Clinic of the Imaging Methods, University Hospital Plzen, Alej Svobody 80, 304 60 Plzeň, Czech Republic.
Sikl's Institute of Pathological Anatomy, University Hospital Plzen, Alej Svobody 80;304 60 Plzeň, Czech Republic.
Eur J Radiol. 2017 Sep;94:A14-A25. doi: 10.1016/j.ejrad.2017.02.034. Epub 2017 Feb 22.
A combination of morphological imaging of the brain with microstructural and functional imaging provides a comprehensive overview of the properties of individual tissues. While diffusion weighted imaging provides information about tissue cellularity, spectroscopic imaging allows us to evaluate the integrity of neurons and possible anaerobic glycolysis during tumor hypoxia, in addition to the presence of accelerated synthesis or degradation of cellular membranes; on the other hand, PET metabolic imaging is used to evaluate major metabolic pathways, determining the overall extent of the tumor (F-FET, F-FDOPA, F-FCH) or the degree of differentiation (F-FDG, F-FLT, F-FDOPA and F-FET). Multi-parameter analysis of tissue characteristics and determination of the phenotype of the tumor tissue is a natural advantage of PET/MRI scanning. The disadvantages are higher cost and limited availability in all centers with neuro-oncology surgery. PET/MRI scanning of brain tumors is one of the most promising indications since the earliest experiments with integrated PET/MRI imaging systems, and along with hybrid imaging of neurodegenerative diseases, represent a new direction in the development of neuroradiology on the path towards comprehensive imaging at the molecular level.
脑形态影像学与微观结构和功能影像学相结合，为个体组织特性提供了全面的概述。弥散加权成像提供了关于组织细胞结构的信息，而波谱成像是评估肿瘤缺氧时神经元完整性和可能的无氧糖酵解的方法，此外还可以评估细胞膜的加速合成或降解；另一方面，PET 代谢成像是用于评估主要代谢途径，确定肿瘤的总体范围（F-FET、F-FDOPA、F-FCH）或分化程度（F-FDG、F-FLT、F-FDOPA 和 F-FET）。组织特征的多参数分析和肿瘤组织表型的确定是 PET/MRI 扫描的自然优势。缺点是成本更高，并且并非所有具有神经肿瘤手术的中心都可以提供。脑肿瘤的 PET/MRI 扫描是最有前途的适应症之一，因为最早的集成 PET/MRI 成像系统的实验，以及神经退行性疾病的混合成像，代表了神经放射学发展的一个新方向，朝着分子水平的全面成像迈进。
