Multiparametric Characterization of Intracranial Gliomas Using Dynamic [18F]FET-PET and Magnetic Resonance Spectroscopy

TY - JOUR

T1 - Multiparametric Characterization of Intracranial Gliomas Using Dynamic [18F]FET-PET and Magnetic Resonance Spectroscopy

AU - Pyka, Thomas

AU - Krzyzanowska, Iwona

AU - Rominger, Axel

AU - Delbridge, Claire

AU - Meyer, Bernhard

AU - Boeckh-Behrens, Tobias

AU - Zimmer, Claus

AU - Gempt, Jens

PY - 2022/9/27

Y1 - 2022/9/27

N2 - Both static and dynamic O-(2-[18F]fluoroethyl)-l-tyrosine-(FET)-PET and 1H magnetic resonance spectroscopy (MRS) are useful tools for grading and prognostication in gliomas. However, little is known about the potential of multimodal imaging comprising both procedures. We therefore acquired NAA/Cr and Cho/Cr ratios in multi-voxel MRS as well as FET-PET parameters in 67 glioma patients and determined multiparametric parameter combinations. Using receiver operating characteristics, differentiation between low-grade and high-grade glioma was possible by static FET-PET (area under the curve (AUC) 0.86, p = 0.001), time-to-peak (TTP; AUC 0.79, p = 0.049), and using the Cho/Cr ratio (AUC 0.72, p = 0.039), while the multimodal analysis led to improved discrimination with an AUC of 0.97 (p = 0.001). In order to distinguish glioblastoma from non-glioblastoma, MRS (NAA/Cr ratio, AUC 0.66, p = 0.031), and dynamic FET-PET (AUC 0.88, p = 0.001) were superior to static FET imaging. The multimodal analysis increased the accuracy with an AUC of 0.97 (p < 0.001). In the survival analysis, PET parameters, but not spectroscopy, were significantly correlated with overall survival (OS, static PET p = 0.014, TTP p = 0.012), still, the multiparametric analysis, including MRS, was also useful for the prediction of OS (p = 0.002). In conclusion, FET-PET and MRS provide complementary information to better characterize gliomas before therapy, which is particularly interesting with respect to the increasing use of hybrid PET/MRI for brain tumors.

AB - Both static and dynamic O-(2-[18F]fluoroethyl)-l-tyrosine-(FET)-PET and 1H magnetic resonance spectroscopy (MRS) are useful tools for grading and prognostication in gliomas. However, little is known about the potential of multimodal imaging comprising both procedures. We therefore acquired NAA/Cr and Cho/Cr ratios in multi-voxel MRS as well as FET-PET parameters in 67 glioma patients and determined multiparametric parameter combinations. Using receiver operating characteristics, differentiation between low-grade and high-grade glioma was possible by static FET-PET (area under the curve (AUC) 0.86, p = 0.001), time-to-peak (TTP; AUC 0.79, p = 0.049), and using the Cho/Cr ratio (AUC 0.72, p = 0.039), while the multimodal analysis led to improved discrimination with an AUC of 0.97 (p = 0.001). In order to distinguish glioblastoma from non-glioblastoma, MRS (NAA/Cr ratio, AUC 0.66, p = 0.031), and dynamic FET-PET (AUC 0.88, p = 0.001) were superior to static FET imaging. The multimodal analysis increased the accuracy with an AUC of 0.97 (p < 0.001). In the survival analysis, PET parameters, but not spectroscopy, were significantly correlated with overall survival (OS, static PET p = 0.014, TTP p = 0.012), still, the multiparametric analysis, including MRS, was also useful for the prediction of OS (p = 0.002). In conclusion, FET-PET and MRS provide complementary information to better characterize gliomas before therapy, which is particularly interesting with respect to the increasing use of hybrid PET/MRI for brain tumors.

U2 - 10.3390/diagnostics12102331

DO - 10.3390/diagnostics12102331

M3 - SCORING: Journal article

C2 - 36292019

VL - 12

JO - DIAGNOSTICS

JF - DIAGNOSTICS

SN - 2075-4418

IS - 10

M1 - 2331

ER -