7 research outputs found
The Sum of Tumour-to-Brain Ratios Improves the Accuracy of Diagnosing Gliomas Using 18F-FET PET.
Gliomas are common brain tumours, but obtaining tissue for definitive diagnosis can be difficult. There is, therefore, interest in the use of non-invasive methods to diagnose and grade the disease. Although positron emission tomography (PET) with 18F-fluorethyltyrosine (18F-FET) can be used to differentiate between low-grade (LGG) and high-grade (HGG) gliomas, the optimal parameters to measure and their cut-points have yet to be established. We therefore assessed the value of single and dual time-point acquisition of 18F-FET PET parameters to differentiate between primary LGGs (n = 22) and HGGs (n = 24). PET examination was considered positive for glioma if the metabolic activity was 1.6-times higher than that of background (contralateral) brain, and maximum tissue-brain ratios (TBRmax) were calculated 10 and 60 min after isotope administration with their sums and differences calculated from individual time-point values. Using a threshold-based method, the overall sensitivity of PET was 97%. Several analysed parameters were significantly different between LGGs and HGGs. However, in a receiver operating characteristics analysis, TBR sum had the best diagnostic accuracy of 87% and sensitivity, specificity, and positive and negative predictive values of 100%, 72.7%, 80%, and 100%, respectively. 18F-FET PET is valuable for the non-invasive determination of glioma grade, especially when dual time-point metrics are used. TBR sum shows the greatest accuracy, sensitivity, and negative predictive value for tumour grade differentiation and is a simple method to implement. However, the cut-off may differ between institutions and calibration strategies would be useful
Values of single and dual time-point PET parameters for high-grade and low-grade gliomas.
<p>Values of single and dual time-point PET parameters for high-grade and low-grade gliomas.</p
Parameter values as predictive factors for high-grade glioma.
<p>Parameter values as predictive factors for high-grade glioma.</p
Studies estimating TBR<sub>max</sub> values in gliomas.
<p>Studies estimating TBR<sub>max</sub> values in gliomas.</p
SUV kinetics for high (left graph) and low (right graph) grade gliomas.
<p>SUV kinetics for high (left graph) and low (right graph) grade gliomas.</p
ROC curve for the combined parameter TBR10 + TBR difference; Threshold = 1.602.
<p>ROC curve for the combined parameter TBR10 + TBR difference; Threshold = 1.602.</p