18F-fluoromisonidazole positron emission tomography can predict pathological necrosis of brain tumors

Toyonaga Takuya; Hirata Kenji; Yamaguchi Shigeru; Hatanaka Kanako C.; Yuzawa Sayaka; Manabe Osamu; Kobayashi Kentaro; Watanabe Shiro; Shiga Tohru; Terasaka Shunsuke; Kobayashi Hiroyuki; Kuge Yuji; Tamaki Nagara

タイトル	en 18F-fluoromisonidazole positron emission tomography can predict pathological necrosis of brain tumors
作成者	en Toyonaga, Takuya en Hirata, Kenji NRID 1000030431365 en Yamaguchi, Shigeru en Hatanaka, Kanako C. en Yuzawa, Sayaka en Manabe, Osamu NRID 1000040443957 en Kobayashi, Kentaro en Watanabe, Shiro en Shiga, Tohru NRID 1000080374495 en Terasaka, Shunsuke NRID 1000010447055 en Kobayashi, Hiroyuki en Kuge, Yuji NRID 1000070321958 en Tamaki, Nagara NRID 1000030171888
アクセス権	open access
権利情報	en The final publication is available at link.springer.com
主題	Other en Necrosis Other en FMISO PET Other en Hypoxia Other en Brain tumor Other en Biopsy Other en Histology NDC 490
内容注記	Abstract en Purpose: Tumour necrosis is one of the indicators of tumour aggressiveness. 18F-fluoromisonidazole (FMISO) is the most widely used positron emission tomography (PET) tracer to evaluate severe hypoxia in vivo. Because severe hypoxia causes necrosis, we hypothesized that intratumoural necrosis can be detected by FMISO PET in brain tumours regardless of their histopathology. We applied FMISO PET to various types of brain tumours before tumour resection and evaluated the correlation between histopathological necrosis and FMISO uptake. Methods: This study included 59 brain tumour patients who underwent FMISO PET/computed tomography before any treatments. According to the pathological diagnosis, the brain tumours were divided into three groups: astrocytomas (group 1), neuroepithelial tumours except for astrocytomas (group 2), and others (group 3). Two experienced neuropathologists evaluated the presence of necrosis in consensus. FMISO uptake in the tumour was evaluated visually and semi-quantitatively using the tumour-to-normal cerebellum ratio (TNR). Results: In visual analyses, 26/27 cases in the FMISO-positive group presented with necrosis, whereas 28/32 cases in the FMISO-negative group did not show necrosis. Mean TNRs with and without necrosis were 3.49 ± 0.97 and 1.43 ± 0.42 (p < 0.00001) in group 1, 2.91 ± 0.83 and 1.44 ± 0.20 (p < 0.005) in group 2, and 2.63 ± 1.16 and 1.35 ± 0.23 (p < 0.05) in group 3, respectively. Using a cut-off value of TNR=1.67, which was calculated by normal reference regions of interest, we could predict necrosis with sensitivity, specificity, and accuracy of 96.7%, 93.1%, and 94.9%, respectively. Conclusions: FMISO uptake within the lesion indicated the presence of histological micro-necrosis. When we used a TNR of 1.67 as the cut-off value, intratumoural micro-necrosis was sufficiently predictable. Because the presence of necrosis implies a poor prognosis, our results suggest that FMISO PET could provide important information for treatment decisions or surgical strategies of any type of brain tumour.
出版者	en Springer
日付	Issued2016-07
言語	eng
資源タイプ	journal article
出版タイプ	AM
資源識別子	HDL http://hdl.handle.net/2115/66417
関連	isVersionOf DOI https://doi.org/10.1007/s00259-016-3320-x PMID 26841941
収録誌情報	PISSN 1619-7070 en European Journal of Nuclear Medicine and Molecular Imaging 巻43 号8 開始ページ1469 終了ページ1476
ファイル	fulltext EurJNuclMedMolImaging43_1469.pdf 2.0 MB (application/pdf) Issued2016-07
コンテンツ更新日時	2023-07-26