Hybrid MR-PET of brain tumours using amino acid PET and chemical exchange saturation transfer MRI

Silva, Nuno da; Lohmann, Philipp; Fairney, J; Magill, Arthur W.; Peusquens, A.-M. Oros; Choi, C.; Stirnberg, Rüdiger; Stoffels, Gabriele; Galldiks, Norbert; Golay, Xavier; Langen, K.-J.; Shah, N. Jon

doi:10.1007/s00259-018-3940-4

Cited by 21 publications

(11 citation statements)

References 66 publications

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“…Our findings contradict a recent report by da Silva et al [18], who reported no overlap between APTw MRI and FET-PET in simultaneous PET-MRI of eight patients. APTw values cannot be directly compared, because different RF saturation (B 1,rms = 1.0μT, T sat = 0.1 s) and image acquisition techniques (steady-state saturation transfer with 3D gradient echo EPI readout) were used in that study.…”

Section: Discussioncontrasting

confidence: 99%

“…In gliomas, a recent study surprisingly reported no correlation between APTw and FET [18]. Given the partially overlapping biological processes captured by these imaging modalities, these findings motivated us to investigate the synergism of APTw, FET, and CBV and how well they capture cellularity and vascularisation in a series of patients with newly diagnosed gliomas, both in IDH mutant and wild type tumors.…”

Section: Introductionmentioning

confidence: 99%

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Imaging glioma biology: spatial comparison of amino acid PET, amide proton transfer, and perfusion-weighted MRI in newly diagnosed gliomas

Schön

Cabello

Liesche‐Starnecker

et al. 2020

Eur J Nucl Med Mol Imaging

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Purpose Imaging glioma biology holds great promise to unravel the complex nature of these tumors. Besides well-established imaging techniques such O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-PET and dynamic susceptibility contrast (DSC) perfusion imaging, amide proton transfer-weighted (APTw) imaging has emerged as a promising novel MR technique. In this study, we aimed to better understand the relation between these imaging biomarkers and how well they capture cellularity and vascularity in newly diagnosed gliomas. Methods Preoperative MRI and FET-PET data of 46 patients (31 glioblastoma and 15 lower-grade glioma) were segmented into contrast-enhancing and FLAIR-hyperintense areas. Using established cutoffs, we calculated hot-spot volumes (HSV) and their spatial overlap. We further investigated APTw and CBV values in FET-HSV. In a subset of 10 glioblastoma patients, we compared cellularity and vascularization in 34 stereotactically targeted biopsies with imaging. Results In glioblastomas, the largest HSV was found for APTw, followed by PET and CBV (p < 0.05). In lower-grade gliomas, APTw-HSV was clearly lower than in glioblastomas. The spatial overlap of HSV was highest between APTw and FET in both tumor entities and regions. APTw correlated significantly with cellularity, similar to FET, while the association with vascularity was more pronounced in CBV and FET. Conclusions We found a relevant spatial overlap in glioblastomas between hotspots of APTw and FET both in contrast-enhancing and FLAIR-hyperintense tumor. As suggested by earlier studies, APTw was lower in lower-grade gliomas compared with glioblastomas. APTw meaningfully contributes to biological imaging of gliomas.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Imaging glioma biology: spatial comparison of amino acid PET, amide proton transfer, and perfusion-weighted MRI in newly diagnosed gliomas

Schön

Cabello

Liesche‐Starnecker

et al. 2020

Eur J Nucl Med Mol Imaging

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“…Although amino acid PET and advanced MRI such as perfusion-weighted imaging or chemical exchange saturation transfer are increasingly gaining attention in Neuro-Oncology (Langen et al, 2017; da Silva et al, 2018), to date conventional MRI is the method of choice in brain tumor diagnostics. Several studies have investigated the potential of conventional MRI for differentiation of radiation injury from brain metastasis recurrence.…”

Section: Discussionmentioning

confidence: 99%

Combined FET PET/MRI radiomics differentiates radiation injury from recurrent brain metastasis

