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Clinical Pharmacokinetics
Published in: Clinical Pharmacokinetics 8/2017

01-08-2017 | Original Research Article

Population Pharmacokinetic Approach Applied to Positron Emission Tomography: Computed Tomography for Tumor Tissue Identification in Patients with Glioma

Authors: Peggy Gandia, Cyril Jaudet, Hendrik Everaert, Johannes Heemskerk, Anne Marie Vanbinst, Johan de Mey, Johnny Duerinck, Bart Neyns, Mark de Ridder, Etienne Chatelut, Didier Concordet

Published in: Clinical Pharmacokinetics | Issue 8/2017

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Abstract

Background and Aims

18F-fluoro-ethyl-tyrosine (FET) is a radiopharmaceutical used in positron emission tomography (PET)-computed tomography in patients with glioma. We propose an original approach combining a radiotracer-pharmacokinetic exploration performed at the voxel level (three-dimensional pixel) and voxel classification to identify tumor tissue. Our methodology was validated using the standard FET-PET approach and magnetic resonance imaging (MRI) data acquired according to the current clinical practices.

Methods

FET-PET and MRI data were retrospectively analyzed in ten patients presenting with progressive high-grade glioma. For FET-PET exploration, radioactivity acquisition started 15 min after radiotracer injection, and was measured each 5 min during 40 min. The tissue segmentation relies on population pharmacokinetic modeling with dependent individuals (voxels). This model can be approximated by a linear mixed-effects model. The tumor volumes estimated by our approach were compared with those determined with the current clinical techniques, FET-PET standard approach (i.e., a cumulated value of FET signal is computed during a time interval) and MRI sequences (T1 and T2/fluid-attenuated inversion recovery [FLAIR]), used as references. The T1 sequence is useful to identify highly vascular tumor and necrotic tissues, while the T2/FLAIR sequence is useful to isolate infiltration and edema tissue located around the tumor.

Results

With our kinetic approach, the volumes of tumor tissue were larger than the tissues identified by the standard FET-PET and MRI T1, while they were smaller than those determined with MRI T2/FLAIR.

Conclusion

Our results revealed the presence of suspected tumor voxels not identified by the standard PET approach.
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Metadata
Title
Population Pharmacokinetic Approach Applied to Positron Emission Tomography: Computed Tomography for Tumor Tissue Identification in Patients with Glioma
Authors
Peggy Gandia
Cyril Jaudet
Hendrik Everaert
Johannes Heemskerk
Anne Marie Vanbinst
Johan de Mey
Johnny Duerinck
Bart Neyns
Mark de Ridder
Etienne Chatelut
Didier Concordet
Publication date
01-08-2017
Publisher
Springer International Publishing
Published in
Clinical Pharmacokinetics / Issue 8/2017
Print ISSN: 0312-5963
Electronic ISSN: 1179-1926
DOI
https://doi.org/10.1007/s40262-016-0490-4

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