Direct Comparison of Perfusion Magnetic Resonance Imaging with [11C]Methionine PET in Differentiating Brain Tumor Recurrence From Radiation-Induced Brain Injury after Combined Treatment
Abstract
The aim of the study was to compare T2*-weighted MR-perfusion (pMRI) and positron emission tomography using [11C]methionine (PET-Met) in differentiating recurrent brain tumor (RT) from posttreatment radiation effect (PTRE). Material and methods. PET-Met and pMRIwere performed in 45 patients with previously treated brain tumor A total 57 lesions were analyzed. The rCBV index and [11C] methionine uptake index (UI-Met) were calculated as the ratios of the highest lesion value to the that in the reference region. The diagnostic accuracy of UI-Met and rCBV for correct identification of recurrent tumor (RT) versus PTRE was evaluated by ROC-analysis using subsequent histologic analysis or clinical and radiological follow-up. Results. According to the final diagnosis patientsexhibitedthetwo typesofabnormalities: recurrent tumor (n = 33) and non-progressive lesions (n = 24). The inter-individual agreement between the both techniques was observed in 93% of cases. In 4 patients results were discordant. High [11C]methionine uptake and low rCBV were detected in 2 cases of radiation necrosis. In 2 patients PET-Met was able to distinguish foci of radionecrosis and the viable tumor tissue. Conclusion. T2*-weighted MR-perfusion and PET-Met could be efficiently used for differentiation RT from PTRE. Inter-individual comparison of the both methods showed that PET-Met was more sensitive in imaging recurrent tumor, but perfusion MRI had higher specificity.
About the Authors
Zhanna Igorevna Savintseva
N.P. Bechtereva Institute of the Human Brain of Russian academy of sciences
Russian Federation
Russian Federation
Tatiana Nikolaevna Trofimova
N.P. Bechtereva Institute of the Human Brain of Russian academy of sciences
Russian Federation
Russian Federation
Tatiana Yurievna Skvortsova
N.P. Bechtereva Institute of the Human Brain of Russian academy of sciences
Russian Federation
Russian Federation
Zorya L’vovna Brodskaya
N.P. Bechtereva Institute of the Human Brain of Russian academy of sciences
Russian Federation
Russian Federation
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Review
For citations:
Savintseva Zh.I., Trofimova T.N., Skvortsova T.Yu., Brodskaya Z.L. Direct Comparison of Perfusion Magnetic Resonance Imaging with [11C]Methionine PET in Differentiating Brain Tumor Recurrence From Radiation-Induced Brain Injury after Combined Treatment. Medical Visualization. 2014;(5):10-19. (In Russ.)
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