Department of Neurooncology and Radiosurgery, Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Poland.
Department of Oncology and Brachytherapy, Faculty of Medicine, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Nat Commun. 2023 Jul 29;14(1):4572. doi: 10.1038/s41467-023-39731-8.
Accurate determination of the extent and grade of adult-type diffuse gliomas is critical to patient management. In clinical practice, contrast-enhancing areas of diffuse gliomas in magnetic resonance imaging (MRI) sequences are usually used to target biopsy, surgery, and radiation therapy, but there can be discrepancies between these areas and the actual tumor extent. Here we show that adding F-fluoro-ethyl-tyrosine positron emission tomography (FET-PET) to MRI sequences accurately locates the most malignant areas of contrast-enhancing gliomas, potentially impacting subsequent management and outcomes. We present a prospective analysis of over 300 serial biopsy specimens from 23 patients with contrast-enhancing adult-type diffuse gliomas using a hybrid PET-MRI scanner to compare T2-weighted and contrast-enhancing MRI images with FET-PET. In all cases, we observe and confirm high FET uptake in early PET acquisitions (5-15 min after F-FET administration) outside areas of contrast enhancement on MRI, indicative of high-grade glioma. In 30% cases, inclusion of FET-positive sites changes the biopsy result to a higher tumor grade.
准确确定成人弥漫性胶质瘤的程度和分级对于患者的管理至关重要。在临床实践中，磁共振成像（MRI）序列中弥漫性胶质瘤的增强区域通常用于靶向活检、手术和放射治疗，但这些区域与实际肿瘤范围之间可能存在差异。在这里，我们表明，将 F-氟乙基酪氨酸正电子发射断层扫描（FET-PET）添加到 MRI 序列中可以准确定位增强型胶质瘤最恶性的区域，这可能会影响后续的管理和结果。我们使用混合 PET-MRI 扫描仪对 23 名增强型成人弥漫性胶质瘤患者的 300 多个连续活检标本进行了前瞻性分析，将 T2 加权和增强 MRI 图像与 FET-PET 进行了比较。在所有情况下，我们观察并确认在 MRI 增强区域外的早期 PET 采集（F-FET 给药后 5-15 分钟）中存在高 FET 摄取，提示高级别胶质瘤。在 30%的情况下，包括 FET 阳性部位会导致活检结果为更高的肿瘤分级。
