Dataset Information

Improved detection of diffuse glioma infiltration with imaging combinations: a diagnostic accuracy study.

ABSTRACT:

Background

Surgical resection and irradiation of diffuse glioma are guided by standard MRI: T2/fluid attenuated inversion recovery (FLAIR)-weighted MRI for non-enhancing and T1-weighted gadolinium-enhanced (T1G) MRI for enhancing gliomas. Amino acid PET has been suggested as the new standard. Imaging combinations may improve standard MRI and amino acid PET. The aim of the study was to determine the accuracy of imaging combinations to detect glioma infiltration.

Methods

We included 20 consecutive adults with newly diagnosed non-enhancing glioma (7 diffuse astrocytomas, isocitrate dehydrogenase [IDH] mutant; 1 oligodendroglioma, IDH mutant and 1p/19q codeleted; 1 glioblastoma IDH wildtype) or enhancing glioma (glioblastoma, 9 IDH wildtype and 2 IDH mutant). Standardized preoperative imaging (T1-, T2-, FLAIR-weighted, and T1G MRI, perfusion and diffusion MRI, MR spectroscopy and O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET) PET) was co-localized with multiregion stereotactic biopsies preceding resection. Tumor presence in the biopsies was assessed by 2 neuropathologists. Diagnostic accuracy was determined using receiver operating characteristic analysis.

Results

A total of 174 biopsies were obtained (63 from 9 non-enhancing and 111 from 11 enhancing gliomas), of which 129 contained tumor (50 from non-enhancing and 79 from enhancing gliomas). In enhancing gliomas, the combination of apparent diffusion coefficient (ADC) with [18F]FET PET (area under the curve [AUC], 95% CI: 0.89, 0.79?0.99) detected tumor better than T1G MRI (0.56, 0.39?0.72; P < 0.001) and [18F]FET PET (0.76, 0.66?0.86; P = 0.001). In non-enhancing gliomas, no imaging combination detected tumor significantly better than standard MRI. FLAIR-weighted MRI had an AUC of 0.81 (0.65-0.98) compared with 0.69 (0.56-0.81; P = 0.019) for [18F]FET PET.

Conclusion

Combining ADC and [18F]FET PET detects glioma infiltration better than standard MRI and [18F]FET PET in enhancing gliomas, potentially enabling better guidance of local therapy.

SUBMITTER: Verburg N

PROVIDER: S-EPMC7058442 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Improved detection of diffuse glioma infiltration with imaging combinations: a diagnostic accuracy study.

Verburg Niels N Koopman Thomas T Yaqub Maqsood M MM Hoekstra Otto S OS Lammertsma Adriaan A AA Barkhof Frederik F Pouwels Petra J W PJW Reijneveld Jaap C JC Heimans Jan J JJ Rozemuller Annemarie J M AJM Bruynzeel Anne M E AME Lagerwaard Frank F Vandertop William P WP Boellaard Ronald R Wesseling Pieter P de Witt Hamer Philip C PC

Neuro-oncology 20200301 3

<h4>Background</h4>Surgical resection and irradiation of diffuse glioma are guided by standard MRI: T2/fluid attenuated inversion recovery (FLAIR)-weighted MRI for non-enhancing and T1-weighted gadolinium-enhanced (T1G) MRI for enhancing gliomas. Amino acid PET has been suggested as the new standard. Imaging combinations may improve standard MRI and amino acid PET. The aim of the study was to determine the accuracy of imaging combinations to detect glioma infiltration.<h4>Methods</h4>We included ...[more]

PMID: 31550353

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Dataset Information

Improved detection of diffuse glioma infiltration with imaging combinations: a diagnostic accuracy study.

Background

Methods

Results

Conclusion

Publications

Improved detection of diffuse glioma infiltration with imaging combinations: a diagnostic accuracy study.

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