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Diagnostic Accuracy of MR Spectroscopic Imaging and 18F-FET PET for Identifying Glioma: A Biopsy-Controlled Hybrid PET/MRI Study.

Author information

Affiliations

  • 1. Institute of Neuroscience and Medicine (INM-3/INM-4/INM-11), Forschungszentrum Juelich, Juelich, Germany;
      Authors
    • Mauler J 1
    (1 author)
  • 2. Institute of Neuroscience and Medicine (INM-3/INM-4/INM-11), Forschungszentrum Juelich, Juelich, Germany.
      Authors
    • Lohmann P 2, 4
    • Filss CP 2, 7
    • Stoffels G 2
    • Dammers J 2
    • Galldiks N 2
    • Langen KJ 2, 7
    • Shah NJ 2
    (7 authors)
  • 3. Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida.
      Authors
    • Maudsley AA 3
    • Sheriff S 3
    (2 authors)
  • 4. Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
      Authors
    • Lohmann P 2, 4
    • Hoevels M 4
    • Hamisch C 4
    • Ruge MI 4
    (4 authors)
  • 5. Department of General Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
      Authors
    • Meissner AK 5
    (1 author)
    • Show all (7)

ORCIDs linked to this article

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine, 02 Jan 2024, 65(1):16-21
https://doi.org/10.2967/jnumed.123.265868 PMID: 37884332 

Abstract 

Contrast-enhanced MRI is the method of choice for brain tumor diagnostics, despite its low specificity for tumor tissue. This study compared the contribution of MR spectroscopic imaging (MRSI) and amino acid PET to improve the detection of tumor tissue. Methods: In 30 untreated patients with suspected glioma, O-(2-[18F]fluoroethyl)-l-tyrosine (18F-FET) PET; 3-T MRSI with a short echo time; and fluid-attenuated inversion recovery, T2-weighted, and contrast-enhanced T1-weighted MRI were performed for stereotactic biopsy planning. Serial samples were taken along the needle trajectory, and their masks were projected to the preoperative imaging data. Each sample was individually evaluated neuropathologically. 18F-FET uptake and the MRSI signals choline (Cho), N-acetyl-aspartate (NAA), creatine, myoinositol, and derived ratios were evaluated for each sample and classified using logistic regression. The diagnostic accuracy was evaluated by receiver operating characteristic analysis. Results: On the basis of the neuropathologic evaluation of tissue from 88 stereotactic biopsies, supplemented with 18F-FET PET and MRSI metrics from 20 areas on the healthy-appearing contralateral hemisphere to balance the glioma/nonglioma groups, 18F-FET PET identified glioma with the highest accuracy (area under the receiver operating characteristic curve, 0.89; 95% CI, 0.81-0.93; threshold, 1.4 × background uptake). Among the MR spectroscopic metabolites, Cho/NAA normalized to normal brain tissue showed the highest diagnostic accuracy (area under the receiver operating characteristic curve, 0.81; 95% CI, 0.71-0.88; threshold, 2.2). The combination of 18F-FET PET and normalized Cho/NAA did not improve the diagnostic performance. Conclusion: MRI-based delineation of gliomas should preferably be supplemented by 18F-FET PET.

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Read article at publisher's site: https://doi.org/10.2967/jnumed.123.265868

Read article for free, from open access legal sources, via Unpaywall: https://jnm.snmjournals.org/content/jnumed/65/1/16.full.pdfUnpaywall

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