Metabolic Mapping of Gliomas Using Hybrid MR-PET Imaging

• DOI: 10.1097/rli.0b013e31827188d6
• Publication Date: 2013-01-05T09:57:33Z
• Authors: Sotirios Bisdas; Rainer Ritz; Benjamin Bender; Christian Braun; Christina Pfannen...; Matthias Reimold; Thomas Naegele; Ulrike Ernemann
• Keywords: Grading (engineering); Choline; Creatine

The most powerful adjunct to histopathology for the grading of gliomas seems be metabolic imaging using positron emission tomography and magnetic resonance spectroscopy (MRS). purposes this study were examine feasibility simultaneous acquisition both techniques tumor in a newly launched hybrid (MR-PET) spatial distributions changes gliomas.Twenty-eight consecutive patients with underwent methionine (Met) MR-PET detection malignant part before surgical sampling. After coregistration fusion MRS data, normal brain (T/N) Met uptake ratios corresponding metabolites peaks (choline [Cho], creatine [Cr], N-acetylaspartate [NAA]) recorded. divided into 4 types on basis relation between area increased metabolite ratios: type I, had at least 50% overlap or was completely within Cho/NAA ratio; II, site less than ratio site; III, region no relationship "hot" lesions maps; IV, there pathologically uptake. sampling performed highest and, absence accumulation, ratio. All samples referred neuropathology division histological grading.A total 16 low-grade (World Health Organization grade II) 12 high-grade III) included. Three (10%) I identified. Four (14%) classified as II 6 (21%) 3, where hot maps. In 15 28 (54%), accumulation (type lesions). Maps Cr/NAA showed close patients. Median T/N pooled surgically sampled sites 1.6 (range, 1-3), median Cho/Cr 2.1 0.9-5.8) 1.5 0.5-8.3), respectively. Spearman rank correlations markers significant (ρ = 0.59; P 0.015) well 0.79; 0.0002). normalized significantly higher anaplastic tumors compared (P 0.001). A tendency positive correlation found tumors.Metabolic mapping is feasible imaging. High reflecting high expression amino-acid membrane transporters, which indicative proliferating cell populations, does not always spatially correlate neuronal loss proliferation (Cho/NAA) seen MRS. Increased associated gliomas, whereas tends indicates possible coupling these indices tumors. Thus, distribution differences should taken account when planning