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Voxel-wise analysis of dynamic

Lena Vomacka1, Marcus Unterrainer1,2, Adrien Holzgreve1,3

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Summary
This summary is machine-generated.

Voxel-based analysis of dynamic 18F-FET PET provides enhanced characterization of gliomas. This method can rapidly identify aggressive sub-volumes within the biological tumor volume, aiding in personalized therapy.

Keywords:
FET PETGliomaHistogram analysisIDH mutation

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Area of Science:

  • Neuro-oncology
  • Nuclear Medicine
  • Radiomics

Background:

  • Standard glioma grading using dynamic 18F-FET PET relies on average tumor curves, potentially missing heterogeneous aggressive areas.
  • This study introduces a voxel-based approach for more detailed glioma characterization.

Purpose of the Study:

  • To develop and evaluate a reader-independent method for glioma characterization using voxel-wise kinetic and static 18F-FET PET parameters.
  • To identify aggressive sub-volumes within the biological tumor volume (BTV).

Main Methods:

  • 162 newly diagnosed glioma patients were analyzed using dynamic 18F-FET PET (0-40 min p.i.).
  • Voxel-based analysis of time-to-peak (TTP), late slope (Slope15-40), and tumor-to-background ratios (TBR5-15, TBR20-40) within the BTV.
  • Evaluation of percentage volume fractions (PVFs) and cumulative percentage volume histograms (PVHs) to differentiate glioma grades and molecular subtypes.

Main Results:

  • Aggressive gliomas (WHO grades III/IV, IDH-wildtype) showed a high proportion of voxels with early TTP, negative Slope15-40, and high TBR.
  • Voxel-based PVHs demonstrated significant differences between glioma grades and IDH mutation status, often with higher effect sizes than VOI-based parameters.
  • Low overlap was observed between sub-volumes defined by TTP/Slope15-40 and TBR thresholds.

Conclusions:

  • Voxel-wise analysis of dynamic 18F-FET PET enhances glioma characterization and can rapidly identify aggressive sub-volumes.
  • Parametric 3D 18F-FET PET data holds potential for guiding individual therapy and future biopsy studies.