同时获得瘤周区18F-FDG/MRI rSUV和rCBF有助于胶质瘤的分级

Hong Qu , Yuping Zeng , Lifeng Hang , Jin Fang , Hui Sun , Hong Li , Guihua Jiang
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引用次数: 0

摘要

目的探讨瘤周脑区(PBZ)对胶质瘤分级的诊断作用。这是通过比较从不同感兴趣区域(包括固体部分(SP)和PBZ)内的混合18F-氟-2-脱氧-d-葡萄糖正电子发射断层扫描/磁共振成像(18F-FDG PET/MRI)获得的相对标准化摄取值(rSUV)和相对脑血流量(rCBF)来实现的。方法24例胶质瘤患者术前均行18F-PET/MRI检查。最大标准化摄取值(SUVmax)和相对最大脑血流量(rCBFmax)分别从FDG-PET和ASL数据中获得。相对SUVmax(rSUVmax)是通过对照对侧正常出现的大脑皮层进行标准化来计算的。肿瘤实体部分(SP)和肿瘤周围脑区(PBZ)距离5的数据​毫米,10​毫米,15​mm和20​记录距SP边缘的mm。Logistic回归用于生成受试者操作特征(ROC)曲线。计算并比较ROC曲线下面积(AUCs),以分析每个参数的诊断效用。结果与低级别胶质瘤(LGG)相比,高级别胶质瘤在SP和PBZ近端的rSUVmax和rCBFmax值均显著升高(P​<;​在各种距离参数及其组合中,单参数rSUVmax SP表现出最高的诊断功效,AUC为0.788(P​<;​但rSUVmax SP与PBZs联合用药后AUC无明显改善(P​>;​0.05)。当将PBZ和SP与rSUVmax和rCBFmax组合时,SP至PBZ的rSUVmax值和rCBVmax值为20​mm与单个参数和较小的感兴趣区域相比表现出优异的性能,AUC为0.848。敏感性和特异性分别为73.8%和83.6%。结论在区分HGG和LGG时,基于混合PET/MRI的SP和PBZ中rSUVmax和rCBFmax的组合被证明优于单独在SP中使用参数。适当扩展研究并结合多个参数的使用可以提供更有价值的诊断信息,具有临床应用的潜力。
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Simultaneously acquired rSUV and rCBF of 18F-FDG/MRI in peritumoral brain zone can help to differentiate the grade of gliomas

Objectives

The purpose of this study is to investigate the diagnostic performance of the peritumoral brain zone (PBZ) in differentiating glioma grades. This is accomplished by comparing the relative standardized uptake values (rSUV) and relative cerebral blood flow (rCBF) obtained from hybrid 18F-fluoro-2-deoxy-d-glucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) within different regions of interest, including the solid portion (SP) and the PBZ.

Methods

Twenty-four patients with gliomas who underwent preoperative 18F-PET/MRI were enrolled in this study. The maximum standardized uptake values (SUVmax) and relative maximum cerebral blood flow (rCBFmax) were obtained from the FDG-PET and ASL data, respectively. The relative SUVmax (rSUVmax) was calculated by standardizing against the contralateral normal-appearing brain cortex. Data from the solid portion (SP) of tumor and the peritumoral brain zone (PBZ) at distance of 5 ​mm, 10 ​mm, 15 ​mm, and 20 ​mm from the SP margin were recorded. Logistic regression was used to generate receiver-operating characteristic (ROC) curves. The areas under the ROC curves (AUCs) were calculated and compared to analyze the diagnostic utility of each parameter.

Results

In comparison to low-grade glioma (LGG), high-grade glioma (HGG) exhibited significantly higher rSUVmax and rCBFmax values in both the SP and the proximal PBZ (P ​< ​0.05). Among the various distance parameters and their combinations, the single parameter rSUVmax-SP demonstrated the highest diagnostic efficacy with an AUC of 0.788 (P ​< ​0.05). However, the AUC of rSUVmax-SP did not show a significantly improvement when combined with PBZs (P ​> ​0.05). When combining PBZs and SP with rSUVmax and rCBFmax, the rSUVmax and rCBFmax values of SP to PBZ 20 ​mm exhibited superior performance compared to single parameters and smaller regions of interest, with an AUC of 0.848. The sensitivity and specificity were determined as 73.8% and 83.6%, respectively.

Conclusion

The combination of rSUVmax and rCBFmax in the SP and PBZ, based on hybrid PET/MRI, proves to be superior to using parameters solely in the SP when it comes to differentiating between HGG and LGG. Expanding the study appropriately and incorporating the use of multiple parameters can offer more valuable diagnostic information, which holds potential for clinical applications.

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