Johannessen Knut, Berntsen Erik Magnus, Johansen Håkon, Solheim Tora S, Karlberg Anna, Eikenes Live
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Postboks 8905, 7491, Trondheim, Norway.
Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Eur J Hybrid Imaging. 2021 Apr 13;5(1):7. doi: 10.1186/s41824-021-00101-6.
Patients with metastatic cancer to the brain have a poor prognosis. In clinical practice, MRI is used to delineate, diagnose and plan treatment of brain metastases. However, MRI alone is limited in detecting micro-metastases, delineating lesions and discriminating progression from pseudo-progression. Combined PET/MRI utilises superior soft tissue images from MRI and metabolic data from PET to evaluate tumour structure and function. The amino acid PET tracer F-FACBC has shown promising results in discriminating high- and low-grade gliomas, but there are currently no reports on its use on brain metastases. This is the first study to evaluate the use of F-FACBC on brain metastases.
A middle-aged female patient with brain metastases was evaluated using hybrid PET/MRI with F-FACBC before and after stereotactic radiotherapy, and at suspicion of recurrence. Static/dynamic PET and contrast-enhanced T1 MRI data were acquired and analysed. This case report includes the analysis of four F-FACBC PET/MRI examinations, investigating their utility in evaluating functional and structural metastasis properties.
Analysis showed high tumour-to-background ratios in brain metastases compared to other amino acid PET tracers, including high uptake in a very small cerebellar metastasis, suggesting that F-FACBC PET can provide early detection of otherwise overlooked metastases. Further studies to determine a threshold for F-FACBC brain tumour boundaries and explore its utility in clinical practice should be performed.
脑转移癌患者预后较差。在临床实践中，MRI用于描绘、诊断和规划脑转移瘤的治疗。然而，单纯MRI在检测微转移瘤、描绘病变以及区分进展与假性进展方面存在局限性。PET/MRI结合了MRI的优质软组织图像和PET的代谢数据来评估肿瘤的结构和功能。氨基酸PET示踪剂F-FACBC在区分高低级别胶质瘤方面已显示出有前景的结果，但目前尚无关于其用于脑转移瘤的报道。这是第一项评估F-FACBC用于脑转移瘤的研究。
一名患有脑转移瘤的中年女性患者在立体定向放疗前后以及怀疑复发时使用含F-FACBC的PET/MRI进行评估。采集并分析了静态/动态PET和对比增强T1 MRI数据。本病例报告包括对四次F-FACBC PET/MRI检查的分析，研究它们在评估转移瘤功能和结构特性方面的效用。
分析显示，与其他氨基酸PET示踪剂相比，脑转移瘤中的肿瘤与本底比值较高，包括一个非常小的小脑转移瘤摄取较高，这表明F-FACBC PET能够早期检测出原本被忽视的转移瘤。应开展进一步研究以确定F-FACBC脑肿瘤边界的阈值，并探索其在临床实践中的效用。
