1
|
Hong Y, Fu C, Xing Y, Tao J, Zhao T, Wang N, Chen Y, You Y, Ren Z, Hong Y, Wang Q, Zhao Y, Yang Y, Zhang J, Xu J, Han X. Delayed 18F-FDG PET imaging provides better metabolic asymmetry in potential epileptogenic zone in temporal lobe epilepsy. Front Med (Lausanne) 2023; 10:1180541. [PMID: 37465642 PMCID: PMC10350642 DOI: 10.3389/fmed.2023.1180541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/14/2023] [Indexed: 07/20/2023] Open
Abstract
Objective To investigate the value of 18F-FDG positron emission tomography/computed tomography (PET/CT) two time point imaging for the identification of the potential epileptogenic zone (EZ) in temporal lobe epilepsy (TLE). Methods Fifty-two patients with TLE were prospectively enrolled in the 18F-FDG PET/CT two time point imaging study. The early imaging was obtained approximately 40 min (43.44 ± 18.04 min) after 18F-FDG injection, and the delayed imaging was obtained about 2 to 3 h (160.46 ± 28.70 min) after the injection. Visual and semi-quantitative analysis of 18F-FDG uptake were performed at the two time points in EZ and contralateral symmetrical region. The mean standardized uptake value (SUVmean) of EZ and contralateral symmetrical region was calculated to determine the asymmetry index (AI) of the early and delayed images, as well as in the MRI positive and negative patient groups. Results Semi-quantitative analysis demonstrated that AI of the early and delayed 18F-FDG PET/CT images was 13.47 ± 6.10 and 16.43 ± 6.66, respectively. The ΔAI was 2.95 ± 3.05 in 52 TLE patients between the two time points. The AI of the EZ was significantly elevated in delayed images compared to the early images (p < 0.001). The AI of delayed imaging was also significantly elevated compared to the early imaging in both MRI positive (ΔAI = 2.81 ± 2.54, p < 0.001) and MRI negative (ΔAI = 3.21 ± 3.91, p < 0.003) groups, and more pronounced in MRI negative group. Visual analysis also showed that the delayed imaging appeared to be superior to the early imaging for identification of potential EZ. Conclusion Delayed 18F-FDG PET imaging provided significantly better than the early imaging in the identification of potential EZ, which can be valuable during epilepsy pre-surgical evaluation in patients with TLE.
Collapse
Affiliation(s)
- Yang Hong
- Department of Neurology, People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Chang Fu
- Department of Nuclear Medicine, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Yazhou Xing
- Department of Neurosurgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - James Tao
- Division of Biological Sciences, University of Chicago, Chicago, IL, United States
| | - Ting Zhao
- Department of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Na Wang
- Department of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Yanan Chen
- Department of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Yang You
- Department of Nuclear Medicine, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Zhe Ren
- Department of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Yingxing Hong
- Department of Neurology, People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Qi Wang
- Department of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Yibo Zhao
- Department of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, Beijing, China
| | - Jiewen Zhang
- Department of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Junling Xu
- Department of Nuclear Medicine, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Xiong Han
- Department of Neurology, People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| |
Collapse
|
2
|
Sarlo GL, Holton KF. Brain concentrations of glutamate and GABA in human epilepsy: A review. Seizure 2021; 91:213-227. [PMID: 34233236 DOI: 10.1016/j.seizure.2021.06.028] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/27/2022] Open
Abstract
An imbalance between excitation and inhibition has been a longstanding proposed mechanism regarding ictogenesis and epileptogenesis. This imbalance is related to increased extracellular glutamate in the brain and/or reduction in GABA concentrations, leading to excitotoxicity, seizures, and cell death. This review aims to summarize the microdialysis and magnetic resonance spectroscopy (MRS) literature investigating glutamate and GABA concentrations in epilepsy patients, present limitations, and suggest future directions to help direct the search for novel epilepsy treatments. The majority of microdialysis studies demonstrated increased glutamate in epileptic regions either compared to control regions or to baseline levels; however, sample sizes were small, with some statistical comparisons missing. For the MRS research, two of six studies reported significant changes in glutamate levels compared to controls, though the results were mixed, with one reporting increased and the other reporting decreased glutamate levels. Eleven of 20 studies reported significant changes in Glx (glutamate + glutamine) or Glx ratios, with most reporting increased levels, except for a few epilepsy syndromes where reduced levels were reported. Few studies investigated GABA concentrations, with one microdialysis and four spectroscopy studies reporting increased GABA levels, and one study reporting decreased GABA in a different brain region. Based on this review, future research should account for medication use; include measurements of GABA, glutamate, and glutamine; use high-tesla strength MRI; and further evaluate the timing of microdialysis. Understanding the importance of brain glutamate and GABA levels in epilepsy may provide direction for future therapies and treatments.
