PDF(Sci-hub)
Abstract：
Positron emission tomography (PET) using O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET) improves the diagnostics of cerebral gliomas compared with conventional magnetic resonance imaging (MRI). Sodium MRI is an evolving method to assess tumor metabolism. In this pilot study, we explored the relationship of [18F]FET-PET and sodium MRI in patients with cerebral gliomas in relation to the mutational status of the enzyme isocitrate dehydrogenase (IDH).
Ten patients with untreated cerebral gliomas and one patient with a recurrent glioblastoma (GBM) were investigated by dynamic [18F]FET-PET and sodium MRI using an enhanced simultaneous single-quantum- and triple-quantum-filtered imaging of 23Na (SISTINA) sequence to estimate total (NaT), weighted non-restricted (NaNR, mainly extracellular), and restricted (NaR, mainly intracellular) sodium in tumors and normal brain tissue. [18F]FET uptake and sodium parameters in tumors with a different IDH mutational status were compared. After biopsy or resection, histology and the IDH mutational status were determined neuropathologically.
NaT (p = 0.05), tumor-to-brain ratios (TBR) of NaT (p = 0.02), NaNR (p = 0.003), and the ratio of NaT/NaR (p < 0.001) were significantly higher in IDH-mutated than in IDH-wild-type gliomas (n = 5 patients each) while NaR was significantly lower in IDH-mutated gliomas (p = 0.01). [18F]FET parameters (TBR, time-to-peak) were not predictive of IDH status in this small cohort of patients. There was no obvious relationship between sodium distribution and [18F]FET uptake. The patient with a recurrent GBM exhibited an additional radiation injury with strong abnormalities in sodium MRI.
Sodium MRI appears to be more strongly related to the IDH mutational status than are [18F]FET-PET parameters. A further evaluation of the combination of the two methods in a larger group of high- and low-grade gliomas seems promising.
Ten patients with untreated cerebral gliomas and one patient with a recurrent glioblastoma (GBM) were investigated by dynamic [18F]FET-PET and sodium MRI using an enhanced simultaneous single-quantum- and triple-quantum-filtered imaging of 23Na (SISTINA) sequence to estimate total (NaT), weighted non-restricted (NaNR, mainly extracellular), and restricted (NaR, mainly intracellular) sodium in tumors and normal brain tissue. [18F]FET uptake and sodium parameters in tumors with a different IDH mutational status were compared. After biopsy or resection, histology and the IDH mutational status were determined neuropathologically.
NaT (p = 0.05), tumor-to-brain ratios (TBR) of NaT (p = 0.02), NaNR (p = 0.003), and the ratio of NaT/NaR (p < 0.001) were significantly higher in IDH-mutated than in IDH-wild-type gliomas (n = 5 patients each) while NaR was significantly lower in IDH-mutated gliomas (p = 0.01). [18F]FET parameters (TBR, time-to-peak) were not predictive of IDH status in this small cohort of patients. There was no obvious relationship between sodium distribution and [18F]FET uptake. The patient with a recurrent GBM exhibited an additional radiation injury with strong abnormalities in sodium MRI.
Sodium MRI appears to be more strongly related to the IDH mutational status than are [18F]FET-PET parameters. A further evaluation of the combination of the two methods in a larger group of high- and low-grade gliomas seems promising.
摘要：
与常规磁共振成像（MRI）相比，使用O-（2-[18F]氟乙基）-L-酪氨酸（[18F]FET）的正电子发射断层扫描（PET）可改善脑胶质瘤的诊断。钠MRI是一种评估肿瘤代谢的方法。在这项试点研究中，我们探讨了脑胶质瘤患者[18F]FET-PET和钠MRI与酶异柠檬酸脱氢酶(IDH)突变状态的关系.
通过动态[18F]FET-PET和钠MRI研究了10例未经治疗的脑胶质瘤患者和1例复发性胶质母细胞瘤（GBM）患者，使用增强的同时单量子和三量子滤波成像23Na（SISTINA）序列来估计总（NaT）。加权非限制性(NaNR，主要是细胞外)，并受限制(NaR，主要存在于肿瘤和正常脑组织中的胞内)钠。比较了具有不同IDH突变状态的肿瘤中的[18F]FET摄取和钠参数。活检或切除后，组织学和IDH突变状态由神经病理学确定。
NaT(p=0.05)，NaT的肿瘤脑比（TBR）（p=0.02），NaNR（p=0.003），IDH突变的NaT/NaR比率（p<0.001）显着高于IDH野生型神经胶质瘤（每位患者n=5），而IDH突变的神经胶质瘤中NaR显着降低（p=0.01）。[18F]FET参数(TBR，达到峰值的时间）不能预测这一小批患者的IDH状态。钠分布与[18F]FET摄取之间没有明显关系。患有复发性GBM的患者表现出额外的放射损伤，钠MRI异常强烈。
钠MRI似乎比[18F]FET-PET参数更强烈地与IDH突变状态相关。在更大的高和低级别神经胶质瘤组中对两种方法的组合的进一步评估似乎是有希望的。
通过动态[18F]FET-PET和钠MRI研究了10例未经治疗的脑胶质瘤患者和1例复发性胶质母细胞瘤（GBM）患者，使用增强的同时单量子和三量子滤波成像23Na（SISTINA）序列来估计总（NaT）。加权非限制性(NaNR，主要是细胞外)，并受限制(NaR，主要存在于肿瘤和正常脑组织中的胞内)钠。比较了具有不同IDH突变状态的肿瘤中的[18F]FET摄取和钠参数。活检或切除后，组织学和IDH突变状态由神经病理学确定。
NaT(p=0.05)，NaT的肿瘤脑比（TBR）（p=0.02），NaNR（p=0.003），IDH突变的NaT/NaR比率（p<0.001）显着高于IDH野生型神经胶质瘤（每位患者n=5），而IDH突变的神经胶质瘤中NaR显着降低（p=0.01）。[18F]FET参数(TBR，达到峰值的时间）不能预测这一小批患者的IDH状态。钠分布与[18F]FET摄取之间没有明显关系。患有复发性GBM的患者表现出额外的放射损伤，钠MRI异常强烈。
钠MRI似乎比[18F]FET-PET参数更强烈地与IDH突变状态相关。在更大的高和低级别神经胶质瘤组中对两种方法的组合的进一步评估似乎是有希望的。
