The Department of Radiology and Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, 725 Welch Rd, Rm 1665, Stanford, CA, 94305-5654, USA.
Department of Radiology, Boston University Medical Center, Boston, MA, USA.
Mol Imaging Biol. 2019 Jun;21(3):591-598. doi: 10.1007/s11307-018-1272-1.
To evaluate whether the extent of restricted diffusion and 2-deoxy-2-[F] fluoro-D-glucose ([F]FDG) uptake of pediatric rhabdomyosarcomas (RMS) on positron emission tomography (PET)/magnetic resonance (MR) images provides prognostic information.
In a retrospective, IRB-approved study, we evaluated [F]FDG PET/CT and diffusion-weighted (DW) MR imaging studies of 21 children and adolescents (age 1-20 years) with RMS of the head and neck. [F]FDG PET and DW MR scans at the time of the initial tumor diagnosis were fused using MIM software. Quantitative measures of the tumor mass with restricted diffusion, [F]FDG hypermetabolism, or both were dichotomized at the median and tested for significance using Gray's test. Data were analyzed using a survival analysis and competing risk model with death as the competing risk.
[F]FDG PET/MR images demonstrated a mismatch between tumor areas with increased [F]FDG uptake and restricted diffusion. The DWI, PET, and DWI + PET tumor volumes were dichotomized at their median values, 23.7, 16.4, and 9.5 cm, respectively, and were used to estimate survival. DWI, PET, and DWI + PET overlap tumor volumes above the cutoff values were associated with tumor recurrence, regardless of post therapy COG stage (p = 0.007, p = 0.04, and p = 0.07, respectively).
The extent of restricted diffusion within RMS and overlap of hypermetabolism plus restricted diffusion predict unfavorable clinical outcomes.
评估儿童横纹肌肉瘤（RMS）在正电子发射断层扫描（PET）/磁共振（MR）图像上的弥散受限程度和 2-脱氧-2-[F]氟-D-葡萄糖（[F]FDG）摄取程度是否提供预后信息。
在一项回顾性、IRB 批准的研究中，我们评估了 21 例头颈部 RMS 儿童和青少年（年龄 1-20 岁）的 [F]FDG PET/CT 和弥散加权（DW）MR 成像研究。使用 MIM 软件对初始肿瘤诊断时的 [F]FDG PET 和 DW MR 扫描进行融合。将肿瘤质量的弥散受限、[F]FDG 高代谢或两者的定量测量值在中位数处进行二分，并使用 Gray 检验测试其显著性。使用生存分析和竞争风险模型对数据进行分析，以死亡为竞争风险。
[F]FDG PET/MR 图像显示肿瘤区域内 [F]FDG 摄取增加和弥散受限之间存在不匹配。DWI、PET 和 DWI+PET 肿瘤体积分别以中位数 23.7、16.4 和 9.5 cm 进行二分，并用于估计生存。肿瘤体积超过截断值的 DWI、PET 和 DWI+PET 重叠与肿瘤复发相关，无论治疗后 COG 分期如何（p=0.007、p=0.04 和 p=0.07）。
RMS 内弥散受限的程度和高代谢加弥散受限的重叠预测临床结果不良。
