Verger Antoine, Filss Christian P, Lohmann Philipp, Stoffels Gabriele, Sabel Michael, Wittsack Hans-J, Kops Elena Rota, Galldiks Norbert, Fink Gereon R, Shah Nadim J, Langen Karl-Josef
Institute of Neuroscience and Medicine (INM-3, -4), Forschungszentrum Jülich, Jülich, Germany; Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy, Lorraine University, Nancy, France; IADI, INSERM, UMR 947, Lorraine University, Nancy, France.
Institute of Neuroscience and Medicine (INM-3, -4), Forschungszentrum Jülich, Jülich, Germany; Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany.
World Neurosurg. 2018 May;113:e727-e737. doi: 10.1016/j.wneu.2018.02.139. Epub 2018 Mar 3.
To compare the diagnostic performance of O-(2-F-fluoroethyl)-L-tyrosine (F-FET) positron emission tomography (PET) and perfusion-weighted magnetic resonance imaging (PWI) for the diagnosis of progressive or recurrent glioma.
Thirty-two pretreated gliomas (25 progressive or recurrent tumors, 7 treatment-related changes) were investigated with F-FET PET and PWI via a hybrid PET/magnetic resonance scanner. Volumes of interest with a diameter of 16 mm were centered on the maximum of abnormality in the tumor area in PET and PWI maps (relative cerebral blood volume, relative cerebral blood flow, mean transit time) and the contralateral unaffected hemisphere. Mean and maximum tumor-to-brain ratios as well as dynamic data for F-FET uptake were calculated. Diagnostic accuracies were evaluated by receiver operating characteristic analyses, calculating the area under the curve.
F-FET PET showed a significant greater sensitivity to detect abnormalities in pretreated gliomas than PWI (76% vs. 52%, P = 0.03). The maximum tumor-to-brain ratio of F-FET PET was the only parameter that discriminated treatment-related changes from progressive or recurrent gliomas (area under the curve, 0.78; P = 0.03, best cut-off 2.61; sensitivity 80%, specificity 86%, accuracy 81%). Among patients with signal abnormality in both modalities, 75% revealed spatially incongruent local hot spots.
This pilot study suggests that F-FET PET is superior to PWI to diagnose progressive or recurrent glioma.
比较O-(2-氟乙基)-L-酪氨酸（F-FET）正电子发射断层扫描（PET）和灌注加权磁共振成像（PWI）对进展性或复发性胶质瘤的诊断性能。
通过PET/磁共振混合扫描仪，对32例接受过预处理的胶质瘤患者（25例进展性或复发性肿瘤，7例治疗相关改变）进行F-FET PET和PWI检查。在PET和PWI图像（相对脑血容量、相对脑血流量、平均通过时间）以及对侧未受影响的半球中，以肿瘤区域异常最大值为中心，设置直径为16 mm的感兴趣区。计算F-FET摄取的平均和最大肿瘤与脑比值以及动态数据。通过受试者操作特征分析评估诊断准确性，计算曲线下面积。
F-FET PET检测预处理胶质瘤异常的敏感性显著高于PWI（76%对52%，P = 0.03）。F-FET PET的最大肿瘤与脑比值是区分治疗相关改变与进展性或复发性胶质瘤的唯一参数（曲线下面积，0.78；P = 0.03，最佳截断值2.61；敏感性80%，特异性86%，准确性81%）。在两种检查均有信号异常的患者中，75%显示局部热点在空间上不一致。
这项初步研究表明，F-FET PET在诊断进展性或复发性胶质瘤方面优于PWI。