Collapse
Affiliation(s)
- Gabrielle L Sarlo
- Department of Psychology, Behavior, Cognition and Neuroscience Program, American University, Washington DC, United States
| | - Kathleen F Holton
- Department of Health Studies, American University, Washington DC, United States; Center for Behavioral Neuroscience, American University, Washington DC, United States.
| |
Collapse
|
3
|
Al-Sharydah AM, Al-Abdulwahhab AH, Al-Suhibani SS, Al-Issawi WM, Al-Zahrani F, Katbi FA, Al-Thuneyyan MA, Jallul T, Mishaal Alabbas F. Posterior fossa extra-axial variations of medulloblastoma: a pictorial review as a primer for radiologists. Insights Imaging 2021; 12:43. [PMID: 33822292 PMCID: PMC8024434 DOI: 10.1186/s13244-021-00981-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/01/2021] [Indexed: 11/29/2022] Open
Abstract
Manifestations of an atypical variant of medulloblastoma of the posterior fossa in extra-axial locations have been reported, and key questions concerning its interpretation have been raised previously. This review illustrated the clinico-radiological and histopathological features of the posterior fossa extra-axial medulloblastoma and described possible management strategies. We thoroughly reviewed all atypical anatomical locations of medulloblastoma reported within the posterior fossa and extra-axial spaces. The main characteristics of diagnostic imaging and histopathological results, primarily the distinctive radiopathological characteristics, were summarized to distinguish between intra- and extra-axial medulloblastoma, or pathologies mimicking this tumor. Most cases of posterior fossa extra-axial medulloblastoma have been reported in the cerebellopontine angle, followed by the tentorial and lateral cerebellar locations. The dural tail sign, which is commonly observed in meningioma, is rarely seen in intra- or extra-axial medulloblastoma and might be associated with other benign or malignant lesions. In addition to magnetic resonance imaging, the proposed new imaging techniques, including advances in modern neuroimaging modalities, were discussed, as potentially efficient modalities for characterizing extra-axial medulloblastoma. Radionuclide imaging and magnetic resonance perfusion imaging are practical alternatives to limit the number of differential diagnoses. We believe that medulloblastoma cases are likely under-reported because of publication bias and frequent tumors in unusual locations. Addressing these issues would help establish a more accurate understanding of this entity.
Collapse
Affiliation(s)
- Abdulaziz M Al-Sharydah
- Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar City, Eastern Province, Saudi Arabia
| | - Abdulrahman Hamad Al-Abdulwahhab
- Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar City, Eastern Province, Saudi Arabia.
