Back

Title
  • en 18F-fluoromisonidazole positron emission tomography can predict pathological necrosis of brain tumors
Creator
Accessrights open access
Rights
  • en The final publication is available at link.springer.com
Subject
  • Other en Necrosis
  • Other en FMISO PET
  • Other en Hypoxia
  • Other en Brain tumor
  • Other en Biopsy
  • Other en Histology
  • NDC 490
Description
  • 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.
Publisher en Springer
Date
    Issued2016-07
Language
  • eng
Resource Type journal article
Version Type AM
Identifier HDL http://hdl.handle.net/2115/66417
Relation
  • isVersionOf DOI https://doi.org/10.1007/s00259-016-3320-x
  • PMID 26841941
Journal
    • PISSN 1619-7070
      • en European Journal of Nuclear Medicine and Molecular Imaging
      • Volume Number43 Issue Number8 Page Start1469 Page End1476
File
Oaidate 2023-07-26