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31.03.2021 | Neuro

Simultaneously acquired PET and ASL imaging biomarkers may be helpful in differentiating progression from pseudo-progression in treated gliomas

verfasst von: Arnaud Pellerin, Maya Khalifé, Marc Sanson, Laura Rozenblum-Beddok, Marc Bertaux, Marine Soret, Damien Galanaud, Didier Dormont, Aurélie Kas, Nadya Pyatigorskaya

Erschienen in: European Radiology | Ausgabe 10/2021

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Abstract

Objectives

The aim of this work was investigating the methods based on coupling cerebral perfusion (ASL) and amino acid metabolism ([¹⁸F]DOPA-PET) measurements to evaluate the diagnostic performance of PET/MRI in glioma follow-up.

Methods

Images were acquired using a 3-T PET/MR system, on a prospective cohort of patients addressed for possible glioma progression. Data were preprocessed with statistical parametric mapping (SPM), including registration on T1-weighted images, spatial and intensity normalization, and tumor segmentation. As index tests, tumor isocontour maps of [¹⁸F]DOPA-PET and ASL T-maps were created and metabolic/perfusion abnormalities were evaluated with the asymmetry index z-score. SPM map analysis of significant size clusters and semi-quantitative PET and ASL map evaluation were performed and compared to the gold standard diagnosis. Lastly, ASL and PET topography of significant clusters was compared to that of the initial tumor.

Results

Fifty-eight patients with unilateral treated glioma were included (34 progressions and 24 pseudo-progressions). The tumor isocontour maps and T-maps showed the highest specificity (100%) and sensitivity (94.1%) for ASL and [¹⁸F]DOPA analysis, respectively. The sensitivity of qualitative SPM maps and semi-quantitative rCBF and rSUV analyses were the highest for glioblastoma.

Conclusion

Tumor isocontour T-maps and combined analysis of CBF and [¹⁸F]DOPA-PET uptake allow achieving high diagnostic performance in differentiating between progression and pseudo-progression in treated gliomas. The sensitivity is particularly high for glioblastomas.

Key Points

• Applied separately, MRI and PET imaging modalities may be insufficient to characterize the brain glioma post-therapeutic profile.

• Combined ASL and [¹⁸F]DOPA-PET map analysis allows differentiating between tumor progression and pseudo-progression.

Ricard D, Idbaih A, Ducray F, Lahutte M, Hoang-Xuan K, Delattre JY (2012) Primary brain tumours in adults. Lancet Lond Engl 379:1984–1996CrossRef

Klobukowski L, Falkov A, Chelimo C, Fogh SE (2018) A retrospective review of re-irradiating patients’ recurrent high-grade gliomas. Clin Oncol (R Coll Radiol). https://doi.org/10.1016/j.clon.2018.05.004

Thust SC, Heiland S, Falini A et al (2018) Glioma imaging in Europe: a survey of 220 centres and recommendations for best clinical practice. Eur Radiol 28:3306–3317PubMedPubMedCentralCrossRef

Kumar AJ, Leeds NE, Fuller GN et al (2000) Malignant gliomas: MR imaging spectrum of radiation therapy- and chemotherapy-induced necrosis of the brain after treatment. Radiology 217:377–384PubMedCrossRef

Mullins ME, Barest GD, Schaefer PW et al (2005) Radiation necrosis versus glioma recurrence: conventional MR imaging clues to diagnosis. AJNR Am J Neuroradiol 26:1967–1972PubMedPubMedCentral

Aronen HJ, Gazit IE, Louis DN et al (1994) Cerebral blood volume maps of gliomas: comparison with tumor grade and histologic findings. Radiology 191:41–51PubMedCrossRef

Law M, Yang S, Wang H et al (2003) Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol 24:1989–1998PubMedPubMedCentral

Mabray MC, Barajas RF, Cha S (2015) Modern brain tumor imaging. Brain Tumor Res Treat 3:8–23PubMedPubMedCentralCrossRef

Rossi A, Gandolfo C, Morana G, Severino M, Garrè ML, Cama A (2010) New MR sequences (diffusion, perfusion, spectroscopy) in brain tumours. Pediatr Radiol 40:999–1009PubMedCrossRef

10.

Haller S, Zaharchuk G, Thomas DL, Lovblad KO, Barkhof F, Golay X (2016) Arterial spin labeling perfusion of the brain: emerging clinical applications. Radiology 281:337–356PubMedCrossRef

11.

Galldiks N, Stoffels G, Ruge MI et al (2013) Role of O-(2-18F-fluoroethyl)-L-tyrosine PET as a diagnostic tool for detection of malignant progression in patients with low-grade glioma. J Nucl Med 54:2046–2054PubMedCrossRef

12.

Pirotte BJM, Levivier M, Goldman S et al (2009) Positron emission tomography-guided volumetric resection of supratentorial high-grade gliomas: a survival analysis in 66 consecutive patients. Neurosurgery 64:471–481 discussion 481PubMedCrossRef

13.

Brandes AA, Tosoni A, Spagnolli F et al (2008) Disease progression or pseudoprogression after concomitant radiochemotherapy treatment: pitfalls in neurooncology. Neuro Oncol 10:361–367PubMedPubMedCentralCrossRef

14.

Boscolo Galazzo I, Mattoli MV, Pizzini FB et al (2016) Cerebral metabolism and perfusion in MR-negative individuals with refractory focal epilepsy assessed by simultaneous acquisition of (18)F-FDG PET and arterial spin labeling. Neuroimage Clin 11:648–657

15.

