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Clin Pharmacokinet. 2017 Aug;56(8):953-961. doi: 10.1007/s40262-016-0490-4.

Population Pharmacokinetic Approach Applied to Positron Emission Tomography: Computed Tomography for Tumor Tissue Identification in Patients with Glioma.

Author information

1
CRCT, Université de Toulouse, Inserm, UPS, Toulouse, France.
2
Toxalim, Université de Toulouse, INRA, ENVT, 23 chemin des Capelles, BP 87614, 31076, Toulouse Cedex 3, France.
3
Department of Nuclear Medicine, UZ Brussel, Brussels, Belgium.
4
Department of Radiology, UZ Brussel, Brussels, Belgium.
5
Department of Neurosurgery, UZ Brussel, Brussels, Belgium.
6
Department of Medical Oncology, UZ Brussel, Brussels, Belgium.
7
Department of Radiotherapy, UZ Brussel, Brussels, Belgium.
8
Institut Claudius Regaud, Toulouse, France.
9
Toxalim, Université de Toulouse, INRA, ENVT, 23 chemin des Capelles, BP 87614, 31076, Toulouse Cedex 3, France. d.concordet@envt.fr.

Abstract

BACKGROUND AND AIMS:

18F-fluoro-ethyl-tyrosine (FET) is a radiopharmaceutical used in positron emission tomography (PET)-computed tomography in patients with glioma. We propose an original approach combining a radiotracer-pharmacokinetic exploration performed at the voxel level (three-dimensional pixel) and voxel classification to identify tumor tissue. Our methodology was validated using the standard FET-PET approach and magnetic resonance imaging (MRI) data acquired according to the current clinical practices.

METHODS:

FET-PET and MRI data were retrospectively analyzed in ten patients presenting with progressive high-grade glioma. For FET-PET exploration, radioactivity acquisition started 15 min after radiotracer injection, and was measured each 5 min during 40 min. The tissue segmentation relies on population pharmacokinetic modeling with dependent individuals (voxels). This model can be approximated by a linear mixed-effects model. The tumor volumes estimated by our approach were compared with those determined with the current clinical techniques, FET-PET standard approach (i.e., a cumulated value of FET signal is computed during a time interval) and MRI sequences (T1 and T2/fluid-attenuated inversion recovery [FLAIR]), used as references. The T1 sequence is useful to identify highly vascular tumor and necrotic tissues, while the T2/FLAIR sequence is useful to isolate infiltration and edema tissue located around the tumor.

RESULTS:

With our kinetic approach, the volumes of tumor tissue were larger than the tissues identified by the standard FET-PET and MRI T1, while they were smaller than those determined with MRI T2/FLAIR.

CONCLUSION:

Our results revealed the presence of suspected tumor voxels not identified by the standard PET approach.

PMID:
27995528
DOI:
10.1007/s40262-016-0490-4
[Indexed for MEDLINE]

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