Full kinetic modeling analysis of [18F]fluorocholine Positron Emission Tomography (PET) at initial diagnosis of high-grade glioma

IF 3.4 2区医学 Q2 NEUROIMAGING

Neuroimage-Clinical Pub Date : 2024-01-01 DOI:10.1016/j.nicl.2024.103616

Sebastià Rubí , Pedro Bibilioni , Marina Villar , Marta Brell , Manuel Valiente , Margalida Galmés , María Toscano , Gabriel Matheu , José Luis Chinchilla , Jesús Molina , José Luis Valera , Ángel Ríos , Meritxell López , Cristina Peña

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Abstract

Purpose

The main objective was to characterize the tracer uptake kinetics of [¹⁸F]fluoromethylcholine ([¹⁸F]F-CHO) in high-grade gliomas (HGG) through a full PET kinetic modeling approach. Secondarily, we aimed to explore the relationship between the PET uptake measures and the HGG molecular features.

Materials and methods

Twenty-four patients with a suspected diagnosis of HGG were prospectively included. They underwent a dynamic brain [¹⁸F]F-CHO-PET/CT, from which a tumoral time-activity curve was extracted. The plasma input function was obtained through arterial blood sampling with metabolite correction. These data were fitted to 1- and 2-tissue-compartment models, the best of which was selected through the Akaike information criterion. We assessed the correlation between the kinetic parameters and the conventional static PET metrics (SUV_max, SUV_mean and tumor-to-background ratio TBR). We explored the association between the [¹⁸F]F-CHO-PET quantitative parameters and relevant molecular biomarkers in HGG.

Results

Tumoral time-activity curves in all patients showed a rapid rise of [¹⁸F]F-CHO uptake followed by a plateau-like shape. Best fits were obtained with near-irreversible 2-tissue-compartment models. The perfusion-transport constant K₁ and the net influx rate K_i showed strong correlation with SUV_max (r = 0.808–0.861), SUV_mean (r = 0.794–0.851) and TBR (r = 0.643–0.784), p < 0.002. HGG was confirmed in 21 patients, of which those with methylation of the O-6-methylguanine-DNA methyltransferase (MGMT) gene promoter showed higher mean K_i (p = 0.020), K₁ (p = 0.025) and TBR (p = 0.001) than the unmethylated ones.

Conclusion

[¹⁸F]F-CHO uptake kinetics in HGG is best explained by a 2-tissue-compartment model. The conventional static [¹⁸F]F-CHO-PET measures have been validated against the perfusion-transport constant (K₁) and the net influx rate (K_i) derived from kinetic modeling. A relationship between [¹⁸F]F-CHO uptake rate and MGMT methylation is suggested but needs further confirmation.

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初步诊断高级别胶质瘤时[18F]氟胆碱正电子发射断层扫描（PET）的全动力学模型分析

目的主要目的是通过全 PET 动力学建模方法描述高级别胶质瘤（HGG）对[18F]氟甲基胆碱（[18F]F-CHO）示踪剂的摄取动力学。材料与方法前瞻性地纳入了 24 例疑似诊断为 HGG 的患者。他们接受了动态脑[18F]F-CHO-PET/CT检查，并从中提取了肿瘤时间活动曲线。血浆输入函数通过动脉血采样和代谢物校正获得。这些数据被拟合到 1-组织间室模型和 2-组织间室模型中，并通过 Akaike 信息准则选出了最佳模型。我们评估了动力学参数与传统静态 PET 指标（SUVmax、SUVmean 和肿瘤与背景比值 TBR）之间的相关性。我们探讨了[18F]F-CHO-PET 定量参数与 HGG 中相关分子生物标记物之间的关联。结果所有患者的肿瘤时间-活动曲线均显示[18F]F-CHO 摄取量快速上升，随后呈高原状。近乎不可逆的 2 组织间室模型获得了最佳拟合。灌注-转运常数 K1 和净流入率 Ki 与 SUVmax（r = 0.808-0.861）、SUVmean（r = 0.794-0.851）和 TBR（r = 0.643-0.784）有很强的相关性，p < 0.002。21例患者确诊为HGG，其中O-6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）基因启动子甲基化患者的平均Ki（p = 0.020）、K1（p = 0.025）和TBR（p = 0.001）均高于未甲基化患者。传统的静态[18F]F-CHO-PET测量方法已与动力学模型得出的灌注-传输常数（K1）和净流入率（Ki）进行了验证。表明[18F]F-CHO 摄取率与 MGMT 甲基化之间存在关系，但还需要进一步确认。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroimage-Clinical NEUROIMAGING-

CiteScore

7.50

自引率

4.80%

发文量

368

审稿时长

52 days

期刊介绍： NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.

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