Addition of Amide Proton Transfer Imaging to FDG-PET/CT Improves Diagnostic Accuracy in Glioma Grading: A Preliminary Study Using the Continuous Net Reclassification Analysis

Sakata, Akihiko; Okada, Tomohisa; Yamamoto, Yosuke; Fushimi, Yasutaka; Dodo, Toshiki; Arakawa, Yoshiki; Mineharu, Yohei; Schmitt, Benjamin; Miyamoto, Susumu; Togashi, Kaori

doi:10.3174/ajnr.a5503

Cited by 14 publications

(10 citation statements)

References 38 publications

(61 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our present study, the results presented that the signal intensity was significantly different between the WHO II, III and IV gliomas, which were also consistent with the results of previous studies. [ 10 , 12 ]…”

Section: Discussionmentioning

confidence: 99%

An evidence-based approach to evaluate the accuracy of amide proton transfer-weighted MRI in characterization of gliomas

Zhao¹,

Huang²,

Xie³

et al. 2019

Medicine

View full text Add to dashboard Cite

Backgroud:To perform a meta-analysis to evaluate the diagnostic accuracy of the amide proton transfer (APT) technique in differentiating high-grade gliomas (HGGs) from low grade gliomas (LGGs).Methods:Medical literature databases were searched for studies that evaluated the diagnostic accuracy of APT in patients suspected of brain tumor who underwent APT MRI and surgery. Only English language studies and published before September 2018 were considered to be included in this project. Homogeneity was assessed by the inconsistency index. Mean difference (MD) at 95% confidence interval (CI) of all parameters derived from APT was calculated. Publication bias was explored by Egger's funnel plot.Results:Six eligible studies were included in the meta-analysis, comprising 144 HGGs and 122 LGGs. The APT-related parameter signal intensity (SI) was significantly higher in the HGG than the LGG (WMD = 0.86 (0.61–1.1), P < .0001); A significant difference was also found between grade II and grade III (WMD = 0.6 (0.4–0.8), P < .0001), and between grade II and grade IV (WMD = 1.07 (0.65–1.49), P < .0001).Conclusions:APT imaging may be a useful imaging biomarker for discriminating between LGGs and HGGs. However, large randomized control trials (RCT) were necessary to evaluate its clinical value.

show abstract

Section: Discussionmentioning

confidence: 99%

An evidence-based approach to evaluate the accuracy of amide proton transfer-weighted MRI in characterization of gliomas

Zhao¹,

Huang²,

Xie³

et al. 2019

Medicine

View full text Add to dashboard Cite

show abstract

“…The failure to enhance and overlap of ADCs may be multifactorial and influenced by the tumour microenvironment, cellularity, blood diffusion, oedema and disruption of the blood–brain barrier . These factors may also alter glucose uptake for FDG‐PET/CT where we would normally expect it to be greater in high‐grade glioma as compared to low‐grade (hypometabolic) glioma …”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) is currently the most widely accepted imaging modality for characterisation of brain tumours, with the commonly used sequences of T1, T1 with gadolinium contrast, T2/FLAIR and DWI/ADC (diffusion‐weighted imaging/apparent diffusion coefficient). However, MRI alone may not accurately predict for tumour grade as a proportion may not enhance with contrast and there is substantial overlap of ADCs between differing grades …”

Section: Introductionmentioning

confidence: 99%

“…18F‐fluorodeoxyglucose positron emission tomography co‐registered with computed tomography (FDG‐PET/CT) is a widely available imaging modality and identifies increased glucose uptake via standardised uptake values (SUV). Glucose uptake is greater in high‐grade glioma as compared to low‐grade glioma, and there is interest in using SUV to help differentiate between these entities as well as delineate regions of high‐grade transformation within low‐grade glioma . The ratio of uptake between the glioma and normal brain gray or white matter may be compared to define the grade .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic performance of 18F‐fluorodeoxyglucose positron emission tomography in the evaluation of glioma

