Erschienen in:
05.09.2018 | Research Article
Association of Tumor [18F]FDG Activity and Diffusion Restriction with Clinical Outcomes of Rhabdomyosarcomas
verfasst von:
Arian Pourmehdi Lahiji, Tatianie Jackson, Hossein Nejadnik, Rie von Eyben, Daniel Rubin, Sheri L. Spunt, Andrew Quon, Heike Daldrup-Link
Erschienen in:
Molecular Imaging and Biology
|
Ausgabe 3/2019
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Abstract
Purpose
To evaluate whether the extent of restricted diffusion and 2-deoxy-2-[18F] fluoro-d-glucose ([18F]FDG) uptake of pediatric rhabdomyosarcomas (RMS) on positron emission tomography (PET)/magnetic resonance (MR) images provides prognostic information.
Procedure
In a retrospective, IRB-approved study, we evaluated [18F]FDG PET/CT and diffusion-weighted (DW) MR imaging studies of 21 children and adolescents (age 1–20 years) with RMS of the head and neck. [18F]FDG PET and DW MR scans at the time of the initial tumor diagnosis were fused using MIM software. Quantitative measures of the tumor mass with restricted diffusion, [18F]FDG hypermetabolism, or both were dichotomized at the median and tested for significance using Gray’s test. Data were analyzed using a survival analysis and competing risk model with death as the competing risk.
Results
[18F]FDG PET/MR images demonstrated a mismatch between tumor areas with increased [18F]FDG uptake and restricted diffusion. The DWI, PET, and DWI + PET tumor volumes were dichotomized at their median values, 23.7, 16.4, and 9.5 cm3, respectively, and were used to estimate survival. DWI, PET, and DWI + PET overlap tumor volumes above the cutoff values were associated with tumor recurrence, regardless of post therapy COG stage (p = 0.007, p = 0.04, and p = 0.07, respectively).
Conclusion
The extent of restricted diffusion within RMS and overlap of hypermetabolism plus restricted diffusion predict unfavorable clinical outcomes.