一体化18F-FET PET/MR术前评估成人胶质瘤患者MGMT基因启动子甲基化状态OA北大核心CSTPCD
Preoperative assessment of MGMT gene promoter methylation status in adult high-grade glioma patients by integrated 18F-FET PET/MR
目的 旨在研究一体化18F-氟乙基酪氨酸(18F-fluoroethyltyrosine,18F-FET)正电子发射断层成像(positron emission tomography,PET)/MR对成人胶质瘤的O6-甲基鸟嘌呤DNA甲基转移酶(O6-methylguanine DNA methyltransferase,MGMT)基因启动子甲基化状态的鉴别能力.材料与方法 回顾性分析未经活检或治疗的胶质瘤患者资料16例,均完成一体化PET/MR扫描,包括18F-FET PET、常规MRI及体素内不相干运动(intravoxel incoherent motion,IVIM)成像.以靶本比(target-background ratio,TBR)=1.6为阈值对PET图像进行感兴趣体积(volume of interest,VOI)分割,通过刚性配准获得肿瘤VOI对应的IVIM图及其参数表观扩散系数(apparent diffusion coefficient,ADC)、真实扩散系数(true diffusion coefficient,D)、伪扩散系数(pseudo diffusion coefficient,D)、灌注分数(perfusion fraction,f)、分布扩散系数(distributed diffusion coefficient,DDC)和异质性指数(heterogeneity index,α),使用pyradiomics对各参数进行特征提取,获得对应的一阶灰度直方图特征.计算每个IVIM参数图对应的特征值与18F-FET PET参数的关系,并利用组间比较和受试者工作特征(receive operating characteristic,ROC)曲线分析探究PET和IVIM参数对MGMT启动子甲基化的区分能力.结果 IVIM-α的两个特征值90分位值(r=0.526,P<0.05)和最大值(r=0.520,P<0.05)与PET参数平均标准摄取值(mean standard uptake value,SUVmean)呈正相关;IVIM-α 和SUVmean在MGMT启动子甲基化状态阳性和阴性两组之间的差异有统计学意义(P<0.05),阳性组的IVIM-α均值和SUVmean显著高于阴性组;融合IVIM-α均值和SUVmean对MGMT启动子甲基化状态进行区分的曲线下面积(area under the curve,AUC)为0.77.结论 基于一体化PET/MR的18F-FET PET和IVIM参数能够有效预测胶质瘤的MGMT启动子甲基化状态.
Objective:To investigate the discriminative ability of integrated 18F-fluoroethyltyrosine (18F-FET) positron emission tomography (PET)/MR for O6-methylguanine DNA methyltransferase (MGMT) gene promoter methylation status in adult gliomas. Materials and Methods:A total of 16 patients with unbiopsied or untreated gliomas were retrospectively enrolled to complete integrated PET/MR scans,including 18F-FET PET,conventional MRI and intravoxel incoherent motion (IVIM) imaging. The volume of interest (VOI) segmentation of PET images was performed using target-background ratio (TBR)=1.6 as a threshold,and IVIM maps corresponding to tumor VOI and their parameters,apparent diffusion coefficient (ADC),true diffusion coefficient (D),pseudo diffusion coefficient (D ),perfusion fraction (f),distributed diffusion coefficient (DDC),and heterogeneity index (α),were obtained by rigid alignment,and the corresponding first-order gray-scale histogram features were obtained by feature extraction of each parameter using pyradiomics. The eigenvalues corresponding to each IVIM parameter map were calculated in relation to the 18F-FET PET parameters,and the ability of PET and IVIM parameters to discriminate MGMT promoter methylation was explored using between-group comparisons and receiver operating characteristic (ROC) curve analysis. Results:The two eigenvalues 90th percentile (r=0.526,P<0.05) and maximum (r=0.520,P<0.05) of IVIM-α were positively correlated with mean standard uptake value (SUVmean) of PET parameter;The differences between IVIM-α and SUVmean in the two groups of positive and negative MGMT promoter methylation status were statistically significant (P<0.05),and the positive group had significantly higher mean IVIM-α and SUVmean than the negative group. The area under the curve (AUC) of discrimination of the methylation status of the MGMT promoter by incorporating the mean IVIM-α value and SUVmean was 0.77. Conclusions:18F-FET PET and IVIM parameters based on integrated PET/MR can effectively predict MGMT promoter methylation status in gliomas.
韩青青;霍力;李拓;林增萍;李恩慧;杨阳;刘家惠;邢浩;王裕;程欣
中国医学科学院北京协和医学院北京协和医院核医学科,北京 100730中国医学科学院北京协和医学院北京协和医院核医学科,北京 100730||核医学分子靶向诊疗北京市重点实验室,北京 100730上海联影医疗高新技术研究院有限公司,上海 201807北京联影智能影像技术研究院,北京 100094中国医学科学院北京协和医学院北京协和医院神经外科,北京 100730
临床医学
胶质瘤O6-甲基鸟嘌呤-DNA甲基转移酶启动子甲基化18F-氟乙基酪氨酸正电子发射断层成像正电子发射断层成像/磁共振体素内不相干运动磁共振成像
gliomaO6-methylguanine DNA methyltransferase gene18F-Fluoroethyltyrosine positron emission tomography (18F-FET PET)positron emission tomography/magnetic resonance (PET/MR)intravoxel incoherent motionmagnetic resonance imaging
《磁共振成像》 2024 (007)
21-26 / 6
北京协和医院中央高水平医院临床科研专项(编号:2022-PUMCH-A-019)Peking Union Medical College Hospital Centralized High-level Hospital Clinical Research Special Project(No.2022-PUMCH-A-019).
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