Zhao Jingwang, Chen Zhijuan, Cai Li, Yin Shaoya, Yang Weidong, Wang Zengguang
Department of Neurosurgery, Tianjin Huanhu Hospital, No. 6 Jizhao Road, Jinnan District, Tianjin, China.
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
Neurol Neurochir Pol. 2019;53(3):199-204. doi: 10.5603/PJNNS.a2019.0009. Epub 2019 Mar 11.
To investigate the discrepancy between 11C-methionine (MET) positron emission tomography (PET) and MRI results in primary glioblastoma multiforme (GBM) through three-dimensional (3D) volumetric analysis, we retrospectively analysed patients with primary GBM who underwent preoperative 3D MRI and MET PET and were operated between June 2016 and January 2017. Tumour delineation and volumetric analysis were conducted using MRIcron software. Tumour volumes defined by MRI (VMRI) were manually drawn slice by slice in axial and sagittal or coronal images of enhanced T1 sequence, while metabolic tumour volumes were automatically segmented in MET PET (VMET) based on three (frontal, occipital and temporal) 3D reference volumes of interest (VOI). Discrepancies were evaluated in terms of both absolute volume and percentage on the combined images. MET PET contours contained and extended beyond MRI contours in all five patients; in a subset of cases, MET PET contours extended to the contralateral hemisphere. The discrepancy between MET uptake and MRI results was 27.67 cm3 (4.20-51.20 cm3), i.e. approximately 39.0% (17.4-64.3%) of the metabolic tumour volume was located outside the volumes of the Gd-enhanced area. Metabolic tumour volume is substantially underestimated by Gd-enhanced area in patients with primary GBM. Quantitative volumetric information derived from MET uptake is useful in defining tumour targets and designing individualised therapy strategies in primary GBM.
为了通过三维（3D）体积分析研究原发性多形性胶质母细胞瘤（GBM）中11C-蛋氨酸（MET）正电子发射断层扫描（PET）与MRI结果之间的差异，我们回顾性分析了2016年6月至2017年1月期间接受术前3D MRI和MET PET检查并接受手术的原发性GBM患者。使用MRIcron软件进行肿瘤勾画和体积分析。在增强T1序列的轴向和矢状或冠状图像中逐片手动绘制由MRI定义的肿瘤体积（VMRI），而基于三个（额叶、枕叶和颞叶）3D感兴趣参考体积（VOI）在MET PET中自动分割代谢肿瘤体积（VMET）。在组合图像上从绝对体积和百分比两方面评估差异。所有5例患者中MET PET轮廓均包含并超出MRI轮廓；在部分病例中，MET PET轮廓延伸至对侧半球。MET摄取与MRI结果之间的差异为27.67 cm3（4.20 - 51.20 cm3），即代谢肿瘤体积的约39.0%（17.4 - 64.3%）位于钆增强区域体积之外。原发性GBM患者中钆增强区域严重低估了代谢肿瘤体积。从MET摄取获得的定量体积信息有助于确定原发性GBM中的肿瘤靶点并设计个体化治疗策略。
