Department of Radiology, Sumitomo Besshi Hospital, Niihama, Ehime.
Department of Radiology, Faculty of Medicine, Kagawa University.
Nucl Med Commun. 2022 Mar 1;43(3):270-274. doi: 10.1097/MNM.0000000000001510.
The purpose of this study was to assess the diagnostic value of [18F]fluoromisonidazole (FMISO) and 2-deoxy-2-[18F]fluoro-D-glucose (FDG) PET to discriminate primary central nervous system lymphoma (PCNSL) from glioblastoma.
FMISO and FDG PET/CT scans before therapy obtained in 13 patients with PCNSL and in 62 patients with glioblastoma were retrospectively reviewed. PET results were evaluated by visual and semiquantitative analysis. For semiquantitative analysis, the maximum standardized uptake value (SUV) for tumor (T) and the mean SUV for normal contralateral hemisphere (N) were calculated, and the tumor-to-normal (T/N) ratio was determined. The performance in discriminating PCNSL and glioblastoma was evaluated using a receiver-operating characteristics analysis. Area-under-the-curve (AUC) values for the discrimination were calculated.
On visual analysis, 54% of PCNSL and 89% of glioblastoma showed positive on FMISO PET. All patients with PCNSL and glioblastoma were FDG positive. FMISO T/N ratio in PCNSL (mean ± SD = 1.80 ± 0.59) was significantly lower than that in glioblastoma (mean ± SD = 2.75 ± 0.84) (P < 0.001). FDG T/N ratio in PCNSL (mean ± SD = 3.01 ± 1.11) was significantly higher than that in glioblastoma (mean ± SD = 1.77 ± 0.79) (P < 0.001). For discrimination of patients with PCNSL from glioblastoma, the AUC values for the FMISO T/N ratio, FDG T/N ratio and combination of the two parameters were 0.833, 0.825 and 0.900, respectively.
FMISO PET is as helpful for differentiating PCNSL from glioblastoma as FDG PET.
本研究旨在评估[18F]氟咪索硝唑（FMISO）和 2-脱氧-2-[18F]氟代-D-葡萄糖（FDG）PET 区分原发性中枢神经系统淋巴瘤（PCNSL）和胶质母细胞瘤的诊断价值。
回顾性分析了 13 例 PCNSL 和 62 例胶质母细胞瘤患者治疗前的 FMISO 和 FDG PET/CT 扫描。通过视觉和半定量分析评估 PET 结果。半定量分析时，计算肿瘤（T）的最大标准化摄取值（SUV）和对侧正常半球（N）的平均 SUV，并确定肿瘤与正常（T/N）比值。采用受试者工作特征（ROC）分析评估区分 PCNSL 和胶质母细胞瘤的性能。计算了区分的曲线下面积（AUC）值。
在视觉分析中，54%的 PCNSL 和 89%的胶质母细胞瘤在 FMISO PET 上呈阳性。所有 PCNSL 和胶质母细胞瘤患者均为 FDG 阳性。PCNSL 的 FMISO T/N 比值（均值±标准差=1.80±0.59）明显低于胶质母细胞瘤（均值±标准差=2.75±0.84）（P<0.001）。PCNSL 的 FDG T/N 比值（均值±标准差=3.01±1.11）明显高于胶质母细胞瘤（均值±标准差=1.77±0.79）（P<0.001）。对于区分 PCNSL 患者和胶质母细胞瘤患者，FMISO T/N 比值、FDG T/N 比值和两种参数结合的 AUC 值分别为 0.833、0.825 和 0.900。
FMISO PET 与 FDG PET 一样有助于区分 PCNSL 和胶质母细胞瘤。
