Vindstad Benedikte Emilie, Skjulsvik Anne Jarstein, Pedersen Lars Kjelsberg, Berntsen Erik Magnus, Solheim Ole Skeidsvoll, Ingebrigtsen Tor, Reinertsen Ingerid, Johansen Håkon, Eikenes Live, Karlberg Anna Maria
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, 7030 Trondheim, Norway.
Department of Pathology, St. Olavs Hospital, Trondheim University Hospital, 7030 Trondheim, Norway.
Cancers (Basel). 2024 Jul 18;16(14):2581. doi: 10.3390/cancers16142581.
Gliomas have a heterogeneous nature, and identifying the most aggressive parts of the tumor and defining tumor borders are important for histomolecular diagnosis, surgical resection, and radiation therapy planning. This study evaluated [F]-FACBC PET for glioma tissue classification.
Pre-surgical [F]-FACBC PET/MR images were used during surgery and image-localized biopsy sampling in patients with high- and low-grade glioma. TBR was compared to histomolecular results to determine optimal threshold values, sensitivity, specificity, and AUC values for the classification of tumor tissue. Additionally, PET volumes were determined in patients with glioblastoma based on the optimal threshold. [F]-FACBC PET volumes and diagnostic accuracy were compared to ce-T1 MRI. In total, 48 biopsies from 17 patients were analyzed.
[F]-FACBC had low uptake in non-glioblastoma tumors, but overall higher sensitivity and specificity for the classification of tumor tissue (0.63 and 0.57) than ce-T1 MRI (0.24 and 0.43). Additionally, [F]-FACBC TBR was an excellent classifier for IDH1-wildtype tumor tissue (AUC: 0.83, 95% CI: 0.71-0.96). In glioblastoma patients, PET tumor volumes were on average eight times larger than ce-T1 MRI volumes and included 87.5% of tumor-positive biopsies compared to 31.5% for ce-T1 MRI.
The addition of [F]-FACBC PET to conventional MRI could improve tumor classification and volume delineation.
胶质瘤具有异质性，识别肿瘤中最具侵袭性的部分并确定肿瘤边界对于组织分子诊断、手术切除和放射治疗计划至关重要。本研究评估了[F]-FACBC PET用于胶质瘤组织分类的情况。
在高、低级别胶质瘤患者的手术过程中以及图像定位活检采样时使用术前[F]-FACBC PET/MR图像。将肿瘤摄取比（TBR）与组织分子结果进行比较，以确定肿瘤组织分类的最佳阈值、敏感性、特异性和曲线下面积（AUC）值。此外，根据最佳阈值确定胶质母细胞瘤患者的PET体积。将[F]-FACBC PET体积和诊断准确性与增强T1加权MRI进行比较。总共分析了17例患者的48次活检样本。
[F]-FACBC在非胶质母细胞瘤肿瘤中的摄取较低，但与增强T1加权MRI（敏感性0.24，特异性0.43）相比，对肿瘤组织分类的总体敏感性和特异性更高（分别为0.63和0.57）。此外，[F]-FACBC TBR是IDH1野生型肿瘤组织的优秀分类指标（AUC：0.83，95%可信区间：0.71 - 0.96）。在胶质母细胞瘤患者中，PET肿瘤体积平均比增强T1加权MRI体积大8倍，包含87.5%的肿瘤阳性活检样本，而增强T1加权MRI为31.5%。
在传统MRI基础上增加[F]-FACBC PET可改善肿瘤分类和体积勾画。
