异机融合^(11)C蛋氨酸PET/MRI在原发性、残留/复发性脑胶质瘤诊断中的应用  

Diagnostic value of hybrid^(11)C-methionine PET/MRI for patients with primary or residual/recurrent gliomas

作　　者：姜双士 刘烜利 冯洪燕 王科 周莹 马晓伟 韩芳[2] 卜丽红 Jiang Shuangshi;Liu Xuanli;Feng Hongyan;Wang Ke;Zhou Ying;Ma Xiaowei;Han Fang;Bu Lihong(Department of PET Center,Renmin Hospital of Wuhan University,Wuhan 430061,China;Department of PET/CT Medical Center,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China;PET Image Center,the Second Xiangya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]武汉大学人民医院PET中心,武汉430061 [2]大连大学附属中山医院PET/CT医学中心,大连116001 [3]中南大学湘雅二医院PETCT中心,长沙410011

出　　处：《中华解剖与临床杂志》2023年第10期631-639,共9页Chinese Journal of Anatomy and Clinics

基　　金：国家自然科学基金(81871419);辽宁省科技计划(2022JH2/101300021)。

摘　　要：目的探讨异机融合^(11)C蛋氨酸正电子发射断层显像(^(11)C-MET PET)/MRI对疑似原发性、残留/复发性脑胶质瘤患者的诊断价值。方法回顾性分析。纳入2019年6月—2022年12月于武汉大学人民医院PET中心行异机融合^(11)CMET PET/MRI的65例疑似原发性或残留/复发性脑胶质瘤的患者资料,其中男36例、女29例,年龄13~71(40.6±15.2)岁。疑似原发性脑胶质瘤的初诊患者41例纳入初诊组,脑胶质瘤手术/放射治疗后疑似肿瘤残留/复发患者24例纳入复诊组。初诊组于治疗前、复诊组于治疗结束1个月后,接受^(11)CMET PET/CT与MR扫描,两种检查均于同日内完成,并进行PET/CT与MRI的异机融合。评估PET与MRI各序列及PET/MRI融合图像特征,于AW 4.6后处理工作站测量并计算病灶的标准化最大摄取值(SUVmax)、靶与非靶比值(T/N)、肿瘤代谢体积(MTV)等PET半定量参数,以及脑血流量(CBF)、表观弥散系数(ADC)与胆碱/N乙酰基天门冬氨酸比值(Cho/NAA)等MRI半定量参数。以患者的病理组织学诊断或经长期临床或影像学随访所获的临床最终诊断为金标准,评估并比较异机融合^(11)CMET PET/MRI、^(11)CMET PET/CT或MRI诊断原发性脑胶质瘤和术后残留/复发性胶质瘤的灵敏度、特异度和准确度。对比分析初诊组内良性与恶性病变患者间、恶性病变不同病理类型的患者间,以及复诊组内肿瘤残留/复发与治疗后改变患者间MR图像特征、PET和MRI半定量参数。结果(1)初诊组:^(11)CMET PET/MRI对原发性胶质瘤诊断的灵敏度(91.7%)高于MRI(66.7%),特异度(94.1%)高于^(11)CMET PET/CT(64.7%),准确度(92.7%)高于^(11)CMET PET/CT(75.6%)与MRI(73.2%)。7例良性病变患者与34例恶性病变患者间,瘤周水肿、强化特征与占位效应分级等MR图像特征比较,SUVmax、T/N、CBF、Cho/NAA等半定量参数比较,差异均有统计学意义(P值均<0.05);不同病理类型的恶性病变患者间瘤周水肿、占位效应与强化�Objective This study aims to investigate the diagnostic value of hybrid^(11)C-methionine positron emission tomography/magnetic resonance imaging(^(11)C-MET PET/MRI)in patients with suspected primary and residual/recurrent gliomas.Methods A retrospective analysis was conducted.Data were obtained from 65 patients with suspected primary or residual/recurrent glioma who underwent hybrid^(11)C-MET PET/MRI at the People's Hospital of Wuhan University from June 2019 to December 2022.The patients included 36 males and 29 females,aged 13-71(40.6±15.2)years.Forty-one patients with suspected primary glioma were included in the primary group,and 24 patients with suspected tumor residual/recurrence after surgery/radiation for glioma were included in the follow-up group.The initial group underwent^(11)C-MET PET/CT and MRI scans before treatment and the follow-up group 1 month after the end of treatment.Both examinations were completed within the same day,and the cross-modality fusion of PET/CT and MRI was performed.PET and MRI sequences and PET/MRI fusion image features were evaluated.Semi-quantitative PET parameters such as standardized maximum uptake value(SUVmax),target to non-target ratio(T/N),and tumor metabolic volume(MTV)as well as semi-quantitative MRI parameters such as cerebral blood flow(CBF),apparent diffusion coefficient(ADC),and choline/N-acetyl aspartate ratio(Cho/NAA)were analyzed.The sensitivity,specificity,and accuracy of Hybrid^(11)C-MET PET/MRI,^(11)C-MET PET/CT,or MRI in the diagnosis of primary gliomas and postoperative residual/recurrent tumors were assessed using the patient's pathological histological diagnosis or the final clinical diagnosis obtained after long-term clinical or imaging follow-up as the gold standard.The image characteristics of MRI,PET,and MRI semi-quantitative parameters were compared between patients with benign and malignant lesions within the primary group,between patients with different pathological types of malignant lesions,and between patients with residual/recurrent tumor an

关 键 词：神经胶质瘤 ^(11)C甲硫氨酸 正电子发射断层显像/磁共振成像 正电子发射断层显像/X线计算机体层成像 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]