18F-FACBC PET/MRI in Diagnostic Assessment and Neurosurgery of Gliomas.

Karlberg A, Berntsen EM, Johansen H, Skjulsvik AJ, Reinertsen I1, Dai HY2, Xiao Y3, Rivaz H, Borghammer P4, Solheim O, Eikenes L5.

Author information

1

Department of Health Research, SINTEF, Trondheim, Norway.

2

Department of Pathology and Medical Genetics, St Olavs Hospital.

3

Robarts Research Institute, Western University, London, Ontario, Canada.

4

Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark.

5

Department of Circulation and Medical Imaging, Norwegian University of Science and Technology.

Abstract

PURPOSE:

This pilot study aimed to evaluate the amino acid tracer F-FACBC with simultaneous PET/MRI in diagnostic assessment and neurosurgery of gliomas.

MATERIALS AND METHODS:

Eleven patients with suspected primary or recurrent low- or high-grade glioma received an F-FACBC PET/MRI examination before surgery. PET and MRI were used for diagnostic assessment, and for guiding tumor resection and histopathological tissue sampling. PET uptake, tumor-to-background ratios (TBRs), time-activity curves, as well as PET and MRI tumor volumes were evaluated. The sensitivities of lesion detection and to detect glioma tissue were calculated for PET, MRI, and combined PET/MRI with histopathology (biopsies for final diagnosis and additional image-localized biopsies) as reference.

RESULTS:

Overall sensitivity for lesion detection was 54.5% (95% confidence interval [CI], 23.4-83.3) for PET, 45.5% (95% CI, 16.7-76.6) for contrast-enhanced MRI (MRICE), and 100% (95% CI, 71.5-100.0) for combined PET/MRI, with a significant difference between MRICE and combined PET/MRI (P = 0.031). TBRs increased with tumor grade (P = 0.004) and were stable from 10 minutes post injection. PET tumor volumes enclosed most of the MRICE volumes (>98%) and were generally larger (1.5-2.8 times) than the MRICE volumes. Based on image-localized biopsies, combined PET/MRI demonstrated higher concurrence with malignant findings at histopathology (89.5%) than MRICE (26.3%).

CONCLUSIONS:

Low- versus high-grade glioma differentiation may be possible with F-FACBC using TBR. F-FACBC PET/MRI outperformed MRICE in lesion detection and in detection of glioma tissue. More research is required to evaluate F-FACBC properties, especially in grade II and III tumors, and for different subtypes of gliomas.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

PMID:

 

31107743

 

DOI:

 

10.1097/RLU.0000000000002610

Similar articles