Simultaneous FET-PET and contrast-enhanced MRI based on hybrid PET/MR improves delineation of tumor spatial biodistribution in gliomas: a biopsy validation study

Purpose Glioma treatment planning requires precise tumor delineation, which is typically performed with contrast-enhanced (CE) MRI. However, CE MRI fails to reflect the entire extent of glioma. O-(2- 18 F-fluoroethyl)-L-tyrosine ( 18 F-FET) PET may detect tumor volumes missed by CE MRI. We investiga...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2020-06, Vol.47 (6), p.1458-1467
Main Authors: Song, Shuangshuang, Cheng, Ye, Ma, Jie, Wang, Leiming, Dong, Chengyan, Wei, Yukui, Xu, Geng, An, Yang, Qi, Zhigang, Lin, Qingtang, Lu, Jie
Format: Article
Language:English
Subjects:
Biopsy
Brain Neoplasms - diagnostic imaging
Brain tumors
Cardiology
Delineation
Fluorine isotopes
Glioma
Glioma - diagnostic imaging
Humans
Imaging
Magnetic Resonance Imaging
Medical imaging
Medicine
Medicine & Public Health
Metastases
Nuclear Medicine
Oncology
Oncology – Brain
Original
Original Article
Orthopedics
Patients
Positron emission
Positron emission tomography
Radiology
Tissue Distribution
Tomography
Tumors
Tyrosine
Visual thresholds
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Summary:Purpose Glioma treatment planning requires precise tumor delineation, which is typically performed with contrast-enhanced (CE) MRI. However, CE MRI fails to reflect the entire extent of glioma. O-(2- 18 F-fluoroethyl)-L-tyrosine ( 18 F-FET) PET may detect tumor volumes missed by CE MRI. We investigated the clinical value of simultaneous FET-PET and CE MRI in delineating tumor extent before treatment planning. Guided stereotactic biopsy was used to validate the findings. Methods Conventional MRI and 18 F-FET PET were performed simultaneously on a hybrid PET/MR in 33 patients with histopathologically confirmed glioma. Tumor volumes were quantified using a tumor-to-brain ratio ≥ 1.6 ( V PET ) and a visual threshold ( V CE ). We visually assessed abnormal areas on FLAIR images and calculated Dice’s coefficient (DSC), overlap volume (OV), discrepancy-PET, and discrepancy-CE. Additionally, several stereotactic biopsy samples were taken from “matched” or “mismatched” FET-PET and CE MRI regions. Results Among 31 patients (93.94%), FET-PET delineated significantly larger tumor volumes than CE MRI (77.84 ± 51.74 cm 3 vs. 34.59 ± 27.07 cm 3 , P  
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-019-04656-2