Multiparametric Evaluation in Differentiating Glioma Recurrence from Treatment-Induced Necrosis Using Simultaneous...

Area of Science:

• Neuroimaging
• Oncology
• Radiology

Background:

• Differentiating glioma recurrence from treatment-induced necrosis is difficult with conventional imaging.
• Functional MR imaging and PET parameters offer potential for improved diagnostic accuracy.

Purpose of the Study:

• To assess the diagnostic performance of individual and combined functional MR imaging and PET parameters using simultaneous FDG-PET/MR imaging.
• To evaluate the utility of these parameters in detecting suspected glioma recurrence.

Main Methods:

• Thirty-five treated glioma patients with 41 enhancing lesions underwent simultaneous FDG-PET/MR imaging.
• Calculated parameters included relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC), choline to creatine ratio (Cho/Cr), and target-to-background ratios (TBR).
• Receiver operating characteristic (ROC) analysis was used to determine diagnostic performance individually and in combination.

Main Results:

• Individual parameters showed significant detection capabilities for recurrent lesions.
• The combination of MR imaging parameters (ADCmean and Cho/Cr) with a PET parameter (mean TBR) achieved the highest diagnostic accuracy with an area under the curve of 0.935 ± 0.046.
• Multivariate analysis combining all MR imaging parameters yielded an area under the curve of 0.913 ± 0.053.

Conclusions:

• Simultaneous FDG-PET/MR imaging enables a multiparametric assessment of glioma recurrence.
• This approach offers synergistic benefits, increasing diagnostic accuracy and clinical utility for suspected glioma recurrence.