BACKGROUND AND PURPOSE: Both 11 C-methionine PET/CT and DSC-PWI could be used to differentiate radiation injury from recurrent brain tumors. Our aim was to assess the performance of MET PET/CT and DSC-PWI for differentiation of recurrence and radiation injury in patients with high-grade gliomas and to quantitatively analyze the diagnostic values of PET and PWI parameters. MATERIALS AND METHODS: Forty-two patients with high-grade gliomas were enrolled in this study. The final diagnosis was determined by histopathologic analysis or clinical follow-up. PWI and PET parameters were recorded and compared between patients with recurrence and those with radiation injury using Student t tests. Receiver operating characteristic and logistic regression analyses were used to determine the diagnostic performance of each parameter. RESULTS: The final diagnosis was recurrence in 33 patients and radiation injury in 9. PET/CT showed a patient-based sensitivity and specificity of 0.909 and 0.556, respectively, while PWI showed values of 0.667 and 0.778, respectively. The maximum standardized uptake value, mean standardized uptake value, tumor-to-background maximum standardized uptake value, and mean relative CBV were significantly higher for patients with recurrence than for patients with radiation injury. All these parameters showed a high discriminative power in receiver operating characteristic analysis. The optimal cutoff values for the tumor-to-background maximum standardized uptake value and mean relative CBV were 1.85 and 1.83, respectively, and corresponding sensitivities and specificities for the diagnosis of recurrence were 0.97 and 0.667 and 0.788 and 0.88, respectively. Areas under the curve for the tumor-to-background maximum standardized uptake value and mean relative CBV were 0.847 Ϯ 0.077 and 0.845 Ϯ 0.078, respectively. Combined assessment of the tumor-to-background maximum standardized uptake value and mean relative CBV showed the largest area under the curve (0.953 Ϯ 0.031), with corresponding sensitivity and specificity of 0.848 and 1.0, respectively. CONCLUSIONS: Both 11 C-methionine PET/CT and PWI are equally accurate in the differentiation of recurrence from radiation injury in patients with high-grade gliomas, and a combination of the 2 modalities could result in increased diagnostic accuracy. ABBREVIATIONS: AUC ϭ area under the curve; MET ϭ 11 C-methionine; HGG ϭ high-grade glioma; max ϭ maximum; rCBV ϭ relative CBV; SUV ϭ standardized uptake value; TBR ϭ tumor-to-background G liomas are the most common primary brain tumors. Tumor resection followed by postoperative chemotherapy and radiation therapy is the primary treatment for gliomas. However, radiation therapy may damage normal brain tissue and result in adverse effects involving the brain. Classically, radiation injury can be classified into acute and delayed reactions. Radiation-induced necrosis is the most severe form of radiation injury and usually occurs 3-12 months after radiation therapy, though it can also occur years after treatment. The incid...
Leukoaraiosis (LA) is associated with cognitive impairment in the older people which can be demonstrated in functional connectivity (FC) based on resting-state functional magnetic resonance imaging (rs-fMRI). This study is to explore the FC changes in LA patients with different cognitive status by three network models. Fifty-three patients with LA were divided into three groups: the normal cognition (LA-NC; n = 14, six males), mild cognitive impairment (LA-MCI; n = 27, 13 males), and vascular dementia (LA-VD; n = 12, six males), according to the Mini Mental State Exam (MMSE) and Clinical Dementia Rating (CDR). The three groups and 30 matched healthy controls (HCs; 11 males) underwent rs-fMRI. The data of rs-fMRI were analyzed by independent components analysis (ICA) and region of interest (ROI) analysis by the REST toolbox. Then the FC was respectively analyzed by the default-mode network (DMN), salience networks (SNs) and the central executive network (CEN) with their results compared among the different groups. For inter-brain network analysis, there were negative FC between the SN and DMN in LA groups, and the FC decreased when compared with HC group. While there were enhanced inter-brain network FC between the SN and CEN as well as within the SN. The FC in patients with LA can be detected by different network models of rs-fMRI. The multi-model analysis is helpful for the further understanding of the cognitive changes in those patients.
Background and PurposeCerebral blood oxygenation level is critical for following the evolution of stroke patients. The purpose of this study was to investigate the feasibility of measuring changes in blood oxygen levels for patients with acute stroke using SWI and to compare these changes with the patient's recovery over time.Materials and MethodsA total 30 MRI scans was performed on 10 acute ischemic stroke patients. Every patient was followed at three time points: less than 24 hours; 2–3 weeks after stroke and 2 months after stroke. Both MRI scan and NIH stroke scale (NIHSS) were acquired for each patient at all three time points. Oxygen saturation changes were derived from phase values differences (Δφ) measured over 10 veins from each hemisphere for all 10 patients over 3 time points. The correlation of oxygen saturation and NIHSS was further evaluated.ResultsThe stroke affected side of the brain showed moderate (r = −0.62) to strong (r = −0.70) correlation between the oxygenation change and NIHSS change. The oxygen saturation change from the normal side of the brain had essentially no association with recovery (r = −0.02 and−0.31). The results suggest that increases in oxygen saturation correspond to improved outcome and reductions in oxygen saturation correspond to worse outcome.ConclusionHigh resolution SWI provided a novel method to measure changes in oxygenation change of the human brain in vivo. By using the phase values from the veins, both spatial and temporal information can be found that relates to patient outcome post stroke.
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