Johnson Jason Michael, Chen Melissa M, Rohren Eric M, Prabhu Sujit, Chasen Beth, Mawlawi Osama, Liu Ho-Ling, Gule-Monroe Maria Kristine
Department of Neuroradiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Department of Radiology, Baylor College of Medicine, Houston, TX, United States.
Front Neurol. 2021 Nov 16;12:740280. doi: 10.3389/fneur.2021.740280. eCollection 2021.
Glioblastomas are malignant, often incurable brain tumors. Reliable discrimination between recurrent disease and treatment changes is a significant challenge. Prior work has suggested glioblastoma FDG PET conspicuity is improved at delayed time points vs. conventional imaging times. This study aimed to determine the ideal FDG imaging time point in a population of untreated glioblastomas in preparation for future trials involving the non-invasive assessment of true progression vs. pseudoprogression in glioblastoma. Sixteen pre-treatment adults with suspected glioblastoma received FDG PET at 1, 5, and 8 h post-FDG injection within the 3 days prior to surgery. Maximum standard uptake values were measured at each timepoint for the central enhancing component of the lesion and the contralateral normal-appearing brain. Sixteen patients (nine male) had pathology confirmed IDH-wildtype, glioblastoma. Our results revealed statistically significant improvements in the maximum standardized uptake values and subjective conspicuity of glioblastomas at later time points compared to the conventional (1 h time point). The tumor to background ratio at 1, 5, and 8 h was 1.4 ± 0.4, 1.8 ± 0.5, and 2.1 ± 0.6, respectively. This was statistically significant for the 5 h time point over the 1 h time point ( > 0.001), the 8 h time point over the 1 h time point ( = 0.026), and the 8 h time point over the 5 h time point ( = 0.036). Our findings demonstrate that delayed imaging time point provides superior conspicuity of glioblastoma compared to conventional imaging. Further research based on these results may translate into improvements in the determination of true progression from pseudoprogression.
胶质母细胞瘤是恶性的、通常无法治愈的脑肿瘤。可靠地区分复发性疾病和治疗变化是一项重大挑战。先前的研究表明，与传统成像时间相比，胶质母细胞瘤的氟代脱氧葡萄糖正电子发射断层扫描（FDG PET）在延迟时间点的显见度有所提高。本研究旨在确定未经治疗的胶质母细胞瘤患者群体中理想的FDG成像时间点，为未来涉及胶质母细胞瘤真正进展与假性进展的非侵入性评估的试验做准备。16名术前疑似胶质母细胞瘤的成年患者在手术前3天内于FDG注射后1、5和8小时接受了FDG PET检查。在每个时间点测量病变中央强化部分和对侧外观正常脑区的最大标准摄取值。16名患者（9名男性）经病理证实为异柠檬酸脱氢酶（IDH）野生型胶质母细胞瘤。我们的结果显示，与传统的（1小时时间点）相比，胶质母细胞瘤在后期时间点的最大标准化摄取值和主观显见度有统计学上的显著改善。1、5和8小时的肿瘤与背景比值分别为1.4±0.4、1.8±0.5和2.1±0.6。5小时时间点与1小时时间点相比（>0.001）、8小时时间点与1小时时间点相比（=0.026）以及8小时时间点与5小时时间点相比（=0.036），差异均有统计学意义。我们的研究结果表明，与传统成像相比，延迟成像时间点能提供更好的胶质母细胞瘤显见度。基于这些结果的进一步研究可能会在区分真正进展与假性进展方面带来改善。
