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Neuroradiology. 2018 Apr;60(4):381-389. doi: 10.1007/s00234-018-1993-5. Epub 2018 Feb 20.

Glioma grading by dynamic susceptibility contrast perfusion and 11C-methionine positron emission tomography using different regions of interest.

Author information

1
Diagnostic and Interventional Neuroradiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany. cornelia.brendle@med.uni-tuebingen.de.
2
Diagnostic and Interventional Neuroradiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.
3
Neuropathology, Department of Pathology and Neuropathology, Eberhard Karls University, Liebermeistersstraße 8, 72076, Tuebingen, Germany.
4
University Hospital for Neurosurgery, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.
5
Preclinical Imaging and Radiopharmacy, Eberhard Karls University, Roentgenweg 13, 72076, Tuebingen, Germany.
6
Nuclear Nedicine and Clinical Molecular Imaging, Department of Radiology, Eberhard Karls University, Otfried-Mueller-Straße 14, 72076, Tuebingen, Germany.

Abstract

PURPOSE:

The use of dynamic susceptibility contrast (DSC) perfusion and 11C-methionine positron emission tomography (MET-PET) for glioma grading is currently not standardized. The purpose of this study was to identify regions of interest (ROIs) that enable the best performance and clinical applicability in both methods, as well as to evaluate the complementarity of DSC perfusion and MET-PET in spatial hotspot definition.

METHODS:

In 41 patient PET/MRI datasets, different ROIs were drawn: in T2-hyperintense tumour, in T2-hyperintense tumour and adjacent oedema and in tumour areas with contrast enhancement, altered perfusion or pathological radiotracer uptake. The performance of DSC perfusion and MET-PET using the different ROIs to distinguish high- and low-grade gliomas was assessed. The spatial overlap of hotspots identified by DSC perfusion and MET-PET was assessed visually.

RESULTS:

ROIs in T2 fluid attenuated inversion recovery (FLAIR) sequence-hyperintense tumour revealed the most significant differences between high- and low-grade gliomas and reached the highest diagnostic performance in both DSC perfusion (p = 0.046; area under the curve = 0.74) and MET-PET (p = 0.007; area under the curve = 0.80). The combination of methods yielded an area under the curve of 0.80. Hotspots were completely overlapped in one half of the patients, partially overlapped in one third of the patients and present in only one method in approximately 20% of the patients.

CONCLUSIONS:

For multi-parametric examinations with DSC perfusion and MET-PET, we recommend an ROI definition based on T2-hyperintense tumour. DSC perfusion and MET-PET contain complementary information concerning the spatial hotspot definition.

KEYWORDS:

Glioma; Grading; Magnetic resonance imaging; Multimodal imaging; Positron emission tomography

PMID:
29464269
DOI:
10.1007/s00234-018-1993-5
[Indexed for MEDLINE]

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