Abstracts der 57. DGN-Jahrestagung 2019
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PET-MRT Vorsitz: M. Eiber, L. Stegger 8:30 - 10:00 Saal Focke-Wulf |
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V56 Comparison of [18F]-Fluoroethyltyrosine PET and the IDH status with Sodium MRI in Cerebral Gliomas A. Shymanskaya1, W. A. Worthoff1, G. Stoffels1, J. Lindemeyer1, B. Neumaier2, P. Lohmann1, N. Galldiks3, K. J. Langen1, N. J. Shah1 1Forschungszentrum Jülich GmbH, Institute of Neuroscience and Medicine - 4, Jülich, Germany; 2Forschungszentrum Jülich GmbH, Institute of Neuroscience and Medicine - 5, Jülich, Germany; 3Forschungszentrum Jülich GmbH, Institute of Neuroscience and Medicine - 3, Jülich, Germany | |
Ziel/Aim: O-(2-[18F]fluoroethyl)-L-tyrosine([18F]-FET) PET is used for the supportive diagnostics of cerebral gliomas. In this study, the relationship between the [18F]-FET-PET parameters, distribution of restricted (mainly intracellular) and unrestricted (mainly extracellular) sodium, and the mutational status of the enzyme isocitrate dehydrogenase (IDH) were investigated in patients with cerebral gliomas.Methodik/Methods: Ten patients with untreated gliomas and one patient with a recurrent glioblastoma were investigated by dynamic [18F]-FET-PET and sodium MRI using an enhanced SISTINA sequence to estimate sodium parameters in tumours. The enhanced SISTINA sequence uses single-quantum and triple-quantum-filtered imaging and allows simultaneous acquisition of signal originating from restricted and unrestricted sodium (1). IDH mutational status was determined after biopsy or resection. The untreated patients were analysed independently in two groups (5 patients each) dependent on their IDH mutational status.Ergebnisse/Results: Tumour-to-brain ratio (TBR) of weighted mainly intracellular sodium (NaR) was significantly lower in IDH mutated (p=0.01) than in IDH wildtype gliomas. Total sodium concentration in mmol/L (p=0.05), TBR of the total sodium concentration (NaT) (p=0.02), TBR of weighted unrestricted mainly extracellular sodium (NaNR) (p=0.003), and the ratio of NaT/NaR (p<0.001) were significantly higher in IDH mutated than in IDH wildtype gliomas. [18F]-FET parameters estimated from tracer dynamics curves (TBR, time-to-peak) correlated neither to the IDH status nor to the sodium distribution. The patient with a recurrent GBM exhibited an additional radiation injury with strong abnormalities in sodium MRI.Schlussfolgerungen/Conclusions: Acquired results show that sodium MRI shows stronger relation to the IDH mutational status than [18F]-FET-PET parameters in cerebral gliomas in this patient cohort. Further evaluation of the combination of the three diagnostic modalities in gliomas seems promising and requires higher patient number.Literatur/References: [1] Worthoff WA, Shymanskaya A, Shah NJ. Relaxometry and quantification in simultaneously acquired single and triple quantum filtered sodium MRI. Magn Reson Med. 2018;00:1-13. doi:10.1002/mrm.27387. |
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