预测值为 83.33%（P<0.01）。高级别胶质瘤的 nCho/Cr 和 nCho/NAA 比值明显高于低级别胶质瘤（P<0.03 和 P<0.04）。MRSI 比值与 SUVmax 之间存在显著正相关。