Department of Nuclear Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China.
Department of Radiology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China.
Acta Radiol. 2022 May;63(5):664-671. doi: 10.1177/02841851211006913. Epub 2021 Apr 15.
Heterogeneity of gliomas challenges the neuronavigated biopsy and oncological therapy. Diffusion and perfusion magnetic resonance imaging (MRI) can reveal the cellular and hemodynamic heterogeneity of tumors. Integrated positron emission tomography (PET)/MRI is expected to be a non-invasive imaging approach to characterizing glioma.
To evaluate the value of apparent diffusion coefficient (ADC), cerebral blood volume (CBV), and spatially co-registered maximal standard uptake value (SUV) for tissue characterization and glioma grading.
Thirty-seven consecutive patients with pathologically confirmed gliomas were retrospectively investigated. The relative minimum ADC (rADC), relative maximal ADC (rADC), relative maximal rCBV (rCBV), the relative minimum rCBV (rCBV), and the corresponding relative SUVmax (rSUV) were measured. The paired test was used to compare the quantitative parameters between different regions to clarify tumor heterogeneity. Imaging parameters between WHO grade IV and grade II/III gliomas were compared by -test. The diagnostic efficiency of multiparametric PET/MRI was analyzed by receiver operating characteristic (ROC) curve.
The values of rSUV were significantly different between maximal diffusion/perfusion area and minimum diffusion/perfusion area ( < 0.001/ < 0.001) within tumor. The values of rADC ( < 0.001), rCBV ( = 0.002), and corresponding rSUV ( = 0.001/ < 0.001) could be used for grading gliomas. The areas under the ROC curves of rSUV defined by rADC and rCBV were 0.89 and 0.91, respectively.
Diffusion and perfusion MRI can detect glioma heterogeneity with excellent molecular imaging correlations. Regions with rCBV suggest tissues with the highest metabolism and malignancy for guiding glioma grading and tissue sampling.
胶质瘤的异质性给神经导航活检和肿瘤治疗带来了挑战。弥散和灌注磁共振成像（MRI）可揭示肿瘤的细胞和血流动力学异质性。正电子发射断层扫描（PET）/MRI 一体化有望成为一种无创性成像方法，用于对胶质瘤进行特征描述。
评估表观弥散系数（ADC）、脑血容量（CBV）和空间配准最大标准摄取值（SUV）对组织特征和胶质瘤分级的价值。
回顾性分析了 37 例经病理证实的胶质瘤患者。测量相对最小 ADC（rADC）、相对最大 ADC（rADC）、相对最大 rCBV（rCBV）、相对最小 rCBV（rCBV）和相应的相对 SUVmax（rSUV）。配对检验用于比较不同区域的定量参数，以明确肿瘤异质性。采用 t 检验比较 WHO 分级 IV 级和 II/III 级胶质瘤之间的影像学参数。通过受试者工作特征（ROC）曲线分析多参数 PET/MRI 的诊断效能。
肿瘤内最大弥散/灌注区和最小弥散/灌注区之间的 rSUV 值存在显著差异（ < 0.001/ < 0.001）。rADC（ < 0.001）、rCBV（ = 0.002）和相应的 rSUV（ = 0.001/ < 0.001）值可用于对胶质瘤进行分级。由 rADC 和 rCBV 定义的 rSUV 的 ROC 曲线下面积分别为 0.89 和 0.91。
弥散和灌注 MRI 可以检测胶质瘤的异质性，并与优异的分子成像相关性相关。rCBV 提示具有最高代谢和恶性程度的组织，有助于指导胶质瘤分级和组织取样。
