Quantitative volumetric analysis of gliomas with sequential MRI and 11C-methionine PET assessment: patterns of integration in therapy planning

Arbizu, Javier; Tejada, Sonia; Martí-Climent, Josep M.; Díez-Valle, Ricardo; Prieto, Elena; Quincoces, Gemma; Vigil, C.; Idoate, Miguel A.; Jl, Zubieta; Peñuelas, Iván; Richter, José A.

doi:10.1007/s00259-011-2049-9

Cited by 71 publications

(44 citation statements)

References 33 publications

(77 reference statements)

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“…In vivo, the level of proliferation, as assessed by Ki67 staining, was associated with histologic characteristics in a rat glioblastoma model (23). In human patients, histologic profiles of suspected glioblastomas were in accordance with 11 C-methionine uptake levels (25), and 11 C-methionine uptake was strongly correlated with proliferation (26). In our study, increased staining was observed in tumor foci on the histologic sections of femurs labeled with Ki67.…”

Section: Discussionmentioning

confidence: 99%

Mammary Cancer Bone Metastasis Follow-up Using Multimodal Small-Animal MR and PET Imaging

et al. 2013

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Despite tremendous progress in the management of breast cancer, the survival rate of this disease is still correlated with the development of metastases-most notably, those of the bone. Diagnosis of bone metastasis requires a combination of multiple imaging modalities. MR imaging remains the best modality for soft-tissue visualization, allowing for the distinction between benign and malignant lesions in many cases. On the other hand, PET imaging is frequently more specific at detecting bone metastasis by measuring the accumulation of radiotracers, such as 18 F-sodium fluoride ( 18 F-NaF) and 18 F-FDG. Thus, the main purpose of this study was to longitudinally monitor bone tumor progression using PET/MR image coregistration to improve noninvasive imaging-assisted diagnoses. Methods: After surgical implantation of mammary MRMT-1 cells in a rat femur, we performed minimally invasive imaging procedures at different time points throughout tumor development. The procedure consisted of sequential coregistered MR and PET image acquisition, using gadolinium-diethylenetriaminepentaacetic acid (DTPA) as a contrast agent for MR imaging and 18 F-FDG, 11 C-methionine, and 18 F-NaF as molecular tracers for PET imaging. The animals were then euthanized, and complementary radiologic (micro-CT scans) and histologic analyses were performed. Results: In this preclinical study, we demonstrated that coregistered MR and PET images provide helpful information in a rat mammary-derived bone cancer model. First, MR imaging provided a high-definition anatomic resolution that made the localization of bone resorption and tumor extension detectable between days 9 and 18 after the injection of cancer cells in the medullary channel of the femur. Indeed, the calculation of mean standardized uptake value (SUV mean ) and maximal SUV (SUV max ) in bone and softtissue regions, as defined from the gadolinium-DTPA contrastenhanced MR images, showed 18 F-NaF uptake modifications and increased 18 F-FDG or 11 C-methionine uptake in the bone and surrounding soft tissues. 18 F-FDG and 11 C-methionine were compared in terms of the magnitude of change in their uptake and variability. We observed that 11 C-methionine SUV mean variations in the tumor were more important than those of 18 F-FDG. We also found fewer interindividual variations using SUV mean as a quantitative parameter than SUV max . Conclusion: This preclinical evaluation demonstrated that a PET/MR image coregistration protocol provided a powerful tool to evaluate bone tumor progression in a rat model of bone metastasis and that this protocol could be translated to improve the clinical outcome for metastatic breast cancer management.

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Section: Discussionmentioning

confidence: 99%

Mammary Cancer Bone Metastasis Follow-up Using Multimodal Small-Animal MR and PET Imaging

et al. 2013

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“…[37,38] Unfortunately, the short 20-minute half-life of the 11 C isotope precludes its use at centers that lack access to an onsite cyclotron. In contrast O-(2-18 F-fluoroethyl)-L-tyrosine ( 18 F-FET), another amino acid tracer, has a much longer half-life of 109 minutes allowing for more widespread use.…”

Section: Diffusion-weighted Imaging (Dwi)mentioning

confidence: 99%

Advances in Magnetic Resonance Imaging and Positron Emission Tomography Imaging for Grading and Molecular Characterization of Glioma

