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Biopsy Targeting Gliomas Do Functional Imaging Techniques Identify Similar Target Areas?

机译：靶向胶质瘤的活组织检查功能成像技术是否可识别相似的目标区域？

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Objective: Because of the heterogeneous nature of glioma, biopsies performed should be targeted at the most anaplastic region. Several functional magnetic resonance imaging (MRI) or positron emission tomography (PET) techniques have been proposed for identifying the most anaplastic tumor area. However, it is unclear whether the recommended biopsy targets based on these various functional imaging modalities correspond with each other. Thus, the purpose was to evaluate whether they identify similar target areas. Materials and Methods: A total of 61 patients with suspected glioma were assessed within 2.3 +- 3.5 days by MRI, ~18F-fluorothymidine-, and ~18F-fluorodeoxyglucose-PET. Thirty-five patients underwent gross total resection and 26 were stereotactically biopsied. MRI was performed on a 1.5 Tesla broadband transmit/receive system, using a double-resonant birdcage coil. The MRI protocol comprised of sodium (~23Na)-MRI (3D-radial projection imaging), proton spectroscopic imaging (~1H-MRSI, point-resolved spectros-copy), arterial spin-labeling (ASL) perfusion MRI, dynamic contrast-enhanced (DCE) MRI, and dynamic-susceptibility-weighted (DSC) perfusion MRI after a single dose each of gadobenate dimeglumine. Also, apparent diffusion coefficient (ADC) maps were processed from diffusion tensor images. Image analysis comprised a detailed semiquantitative region of interest analysis of the different parameter values as well as visual identification of the most conspicuous tumor areas on parameter maps, for example, areas with maximum tumor perfusion, highest metabolite ratios of choline-containing compounds/iV-acetyl-aspartate, or lowest ADC values within tumor tissue. Colocalization of these areas was then assessed. Results: Regarding tumor vascularity-related parameters and tumor proliferation-related parameters, the higher the glioma grade the higher were the respective parameters in semiquantitative analysis. ADC values decreased with glioma grade. In the whole stud...
机译：目的：由于神经胶质瘤的异质性，活检应针对变性最高的区域。已经提出了几种功能磁共振成像（MRI）或正电子发射断层扫描（PET）技术来识别最变性的肿瘤区域。然而，尚不清楚基于这些各种功能成像方式的推荐活检目标是否彼此对应。因此，目的是评估它们是否确定相似的目标区域。材料和方法：MRI，〜18F-氟胸苷-和〜18F-氟脱氧葡萄糖-PET在2.3±3.5天内对61例疑似神经胶质瘤患者进行了评估。 35例患者行大体全切除术，其中26例接受了立体定位活检。使用双共振鸟笼线圈在1.5 Tesla宽带发射/接收系统上执行MRI。 MRI协议包括钠（〜23Na）-MRI（3D径向投影成像），质子光谱成像（〜1H-MRSI，点分辨光谱），动脉自旋标记（ASL）灌注MRI，动态对比-单一剂量的gadobenate dimeglumine增强（DCE）MRI和动态磁化加权（DSC）灌注MRI。此外，根据扩散张量图像处理了视在扩散系数（ADC）图。图像分析包括对不同参数值的详细半定量目标区域分析，以及在参数图上视觉识别最明显的肿瘤区域，例如，肿瘤灌注最大，胆碱含量最高的代谢物比率/ iV-肿瘤组织中的乙酰天冬氨酸或最低ADC值。然后评估这些区域的共定位。结果：关于肿瘤血管相关参数和肿瘤增殖相关参数，神经胶质瘤等级越高，半定量分析的各个参数越高。 ADC值随神经胶质瘤等级降低。整个过程中...

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