Lohmann

Köcher

Ceccon

et al. 2018

NeuroImage: Clinical

123

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BackgroundThe aim of this study was to investigate the potential of combined textural feature analysis of contrast-enhanced MRI (CE-MRI) and static O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET for the differentiation between local recurrent brain metastasis and radiation injury since CE-MRI often remains inconclusive.MethodsFifty-two patients with new or progressive contrast-enhancing brain lesions on MRI after radiotherapy (predominantly stereotactic radiosurgery) of brain metastases were additionally investigated using FET PET. Based on histology (n = 19) or clinicoradiological follow-up (n = 33), local recurrent brain metastases were diagnosed in 21 patients (40%) and radiation injury in 31 patients (60%). Forty-two textural features were calculated on both unfiltered and filtered CE-MRI and summed FET PET images (20–40 min p.i.), using the software LIFEx. After feature selection, logistic regression models using a maximum of five features to avoid overfitting were calculated for each imaging modality separately and for the combined FET PET/MRI features. The resulting models were validated using cross-validation. Diagnostic accuracies were calculated for each imaging modality separately as well as for the combined model.ResultsFor the differentiation between radiation injury and recurrence of brain metastasis, textural features extracted from CE-MRI had a diagnostic accuracy of 81% (sensitivity, 67%; specificity, 90%). FET PET textural features revealed a slightly higher diagnostic accuracy of 83% (sensitivity, 88%; specificity, 75%). However, the highest diagnostic accuracy was obtained when combining CE-MRI and FET PET features (accuracy, 89%; sensitivity, 85%; specificity, 96%).ConclusionsOur findings suggest that combined FET PET/CE-MRI radiomics using textural feature analysis offers a great potential to contribute significantly to the management of patients with brain metastases.

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“…Although several studies evaluated CEST in patients with GBM [75,76,77], only few studies directly compared amino acid PET and CEST in more than 5 patients. Da Silva et al [78] compared FET PET and APT CEST MRI in 8 high-grade gliomas patients using a 3 T hybrid PET/MR scanner. The authors showed that FET PET and APT CEST are spatially incongruent and reflect different biological information.…”

Section: Amino Acid Pet and Cestmentioning

confidence: 99%

Combined Amino Acid Positron Emission Tomography and Advanced Magnetic Resonance Imaging in Glioma Patients

Lohmann

Werner

Shah

et al. 2019

Cancers

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Imaging techniques such as positron emission tomography (PET) and magnetic resonance imaging (MRI) provide valuable information about brain tumor patients. Particularly amino acid PET, advanced MRI techniques, and combinations thereof are of great interest for the non-invasive assessment of biological characteristics in patients with primary or secondary brain cancer. A methodological innovation that potentially advances research in patients with brain tumors is the increasing availability of hybrid PET/MRI systems, which enables the simultaneous acquisition of both imaging modalities. Furthermore, the advent of ultra-high field MRI scanners operating at magnetic field strengths of 7 T or more will allow further development of metabolic MR imaging at higher resolution. This review focuses on the combination of amino acid PET with MR spectroscopic imaging, perfusion- and diffusion-weighted imaging, as well as chemical exchange saturation transfer in patients with high-grade gliomas, especially glioblastomas.

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Hybrid MR-PET of brain tumours using amino acid PET and chemical exchange saturation transfer MRI

Cited by 21 publications

References 66 publications

Imaging glioma biology: spatial comparison of amino acid PET, amide proton transfer, and perfusion-weighted MRI in newly diagnosed gliomas

Imaging glioma biology: spatial comparison of amino acid PET, amide proton transfer, and perfusion-weighted MRI in newly diagnosed gliomas

Combined FET PET/MRI radiomics differentiates radiation injury from recurrent brain metastasis

Combined Amino Acid Positron Emission Tomography and Advanced Magnetic Resonance Imaging in Glioma Patients

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