Chung

Metser

Ménard

2015

Seminars in Radiation Oncology

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“…Because contrast enhancement only depicts tumor areas with a disrupted blood-brain barrier, it might not show invasive areas at the border zone of lesions. 1 The only tool other than iMRI established in clinical routine that shows residual tumor in situ is 5-ALAbased fluorescence. Preliminary data comparing 5-ALA fluorescence with preoperative MRI suggest a higher sensitivity for tumor tissue detection.…”

Section: The Gold Standard To Assess Eor In Hggs and Mets Is Postopermentioning

confidence: 99%

Tumor detection with 5-aminolevulinic acid fluorescence and Gd-DTPA–enhanced intraoperative MRI at the border of contrast-enhancing lesions: a prospective study based on histopathological assessment

Coburger¹,

Engelke²,

Scheuerle

et al. 2014

FOC

121

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Object High-grade gliomas (HGGs) and metastasis (MET) are the most common intracranial lesions in neurosurgical routine. Both of them show an invasive growth pattern extending into neural tissue beyond the margins of contrast enhancement on MRI. These “undetected” areas might be the origin of early tumor recurrence. The aim of the present study was to evaluate whether 5-aminolevulinic acid (5-ALA) fluorescence provides an additional benefit in detection of invasive tumor compared with intraoperative MRI (iMRI). Methods The authors prospectively enrolled 45 patients harboring contrast-enhancing lesions, in whom gross-total resection was intended. All patients had surgery in which iMRI and 5-ALA–guided resection were used following a specific protocol. First, a typical white light tumor resection was performed. Then, spatial location of residual fluorescence was marked. After that, an iMRI was performed and residual uptake of contrast was marked. Navigated biopsy samples were taken from all marked areas and from additional sites according to the surgeon's judgment. Cross tables and receiver operating characteristic curves were calculated, assessing performance of the imaging methods for tumor detection alone and for combined detection of infiltration zone and solid tumor (pathological tissue). Also, correlations of histopathological findings with imaging results were tested using Spearman rho. Results Thirty-four patients with HGGs and 11 with METs were enrolled. Three patients harboring a MET showed no 5-ALA enhancement and were excluded; 127 histopathological samples were harvested in the remaining patients. In HGG, sensitivity for tumor detection was significantly higher (p < 0.001) in 5-ALA (0.85) than in iMRI (0.41). Specificity was significantly lower (p < 0.001) in 5-ALA (0.43) than in iMRI (0.70). For detection of pathological tissue, 5-ALA significantly exceeded iMRI in specificity (0.80 vs 0.60) and sensitivity (0.91 vs 0.66) (p < 0.001). Imaging results of iMRI and 5-ALA did not correlate significantly; only 5-ALA showed a significant correlation with final histopathological diagnosis of the specimen and with typical histopathological features of HGGs. In METs, sensitivity and specificity for tumor detection were equal in 5-ALA and iMRI. Both techniques showed high values for sensitivity (0.75) and specificity (0.80). The odds ratio for detection of tumor tissue was 12 for both techniques. Concerning pathological tissue, no statistically significant difference was found either. Imaging results of iMRI and 5-ALA correlated significantly (p < 0.022), as with final histopathological diagnosis in METs. Conclusions In METs, due to the rate of nonenhancing lesions, the authors found no additional benefit of 5-ALA compared with iMRI. In HGG, imaging results of 5-ALA and iMRI are significantly different at the border zone; 5-ALA has a higher sensitivity and a lower specificity for tumor detection than Gd-DTPA–enhanced iMRI. For detection of infiltrating tumor at the border of the resection cavity, 5-ALA is superior to Gd-DTPA–enhanced iMRI concerning both sensitivity and specificity. Thus, use of 5-ALA in addition to iMRI might be beneficial to maximize extent of resection. Clinical synergistic effects will be evaluated in a prospective randomized trial.

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Quantitative volumetric analysis of gliomas with sequential MRI and 11C-methionine PET assessment: patterns of integration in therapy planning

Cited by 71 publications

References 33 publications

Mammary Cancer Bone Metastasis Follow-up Using Multimodal Small-Animal MR and PET Imaging

Mammary Cancer Bone Metastasis Follow-up Using Multimodal Small-Animal MR and PET Imaging

Advances in Magnetic Resonance Imaging and Positron Emission Tomography Imaging for Grading and Molecular Characterization of Glioma

Tumor detection with 5-aminolevulinic acid fluorescence and Gd-DTPA–enhanced intraoperative MRI at the border of contrast-enhancing lesions: a prospective study based on histopathological assessment

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