{"title":"联合氨基酸PET-MRI鉴别治疗后胶质瘤复发:我们一起成长。","authors":"Shumyla Jabeen, Arpana Arbind, Dinesh Kumar, Pardeep Kumar Singh, Jitender Saini, Nishanth Sadashiva, Uday Krishna, Arivazhagan Arimappamagan, Vani Santosh, Chandana Nagaraj","doi":"10.1186/s41824-021-00109-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The 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.</p><p><strong>Methods: </strong>A 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: TBR<sub>max</sub>, TBR<sub>mean</sub>, SUV<sub>max</sub>, and SUV<sub>mean</sub> from the PET images; rCBV from perfusion; and ADC<sub>mean</sub> and ADC<sub>ratio</sub> 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.</p><p><strong>Results: </strong>There were 35 cases of recurrence and 13 cases of post-treatment changes without recurrence. The highest area under curve (AUC) was obtained for TBR<sub>max</sub> followed by rCBV and ADC<sub>ratio</sub>. The AUC increased significantly with a combination of rCBV and TBR<sub>max</sub>. 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.</p><p><strong>Conclusion: </strong>Amino 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.</p>","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"5 1","pages":"15"},"PeriodicalIF":1.7000,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371055/pdf/","citationCount":"7","resultStr":"{\"title\":\"Combined amino acid PET-MRI for identifying recurrence in post-treatment gliomas: together we grow.\",\"authors\":\"Shumyla Jabeen, Arpana Arbind, Dinesh Kumar, Pardeep Kumar Singh, Jitender Saini, Nishanth Sadashiva, Uday Krishna, Arivazhagan Arimappamagan, Vani Santosh, Chandana Nagaraj\",\"doi\":\"10.1186/s41824-021-00109-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The 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.</p><p><strong>Methods: </strong>A 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: TBR<sub>max</sub>, TBR<sub>mean</sub>, SUV<sub>max</sub>, and SUV<sub>mean</sub> from the PET images; rCBV from perfusion; and ADC<sub>mean</sub> and ADC<sub>ratio</sub> 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.</p><p><strong>Results: </strong>There were 35 cases of recurrence and 13 cases of post-treatment changes without recurrence. The highest area under curve (AUC) was obtained for TBR<sub>max</sub> followed by rCBV and ADC<sub>ratio</sub>. The AUC increased significantly with a combination of rCBV and TBR<sub>max</sub>. 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.</p><p><strong>Conclusion: </strong>Amino 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.</p>\",\"PeriodicalId\":36160,\"journal\":{\"name\":\"European Journal of Hybrid Imaging\",\"volume\":\"5 1\",\"pages\":\"15\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2021-08-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371055/pdf/\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Hybrid Imaging\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s41824-021-00109-y\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Hybrid Imaging","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s41824-021-00109-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Combined amino acid PET-MRI for identifying recurrence in post-treatment gliomas: together we grow.
Purpose: The 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.
Methods: A 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.
Results: There 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.
Conclusion: Amino 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.
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