Chaika Maryanna, Männlin Simon, Gassenmaier Sebastian, Tsiflikas Ilias, Dittmann Helmut, Flaadt Tim, Warmann Steven, Gückel Brigitte, Schäfer Jürgen Frank
Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, 72076 Tuebingen, Germany.
J Clin Med. 2023 Sep 15;12(18):5976. doi: 10.3390/jcm12185976.
PURPOSE: The purpose of our study was to evaluate the association between the [F]FDG standard uptake value (SUV) and the apparent diffusion coefficient (ADC) in neuroblastoma (NB) by voxel-wise analysis. METHODS: From our prospective observational PET/MRI study, a subcohort of patients diagnosed with NB with both baseline imaging and post-chemotherapy imaging was further investigated. After registration and tumor segmentation, metabolic and functional tumor volumes were calculated from the ADC and SUV values using dedicated software allowing for voxel-wise analysis. Under the mean of thresholds, each voxel was assigned to one of three virtual tissue groups: highly vital (v) (low ADC and high SUV), possibly low vital (lv) (high ADC and low SUV), and equivocal (e) with high ADC and high SUV or low ADC and low SUV. Moreover, three clusters were generated from the total tumor volumes using the method of multiple Gaussian distributions. The Pearson's correlation coefficient between the ADC and the SUV was calculated for each group. RESULTS: Out of 43 PET/MRIs in 21 patients with NB, 16 MRIs in 8 patients met the inclusion criteria (PET/MRIs before and after chemotherapy). The proportion of tumor volumes were 26%, 36%, and 38% (v, lv, e) at baseline, 0.03%, 66%, and 34% after treatment in patients with response, and 42%, 25%, and 33% with progressive disease, respectively. In all clusters, the ADC and the SUV correlated negatively. In the cluster that corresponded to highly vital tissue, the ADC and the SUV showed a moderate negative correlation before treatment (R = -0.18; < 0.0001) and the strongest negative correlation after treatment (R = -0.45; < 0.0001). Interestingly, only patients with progression ( = 2) under therapy had a relevant part in this cluster post-treatment. CONCLUSION: Our results indicate that voxel-wise analysis of the ADC and the SUV is feasible and can quantify the different quality of tissue in neuroblastic tumors. Monitoring ADCs as well as SUV levels can quantify tumor dynamics during therapy.
目的：本研究旨在通过体素分析评估神经母细胞瘤（NB）中[F]氟代脱氧葡萄糖标准摄取值（SUV）与表观扩散系数（ADC）之间的关联。 方法：在我们的前瞻性观察性PET/MRI研究中，对一组诊断为NB且有基线成像和化疗后成像的患者亚组进行了进一步研究。在配准和肿瘤分割后，使用允许体素分析的专用软件根据ADC和SUV值计算代谢和功能肿瘤体积。在阈值均值以下，每个体素被分配到三个虚拟组织组之一：高活性（v）（低ADC和高SUV）、可能低活性（lv）（高ADC和低SUV）以及具有高ADC和高SUV或低ADC和低SUV的模棱两可（e）组。此外，使用多个高斯分布方法从总肿瘤体积中生成三个簇。计算每组中ADC与SUV之间的Pearson相关系数。 结果：在21例NB患者的43次PET/MRI中，8例患者的16次MRI符合纳入标准（化疗前后的PET/MRI）。在有反应的患者中，基线时肿瘤体积的比例分别为26%、36%和38%（v、lv、e），治疗后分别为0.03%、66%和34%，而疾病进展患者分别为42%、25%和33%。在所有簇中，ADC与SUV呈负相关。在对应于高活性组织的簇中，治疗前ADC与SUV呈中度负相关（R = -0.18；<0.0001），治疗后呈最强负相关（R = -0.45；<0.0001）。有趣的是，仅治疗期间进展（=2）的患者在治疗后该簇中有相关部分。 结论：我们的结果表明，对ADC和SUV进行体素分析是可行的，并且可以量化神经母细胞瘤组织的不同质量。监测ADC以及SUV水平可以量化治疗期间的肿瘤动态。
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