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Combined (18)F-FET PET and diffusion kurtosis MRI in posttreatment glioblastoma: differentiation of true progression from treatment-related changes

BACKGROUND: Radiological differentiation of tumor progression (TPR) from treatment-related changes (TRC) in pretreated glioblastoma is crucial. This study aimed to explore the diagnostic value of diffusion kurtosis MRI combined with information derived from O-(2-[(18)F]-fluoroethyl)-l-tyrosine ((18)...

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Autores principales: D’Amore, Francesco, Grinberg, Farida, Mauler, Jörg, Galldiks, Norbert, Blazhenets, Ganna, Farrher, Ezequiel, Filss, Christian, Stoffels, Gabriele, Mottaghy, Felix M, Lohmann, Philipp, Shah, Nadim Jon, Langen, Karl-Josef
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117449/
https://www.ncbi.nlm.nih.gov/pubmed/34013207
http://dx.doi.org/10.1093/noajnl/vdab044
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author D’Amore, Francesco
Grinberg, Farida
Mauler, Jörg
Galldiks, Norbert
Blazhenets, Ganna
Farrher, Ezequiel
Filss, Christian
Stoffels, Gabriele
Mottaghy, Felix M
Lohmann, Philipp
Shah, Nadim Jon
Langen, Karl-Josef
author_facet D’Amore, Francesco
Grinberg, Farida
Mauler, Jörg
Galldiks, Norbert
Blazhenets, Ganna
Farrher, Ezequiel
Filss, Christian
Stoffels, Gabriele
Mottaghy, Felix M
Lohmann, Philipp
Shah, Nadim Jon
Langen, Karl-Josef
author_sort D’Amore, Francesco
collection PubMed
description BACKGROUND: Radiological differentiation of tumor progression (TPR) from treatment-related changes (TRC) in pretreated glioblastoma is crucial. This study aimed to explore the diagnostic value of diffusion kurtosis MRI combined with information derived from O-(2-[(18)F]-fluoroethyl)-l-tyrosine ((18)F-FET) PET for the differentiation of TPR from TRC in patients with pretreated glioblastoma. METHODS: Thirty-two patients with histomolecularly defined and pretreated glioblastoma suspected of having TPR were included in this retrospective study. Twenty-one patients were included in the TPR group, and 11 patients in the TRC group, as assessed by neuropathology or clinicoradiological follow-up. Three-dimensional (3D) regions of interest were generated based on increased (18)F-FET uptake using a tumor-to-brain ratio of 1.6. Furthermore, diffusion MRI kurtosis maps were obtained from the same regions of interest using co-registered (18)F-FET PET images, and advanced histogram analysis of diffusion kurtosis map parameters was applied to generated 3D regions of interest. Diagnostic accuracy was analyzed by receiver operating characteristic curve analysis and combinations of PET and MRI parameters using multivariate logistic regression. RESULTS: Parameters derived from diffusion MRI kurtosis maps show high diagnostic accuracy, up to 88%, for differentiating between TPR and TRC. Logistic regression revealed that the highest diagnostic accuracy of 94% (area under the curve, 0.97; sensitivity, 94%; specificity, 91%) was achieved by combining the maximum tumor-to-brain ratio of (18)F-FET uptake and diffusion MRI kurtosis metrics. CONCLUSIONS: The combined use of (18)F-FET PET and MRI diffusion kurtosis maps appears to be a promising approach to improve the differentiation of TPR from TRC in pretreated glioblastoma and warrants further investigation.
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spelling pubmed-81174492021-05-18 Combined (18)F-FET PET and diffusion kurtosis MRI in posttreatment glioblastoma: differentiation of true progression from treatment-related changes D’Amore, Francesco Grinberg, Farida Mauler, Jörg Galldiks, Norbert Blazhenets, Ganna Farrher, Ezequiel Filss, Christian Stoffels, Gabriele Mottaghy, Felix M Lohmann, Philipp Shah, Nadim Jon Langen, Karl-Josef Neurooncol Adv Clinical Investigations BACKGROUND: Radiological differentiation of tumor progression (TPR) from treatment-related changes (TRC) in pretreated glioblastoma is crucial. This study aimed to explore the diagnostic value of diffusion kurtosis MRI combined with information derived from O-(2-[(18)F]-fluoroethyl)-l-tyrosine ((18)F-FET) PET for the differentiation of TPR from TRC in patients with pretreated glioblastoma. METHODS: Thirty-two patients with histomolecularly defined and pretreated glioblastoma suspected of having TPR were included in this retrospective study. Twenty-one patients were included in the TPR group, and 11 patients in the TRC group, as assessed by neuropathology or clinicoradiological follow-up. Three-dimensional (3D) regions of interest were generated based on increased (18)F-FET uptake using a tumor-to-brain ratio of 1.6. Furthermore, diffusion MRI kurtosis maps were obtained from the same regions of interest using co-registered (18)F-FET PET images, and advanced histogram analysis of diffusion kurtosis map parameters was applied to generated 3D regions of interest. Diagnostic accuracy was analyzed by receiver operating characteristic curve analysis and combinations of PET and MRI parameters using multivariate logistic regression. RESULTS: Parameters derived from diffusion MRI kurtosis maps show high diagnostic accuracy, up to 88%, for differentiating between TPR and TRC. Logistic regression revealed that the highest diagnostic accuracy of 94% (area under the curve, 0.97; sensitivity, 94%; specificity, 91%) was achieved by combining the maximum tumor-to-brain ratio of (18)F-FET uptake and diffusion MRI kurtosis metrics. CONCLUSIONS: The combined use of (18)F-FET PET and MRI diffusion kurtosis maps appears to be a promising approach to improve the differentiation of TPR from TRC in pretreated glioblastoma and warrants further investigation. Oxford University Press 2021-03-10 /pmc/articles/PMC8117449/ /pubmed/34013207 http://dx.doi.org/10.1093/noajnl/vdab044 Text en © The Author(s) 2021. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigations
D’Amore, Francesco
Grinberg, Farida
Mauler, Jörg
Galldiks, Norbert
Blazhenets, Ganna
Farrher, Ezequiel
Filss, Christian
Stoffels, Gabriele
Mottaghy, Felix M
Lohmann, Philipp
Shah, Nadim Jon
Langen, Karl-Josef
Combined (18)F-FET PET and diffusion kurtosis MRI in posttreatment glioblastoma: differentiation of true progression from treatment-related changes
title Combined (18)F-FET PET and diffusion kurtosis MRI in posttreatment glioblastoma: differentiation of true progression from treatment-related changes
title_full Combined (18)F-FET PET and diffusion kurtosis MRI in posttreatment glioblastoma: differentiation of true progression from treatment-related changes
title_fullStr Combined (18)F-FET PET and diffusion kurtosis MRI in posttreatment glioblastoma: differentiation of true progression from treatment-related changes
title_full_unstemmed Combined (18)F-FET PET and diffusion kurtosis MRI in posttreatment glioblastoma: differentiation of true progression from treatment-related changes
title_short Combined (18)F-FET PET and diffusion kurtosis MRI in posttreatment glioblastoma: differentiation of true progression from treatment-related changes
title_sort combined (18)f-fet pet and diffusion kurtosis mri in posttreatment glioblastoma: differentiation of true progression from treatment-related changes
topic Clinical Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117449/
https://www.ncbi.nlm.nih.gov/pubmed/34013207
http://dx.doi.org/10.1093/noajnl/vdab044
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