In:
European Journal of Nuclear Medicine and Molecular Imaging, Springer Science and Business Media LLC, Vol. 49, No. 13 ( 2022-11), p. 4677-4691
Abstract:
Both amino acid positron emission tomography (PET) and magnetic resonance imaging (MRI) blood volume (BV) measurements are used in suspected recurrent high-grade gliomas. We compared the separate and combined diagnostic yield of simultaneously acquired dynamic contrast-enhanced (DCE) perfusion MRI and O-(2-[ 18 F]-fluoroethyl)-L-tyrosine ([ 18 F]FET) PET in patients with anaplastic astrocytoma and glioblastoma following standard therapy. Methods A total of 76 lesions in 60 hybrid [ 18 F]FET PET/MRI scans with DCE MRI from patients with suspected recurrence of anaplastic astrocytoma and glioblastoma were included retrospectively. BV was measured from DCE MRI employing a 2-compartment exchange model (2CXM). Diagnostic performances of maximal tumour-to-background [ 18 F]FET uptake (TBR max ), maximal BV (BV max ) and normalised BV max (nBV max ) were determined by ROC analysis using 6-month histopathological ( n = 28) or clinical/radiographical follow-up ( n = 48) as reference. Sensitivity and specificity at optimal cut-offs were determined separately for enhancing and non-enhancing lesions. Results In progressive lesions, all BV and [ 18 F]FET metrics were higher than in non-progressive lesions. ROC analyses showed higher overall ROC AUCs for TBR max than both BV max and nBV max in both lesion-wise (all lesions, p = 0.04) and in patient-wise analysis ( p 〈 0.01). Combining TBR max with BV metrics did not increase ROC AUC. Lesion-wise positive fraction/sensitivity/specificity at optimal cut-offs were 55%/91%/84% for TBR max , 45%/77%/84% for BV max and 59%/84%/72% for nBV max . Combining TBR max and best-performing BV cut-offs yielded lesion-wise sensitivity/specificity of 75/97%. The fraction of progressive lesions was 11% in concordant negative lesions, 33% in lesions only BV positive, 64% in lesions only [ 18 F]FET positive and 97% in concordant positive lesions. Conclusion The overall diagnostic accuracy of DCE BV imaging is good, but lower than that of [ 18 F]FET PET. Adding DCE BV imaging did not improve the overall diagnostic accuracy of [ 18 F]FET PET, but may improve specificity and allow better lesion-wise risk stratification than [ 18 F]FET PET alone.
Type of Medium:
Online Resource
ISSN:
1619-7070
,
1619-7089
DOI:
10.1007/s00259-022-05917-3
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2022
detail.hit.zdb_id:
2098375-X
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