Positron emission tomography imaging in gliomas: applications in clinical diagnosis, for assessment of prognosis and of treatment effects, and for detection of recurrences

Abstract

Neuroimaging plays a significant role in the diagnosis of intracranial tumours, especially brain gliomas, and must consist of an assessment of location and extent of the tumour and of its biological activity. Therefore, morphological imaging modalities and functional, metabolic or molecular imaging modalities should be combined for primary diagnosis and for following the course and evaluating therapeutic effects. Magnetic resonance imaging (MRI) is the gold standard for providing detailed morphological information and can supply some additional insights into metabolism (MR spectroscopy) and perfusion (perfusion-weighted imaging) but still has limitations in identifying tumour grade, invasive growth into neighbouring tissue and treatment-induced changes, as well as recurrences. These insights can be obtained by various positron emission tomography (PET) modalities, including imaging of glucose metabolism, amino acid uptake and nucleoside uptake. Diagnostic accuracy can benefit from coregistration of PET results and MRI, combining high-resolution morphological images with biological information. These procedures are optimized by the newly developed combination of PET and MRI modalities, permitting the simultaneous assessment of morphological, functional, metabolic and molecular information on the human brain.

<p>Differentiation of Treatment-Related Effects from Glioma Recurrence Using Machine Learning Classifiers Based Upon Pre-and Post-Contrast T1WI and T2 FLAIR Subtraction Features: A Two-Center Study</p>

“…Also, MRS is restricted in borderline areas and is not available for the entire brain. 11 ASL and DTI are hindered by relatively lower spatial resolutions and longer scanning protocols. To note, T1WI and T2 FLAIR sequences are robust and have gained widespread clinical acceptance in neuroradiology practice.…”

“…Although it has been generally reported that advanced MRI sequences are more accurate than conventional ones, 9 certain limitations hinder the popularity of advanced functional MRI sequences. 10,11 In comparison with other functional MR imaging methods, classic T1WI and T2 FLAIR sequences are less vulnerable to artifacts, more accessible, and allow for higher spatial resolution. 9 However, other tissue sources of bright signal appear as high signal on precontrast T1WI or T2 FLAIR, which greatly influence traditional enhancement observation.…”

Effect of blood glucose level on standardized uptake value (SUV) in 18F- FDG PET-scan: a systematic review and meta-analysis of 20,807 individual SUV measurements

“…In recent decades, fluorodeoxyglucose positron emission tomography (FDG-PET) has emerged as a pivotal imaging modality in clinical oncology [1][2][3][4][5][6][7]. Currently, thousands of PET scanners have been installed worldwide and are extensively used for diagnosis and staging of malignant tumors [8][9][10][11][12] and assessment of response to radiochemotherapy [13][14][15][16]. It is reported that PET results alter staging and treatment management in nearly 40% of patients [17].…”

Contribution of PET Imaging to Clinical Management of Gliomas

“…In this review, which is an update of a previously published paper [13], clinically relevant results studying glucose metabolism, amino acid uptake, and cell proliferation with PET tracers are summarized. Other tracers specifically applied for research topics [4,14] are not discussed.…”