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Open Access 01-09-2013 | Clinical Study

Perfusion and diffusion MRI combined with ¹¹C-methionine PET in the preoperative evaluation of suspected adult low-grade gliomas

Authors: Shala Ghaderi Berntsson, Anna Falk, Irina Savitcheva, Andrea Godau, Maria Zetterling, Göran Hesselager, Irina Alafuzoff, Elna-Marie Larsson, Anja Smits

Published in: Journal of Neuro-Oncology | Issue 2/2013

Abstract

Perfusion and diffusion magnetic resonance imaging (pMRI, dMRI) are valuable diagnostic tools for assessing brain tumors in the clinical setting. The aim of this study was to determine the correlation of pMRI and dMRI with ¹¹C-methionine positron emission tomography (MET PET) in suspected low-grade gliomas (LGG) prior to surgery. Twenty-four adults with suspected LGG were enrolled in an observational study and examined by MET PET, pMRI and dMRI. Histological tumor diagnosis was confirmed in 23/24 patients (18 gliomas grade II, 5 gliomas grade III). The maximum relative cerebral blood volume (rCBV_max) and the minimum mean diffusivity (MD_min) were measured in tumor areas with highest MET uptake (hotspot) on PET by using automated co-registration of MRI and PET scans. A clearly defined hotspot on PET was present in all 23 tumors. Regions with rCBV_max corresponded with hotspot regions in all tumors, regions with MD_min corresponded with hotspot regions in 20/23 tumors. The correlation between rCBV_max (r = 0.19, P = 0.38) and MD_min (r = −0.41, P = 0.053) with MET uptake in the hotspot was not statistically significant. Taken into account the difficulties of measuring perfusion abnormalities in non-enhancing gliomas, this study demonstrates that co-registered MET PET and pMRI facilitates the identification of regions with rCBV_max. Furthermore, the lack of a clear positive correlation between tumor metabolism in terms of MET uptake and tumor vascularity measured as rCBV_max suggests that combined pMRI/PET provides complementary baseline imaging data in these tumors.

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Title: Perfusion and diffusion MRI combined with 11C-methionine PET in the preoperative evaluation of suspected adult low-grade gliomas
Authors: Shala Ghaderi Berntsson
Anna Falk
Irina Savitcheva
Andrea Godau
Maria Zetterling
Göran Hesselager
Irina Alafuzoff
Elna-Marie Larsson
Anja Smits
Publication date: 01-09-2013
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 2/2013
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-013-1178-3

At a glance: The STEP trials

Springer Medicine

Perfusion and diffusion MRI combined with ¹¹C-methionine PET in the preoperative evaluation of suspected adult low-grade gliomas

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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