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

  • Diagnostic Neuroradiology
  • Published:
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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.

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Acknowledgements

CB is supported by the TÜFF program of the Faculty of Medicine, Eberhard Karls University Tuebingen (Application Number 2395-0-0).

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Author notes

  1. ClF and UK contributed equally to this study.

Authors and Affiliations

  1. Diagnostic and Interventional Neuroradiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany

    Cornelia Brendle, Johann-Martin Hempel, Benjamin Bender, Ulrike Ernemann & Uwe Klose

  2. Neuropathology, Department of Pathology and Neuropathology, Eberhard Karls University, Liebermeistersstraße 8, 72076, Tuebingen, Germany

    Jens Schittenhelm

  3. University Hospital for Neurosurgery, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany

    Marco Skardelly

  4. Preclinical Imaging and Radiopharmacy, Eberhard Karls University, Roentgenweg 13, 72076, Tuebingen, Germany

    Gerald Reischl

  5. Nuclear Nedicine and Clinical Molecular Imaging, Department of Radiology, Eberhard Karls University, Otfried-Mueller-Straße 14, 72076, Tuebingen, Germany

    Christian la Fougère

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  1. Cornelia Brendle
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Corresponding author

Correspondence to Cornelia Brendle.

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Conflict of interest

The Department of Diagnostic and Interventional Radiology has a collaboration contract with Siemens Healthcare concerning the technical development of PET/MRI Biograph mMR.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Brendle, C., Hempel, JM., Schittenhelm, J. et al. Glioma grading by dynamic susceptibility contrast perfusion and 11C-methionine positron emission tomography using different regions of interest. Neuroradiology 60, 381–389 (2018). https://doi.org/10.1007/s00234-018-1993-5

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  • DOI: https://doi.org/10.1007/s00234-018-1993-5

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