PDF(Pubmed)
Abstract：
Neuroimaging based on O-[2-(18F)fluoroethyl]-l-tyrosine (FET)-PET provides additional information on tumor grade and extent compared with MRI. Dynamic PET for biopsy target selection further improves results but is often clinically impractical. Static FET-PET performed at two time-points may be a good compromise, but data on this approach are limited. The aim of this study was to compare the histology of lesions obtained from two challenging glioma patients with targets selected based on hybrid dual time-point FET-PET/MRI. Five neuronavigated tumor biopsies were performed in two difficult cases of suspected glioma. Lesions with (T1-CE) and without contrast enhancement (T1 and T2-FLAIR) on MRI were selected. Dual time-point FET-PET imaging was performed 5-15 min (PET10) and 45-60 min (PET60) after radionuclide injection. The most informative FET-PET/MRI images were coregistered with MRI in time of biopsy planning. Five biopsy targets (three from high uptake and two from moderate uptake FET areas) thought to represent the most malignant sites and tumor extent were selected. Histopathological findings were compared with FET-PET and MRI images. Increased FET uptake in the area of non-CE locations on MRI correlated well with high-grade gliomas localized as far as 3 cm from T1-CE foci. Selecting a target in the motor cortex based on FET kinetics defined by dual time-point PET resulted in a grade IV diagnosis after previous negative biopsies based on MRI. An additional grade III diagnosis was obtained from an area of glioma infiltration with moderate FET uptake (between 1 and 1.25 SUV). These findings seem to show that dual time-point FET-PET-based biopsies can provide additional and clinically useful information for glioma diagnosis. Selection of targets based on dual time-point images may be useful for determining the most malignant tumor areas and may therefore be useful for resection and radiotherapy planning.
摘要：
与MRI相比，基于O-[2-（18F）氟乙基]-1-酪氨酸（FET）-PET的神经成像提供了有关肿瘤等级和范围的其他信息。用于活检目标选择的动态PET进一步改善了结果,但通常在临床上是不切实际的。在两个时间点执行的静态FET-PET可能是一个很好的折衷，但是关于这种方法的数据是有限的。这项研究的目的是比较从两名具有挑战性的神经胶质瘤患者获得的病变的组织学，这些患者具有基于混合双时间点FET-PET/MRI选择的目标。在两个疑难的胶质瘤病例中进行了五次神经导航肿瘤活检。选择MRI上有（T1-CE）和无对比增强（T1和T2-FLAIR）的病变。放射性核素注射后5-15分钟（PET10）和45-60分钟（PET60）进行双时间点FET-PET成像。在活检计划时，信息最丰富的FET-PET/MRI图像与MRI进行了配准。选择了被认为代表最恶性位点和肿瘤程度的五个活检靶标(三个来自高摄取,两个来自中等摄取FET区域)。将组织病理学结果与FET-PET和MRI图像进行比较。MRI上非CE位置区域的FET摄取增加与距T1-CE病灶3厘米远的高级别神经胶质瘤密切相关。基于由双时间点PET定义的FET动力学在运动皮质中选择靶标导致在先前基于MRI的阴性活检后的IV级诊断。从具有中等FET摄取（1至1.25SUV）的神经胶质瘤浸润区域获得了额外的III级诊断。这些发现似乎表明，基于双时间点FET-PET的活检可以为神经胶质瘤诊断提供额外的临床有用信息。基于双时间点图像的目标选择可以用于确定最恶性的肿瘤区域,并且因此可以用于切除和放射治疗计划。
