Combined amino acid PET-MRI for identifying recurrence in post-treatment gliomas: together we grow

European Journal of Hybrid Imaging

Dinesh Kumar¹  Jitender Saini¹  Pardeep Kumar Singh¹  Chandana Nagaraj¹  Arpana Arbind¹  Vani Santosh²  Arivazhagan Arimappamagan³  Nishanth Sadashiva³  Uday Krishna⁴  Shumyla Jabeen⁵ 

[1] Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, 560029, Bengaluru, Karnataka, India;Department of Neuropathology, National Institute of Mental Health and Neurosciences, 560029, Bengaluru, Karnataka, India;Department of Neurosurgery, National Institute of Mental Health and Neurosciences, 560029, Bengaluru, Karnataka, India;Department of Radiation Oncology, Kidwai Memorial Institute of Oncology, 560029, Bengaluru, Karnataka, India;Sher-i-Kashmir Institute of Medical Sciences, 190001, Srinagar, Kashmir, India;

关键词: Amino acid PET;    Gliomas;    Radiation necrosis;    Recurrence;    Perfusion;    Diffusion;   

DOI  :  10.1186/s41824-021-00109-y

来源: Springer

【 摘 要 】

PurposeThe aim of this study is to compare the diagnostic accuracy of amino acid PET, MR perfusion and diffusion as stand-alone modalities and in combination in identifying recurrence in post-treatment gliomas and to qualitatively assess spatial concordance between the three modalities using simultaneous PET-MR acquisition.MethodsA retrospective review of 48 cases of post-treatment gliomas who underwent simultaneous PET-MRI using C11 methionine as radiotracer was performed. MR perfusion and diffusion sequences were acquired during the PET study. The following parameters were obtained: TBRmax, TBRmean, SUVmax, and SUVmean from the PET images; rCBV from perfusion; and ADCmean and ADCratio from the diffusion images. The final diagnosis was based on clinical/imaging follow-up and histopathology when available. ROC curve analysis in combination with logistic regression analysis was used to compare the diagnostic performance. Spatial concordance between modalities was graded as 0, 1, and 2 representing discordance, < 50% and > 50% concordance respectively.ResultsThere were 35 cases of recurrence and 13 cases of post-treatment changes without recurrence. The highest area under curve (AUC) was obtained for TBRmax followed by rCBV and ADCratio. The AUC increased significantly with a combination of rCBV and TBRmax. Amino acid PET showed the highest diagnostic accuracy and maximum agreement with the final diagnosis. There was discordance between ADC and PET in 22.9%, between rCBV and PET in 16.7% and between PET and contrast enhancement in 14.6% cases.ConclusionAmino acid PET had the highest diagnostic accuracy in identifying recurrence in post-treatment gliomas. Combination of PET with MRI further increased the AUC thus improving the diagnostic performance.

【 授权许可】

CC BY