低级别胶质瘤中 F-FDOPA 摄取与肿瘤优先定位的关系。
Preferential tumor localization in relation to F-FDOPA uptake for lower-grade gliomas.
机构信息
UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.
Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
出版信息
J Neurooncol. 2021 May;152(3):573-582. doi: 10.1007/s11060-021-03730-w. Epub 2021 Mar 11.
PURPOSE
Although tumor localization and 3,4-dihydroxy-6-F-fluoro-L-phenylalanine (FDOPA) uptake may have an association, preferential tumor localization in relation to FDOPA uptake is yet to be investigated in lower-grade gliomas (LGGs). This study aimed to identify differences in the frequency of tumor localization between FDOPA hypometabolic and hypermetabolic LGGs using a probabilistic radiographic atlas.
METHODS
Fifty-one patients with newly diagnosed LGG (WHO grade II, 29; III, 22; isocitrate dehydrogenase wild-type, 21; mutant 1p19q non-codeleted,16; mutant codeleted, 14) who underwent FDOPA positron emission tomography (PET) were retrospectively selected. Semiautomated tumor segmentation on FLAIR was performed. Patients with LGGs were separated into two groups (FDOPA hypometabolic and hypermetabolic LGGs) according to the normalized maximum standardized uptake value of FDOPA PET (a threshold of the uptake in the striatum) within the segmented regions. Spatial normalization procedures to build a 3D MRI-based atlas using each segmented region were validated by an analysis of differential involvement statistical mapping.
RESULTS
Superimposition of regions of interest showed a high number of hypometabolic LGGs localized in the frontal lobe, while a high number of hypermetabolic LGGs was localized in the insula, putamen, and temporal lobe. The statistical mapping revealed that hypometabolic LGGs occurred more frequently in the superior frontal gyrus (close to the supplementary motor area), while hypermetabolic LGGs occurred more frequently in the insula.
CONCLUSION
Radiographic atlases revealed preferential frontal lobe localization for FDOPA hypometabolic LGGs, which may be associated with relatively early detection.
目的
尽管肿瘤定位和 3,4-二羟基-6-F-氟-L-苯丙氨酸（FDOPA）摄取之间可能存在关联，但低级别胶质瘤（LGG）中 FDOPA 摄取与肿瘤定位之间的关系尚未得到研究。本研究旨在使用概率放射图集来确定 FDOPA 低代谢和高代谢 LGG 之间肿瘤定位频率的差异。
方法
回顾性选择了 51 例新诊断的 LGG（WHO 分级 II，29 例；III，22 例；异柠檬酸脱氢酶野生型，21 例；1p19q 非缺失突变型，16 例；突变型缺失 14 例）患者，他们接受了 FDOPA 正电子发射断层扫描（PET）检查。在 FLAIR 上进行半自动化肿瘤分割。根据 FDOPA PET 摄取的标准化最大标准化摄取值（纹状体摄取的阈值）将 LGG 患者分为两组（FDOPA 低代谢和高代谢 LGG）。使用每个分割区域进行的空间归一化程序通过差异参与统计映射分析进行验证。
结果
感兴趣区域的叠加显示，大量低代谢 LGG 定位于额叶，而大量高代谢 LGG 定位于脑岛、壳核和颞叶。统计映射显示，低代谢 LGG 更频繁地发生在额上回（靠近运动辅助区），而高代谢 LGG 更频繁地发生在脑岛。
结论
放射图集显示 FDOPA 低代谢 LGG 优先定位于额叶，这可能与早期检测有关。
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