et al. 2019

View full text Add to dashboard Cite

Introduction: Identifying glioma grade through imaging allows clinicians to recommend and accurately direct treatment. We sought to quantify the utility of FDG-PET/CT (18F-fluorodeoxyglucose positron emission tomography/computed tomography), alone and in combination with MRI, in identifying highgrade regions of glioma. Methods: This is a retrospective review of patients who had an FDG-PET/CT performed as part of the workup of suspected glioma or in follow-up of known glioma. FDG-PET/CT scans were reviewed and uptake in the identifiable lesion coded as none, diffusely or focally increased. Patients also underwent gadolinium-enhanced MRI, noting regions of contrast enhancement. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated for identification of high-grade histology (WHO III or IV, or metastatic disease) obtained post-FDG-PET/CT. Results: Thirty-three patients had 36 FDG-PET/CT and MRI scans followed by histological confirmation (biopsy or debulking). Increased FDG uptake demonstrated a sensitivity of 59% and specificity of 79%, PPV of 81% and NPV of 55% for identification of high-grade histology. MRI demonstrated a sensitivity of 77% and specificity of 86%, PPV of 89% and NPV of 71% for identification of highgrade histology. Only 64% of MRI and FDG-PET/CT scan series were concordant. When FDG-PET/CT and MRI were concordant, a specificity of 100% and PPV of 100% was achieved, however, sensitivity was 79% and NPV was 75%. Conclusion: The combination of FDG-PET/CT and gadolinium-enhanced MRI demonstrated marked improvement in identifying potential high-grade disease over each modality alone. Increased FDG uptake without gadolinium enhancement rarely occurred and identified high-grade histology in a small number of patients. Due to limited sensitivity and NPV, a negative FDG-PET/ CT alone, or in combination with MRI, should not guide a decision for observation where surgery would otherwise be recommended.

show abstract

“…This novel imaging uses off-resonance saturation pulses to identify peptides and mobile proteins in tissues [54]. In the past five years, APT was only investigated in a retrospective study by Sakata et al in 49 newly diagnosed glioma patients, who underwent 18 F-FDG PET/CT and MRI (including DWI) [41]. The addition of the mean APT (APT mean ) value (extracted from a ROI placed in the most representative slice of the tumor) or minimum ADC (ADC min ) to 18 F-FDG uptake T/N ratio, improved discrimination of HGGs (grade III-IV) from LGGs (grade II).…”

Section: Gradingmentioning

confidence: 99%

The Additional Value of 18F-FDG PET and MRI in Patients with Glioma: A Review of the Literature from 2015 to 2020

et al. 2020

View full text Add to dashboard Cite

Aim: Beyond brain computed tomography (CT) scan, Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) hold paramount importance in neuro-oncology. The aim of this narrative review is to discuss the literature from 2015 to 2020, showing advantages or complementary information of fluorine-18 fluorodeoxyglucose (18F-FDG) PET imaging to the anatomical and functional data offered by MRI in patients with glioma. Methods: A comprehensive Pubmed/MEDLINE literature search was performed to retrieve original studies, with a minimum of 10 glioma patients, published from 2015 until the end of April 2020, on the use of 18F-FDG PET in conjunction with MRI. Results: Twenty-two articles were selected. Combined use of the two modalities improves the accuracy in predicting prognosis, planning treatments, and evaluating recurrence. Conclusion: According to the recent literature, 18F-FDG PET provides different and complementary information to MRI and may enhance performance in the whole management of gliomas. Therefore, integrated PET/MRI may be particularly useful in gliomas, since it could provide accurate morphological and metabolic information in one-shoot examination and improve the diagnostic value compared to each of procedures.

show abstract

Addition of Amide Proton Transfer Imaging to FDG-PET/CT Improves Diagnostic Accuracy in Glioma Grading: A Preliminary Study Using the Continuous Net Reclassification Analysis

Cited by 14 publications

References 38 publications

An evidence-based approach to evaluate the accuracy of amide proton transfer-weighted MRI in characterization of gliomas

An evidence-based approach to evaluate the accuracy of amide proton transfer-weighted MRI in characterization of gliomas

Diagnostic performance of 18F‐fluorodeoxyglucose positron emission tomography in the evaluation of glioma

The Additional Value of 18F-FDG PET and MRI in Patients with Glioma: A Review of the Literature from 2015 to 2020

Contact Info

Product

Resources

About