Storti SF, Boscolo Galazzo I, Del Felice A et al (2014) Combining ESI, ASL and PET for quantitative assessment of drug-resistant focal epilepsy. Neuroimage 102(Pt 1):49–59

16.

Morana G, Piccardo A, Tortora D et al (2017) Grading and outcome prediction of pediatric diffuse astrocytic tumors with diffusion and arterial spin labeling perfusion MRI in comparison with 18F-DOPA PET. Eur J Nucl Med Mol Imaging 44:2084–2093PubMedCrossRef

17.

Alsop DC, Detre JA, Golay X et al (2015) Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: a consensus of the ISMRM perfusion study group and the European consortium for ASL in dementia. Magn Reson Med 73:102–116PubMedCrossRef

18.

Brett M, Leff AP, Rorden C, Ashburner J (2001) Spatial normalization of brain images with focal lesions using cost function masking. Neuroimage 14:486–500

19.

Lim Y-M, Cho Y-W, Shamim S et al (2008) Usefulness of pulsed arterial spin labeling MR imaging in mesial temporal lobe epilepsy. Epilepsy Res 82:183–189PubMedPubMedCentralCrossRef

20.

Chen W, Silverman DHS, Delaloye S et al (2006) 18F-FDOPA PET imaging of brain tumors: comparison study with 18F-FDG PET and evaluation of diagnostic accuracy. J Nucl Med 47:904–911PubMed

21.

Louis DN, Ohgaki H, Wiestler OD et al (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109

22.

Komori T (2017) The 2016 WHO classification of tumours of the central nervous system: the major points of revision. Neurol Med Chir (Tokyo) 57:301–311CrossRef

23.

Bergamino M, Saitta L, Barletta L et al (2013) Measurement of blood-brain barrier permeability with t1-weighted dynamic contrast-enhanced MRI in brain tumors: a comparative study with two different algorithms. ISRN Neurosci 2013:905279PubMedPubMedCentralCrossRef

24.

Dolui S, Vidorreta M, Wang Z et al (2017) Comparison of PASL, PCASL, and background-suppressed 3D PCASL in mild cognitive impairment. Hum Brain Mapp 38:5260–5273PubMedPubMedCentralCrossRef

25.

Gai ND, Chou YY, Pham D, Butman JA (2017) Reduced distortion artifact whole brain CBF mapping using blip-reversed non-segmented 3D echo planar imaging with pseudo-continuous arterial spin labeling. Magn Reson Imaging 44:119–124PubMedPubMedCentralCrossRef

26.

Lindner T, Ahmeti H, Juhasz J et al (2018) A comparison of arterial spin labeling and dynamic susceptibility perfusion imaging for resection control in glioblastoma surgery. Oncotarget 9:18570–18577PubMedPubMedCentralCrossRef

27.

Galldiks N, Langen K-J, Holy R et al (2012) Assessment of treatment response in patients with glioblastoma using O-(2-18F-fluoroethyl)-L-tyrosine PET in comparison to MRI. J Nucl Med 53:1048–1057PubMedCrossRef

28.

Pafundi DH, Laack NN, Youland RS et al (2013) Biopsy validation of 18F-DOPA PET and biodistribution in gliomas for neurosurgical planning and radiotherapy target delineation: results of a prospective pilot study. Neuro Oncol 15:1058–1067PubMedPubMedCentralCrossRef

29.

Furtner J, Bender B, Braun C et al (2014) Prognostic value of blood flow measurements using arterial spin labeling in gliomas. PLoS One 9:e99616PubMedPubMedCentralCrossRef

30.

Salber D, Stoffels G, Pauleit D et al (2007) Differential uptake of O-(2-18F-fluoroethyl)-L-tyrosine, L-3H-methionine, and 3H-deoxyglucose in brain abscesses. J Nucl Med 48:2056–2062PubMedCrossRef

31.

Langen K-J, Bröer S (2004) Molecular transport mechanisms of radiolabeled amino acids for PET and SPECT. J Nucl Med 45:1435–1436PubMed

32.

Gasparetto EL, Pawlak MA, Patel SH et al (2009) Posttreatment recurrence of malignant brain neoplasm: accuracy of relative cerebral blood volume fraction in discriminating low from high malignant histologic volume fraction. Radiology 250:887–896PubMedCrossRef

33.

Filss CP, Cicone F, Shah NJ, Galldiks N, Langen K-J (2017) Amino acid PET and MR perfusion imaging in brain tumours. Clin Transl Imaging 5:209–223PubMedPubMedCentralCrossRef

34.

Wang Y-F, Hou B, Yang S-J et al (2016) Diagnostic significance of arterial spin labeling in the assessment of tumor grade in brain. J Cancer Res Ther 12:259–266PubMedCrossRef

35.

Kinahan PE, Fletcher JW (2010) Positron emission tomography-computed tomography standardized uptake values in clinical practice and assessing response to therapy. Semin Ultrasound CT MR 31:496–505PubMedPubMedCentralCrossRef

Titel: Simultaneously acquired PET and ASL imaging biomarkers may be helpful in differentiating progression from pseudo-progression in treated gliomas
verfasst von: Arnaud Pellerin
Maya Khalifé
Marc Sanson
Laura Rozenblum-Beddok
Marc Bertaux
Marine Soret
Damien Galanaud
Didier Dormont
Aurélie Kas
Nadya Pyatigorskaya
Publikationsdatum: 31.03.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-07732-0

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Simultaneously acquired PET and ASL imaging biomarkers may be helpful in differentiating progression from pseudo-progression in treated gliomas