| | - Sari Saleh Al-Suhibani
- Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar City, Eastern Province, Saudi Arabia
| | - Wisam M Al-Issawi
- Neurosurgery Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar City, Eastern Province, Saudi Arabia
| | - Faisal Al-Zahrani
- Radiodiagnostics and Medical Imaging Department, King Fahd Military Medical Complex, Dhahran City, Eastern Province, Saudi Arabia
| | - Faisal Ahmad Katbi
- Emergency Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Alkhobar City, Eastern Province, Saudi Arabia
| | - Moath Abdullah Al-Thuneyyan
- Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar City, Eastern Province, Saudi Arabia
| | - Tarek Jallul
- Neurosurgery Department, King Fahd Specialist Hospital, Dammam City, Eastern Province, Saudi Arabia
| | - Faisal Mishaal Alabbas
- Neurosurgery Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar City, Eastern Province, Saudi Arabia
| |
Collapse
|
4
|
Yeh CI, Cheng MF, Xiao F, Chen YC, Liu CC, Chen HY, Yen RF, Ju YT, Chen Y, Bodduluri M, Yu PH, Chi CH, Chong NS, Wu LH, Adler JR, Schneider MB. Effects of Focal Radiation on [ 18 F]-Fluoro-D-Glucose Positron Emission Tomography in the Brains of Miniature Pigs: Preliminary Findings on Local Metabolism. Neuromodulation 2020; 24:863-869. [PMID: 32270579 DOI: 10.1111/ner.13147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 01/03/2020] [Accepted: 01/26/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES It would be a medically important advance if durable and focal neuromodulation of the brain could be delivered noninvasively and without ablation. This ongoing study seeks to elucidate the effects of precisely delivered ionizing radiation upon focal brain metabolism and the corresponding cellular integrity at that target. We hypothesize that focally delivered ionizing radiation to the brain can yield focal metabolic changes without lesioning the brain in the process. MATERIALS AND METHODS We used stereotactic radiosurgery to deliver doses from 10 Gy to 120 Gy to the left primary motor cortex (M1) of Lee Sung miniature pigs (n = 8). One additional animal served as a nonirradiated control. We used positron emission tomography-computed tomography (PET-CT) to quantify radiation dose-dependent effects by calculating the ratio of standard uptake values (SUV) of 2-deoxy-2-[18 F]-fluoro-D-glucose (18 F-FDG) between the radiated (left) and irradiated (right) hemispheres across nine months. RESULTS We found that the FDG-PET SUV ratio at the targeted M1 was significantly lowered from the pre-radiation baseline measurements for animals receiving 60 Gy or higher, with the effect persisting at nine months after radiosurgery. Only at 120 Gy was a lesion suggesting ablation visible at the M1 target. Animals treated at 60-100 Gy showed a reduced signal in the absence of an identifiable lesion, a result consistent with the occurrence of neuromodulation. CONCLUSION Focal, noninvasive, and durable changes in brain activity can be induced without a magnetic resonance imaging (MRI)-visible lesion, a result that may be consistent with the occurrence of neuromodulation. This approach may provide new venues for the investigation of neuromodulatory treatments for disorders involving dysfunctional brain circuits. Postmortem pathological analysis is needed to elucidate whether there have been morphological changes not detected by MRI.
Collapse
Affiliation(s)
- Chun-I Yeh
- Department of Psychology, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Mei-Fang Cheng
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Furen Xiao
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Chieh Chen
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Chu Liu
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Yi Chen
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Ten Ju
- Department of Animal Science and Technology, National Taiwan University, Taipei, Taiwan
| | - Yilin Chen
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Mohan Bodduluri
- Zap Medical System, Inc., Cayman Islands, UK.,Zap Surgical Systems, Inc., San Carlos, CA, USA
| | - Pin-Huan Yu
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Chau-Hwa Chi
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Ngot Swan Chong
- Zap Medical System, Inc., Cayman Islands, UK.,Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan
| | - Liang-Hsiang Wu
- Zap Medical System, Inc., Cayman Islands, UK.,Zap Surgical Systems, Inc., San Carlos, CA, USA
| | - John R Adler
- Zap Medical System, Inc., Cayman Islands, UK.,Zap Surgical Systems, Inc., San Carlos, CA, USA.,Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Michael Bret Schneider
- Zap Surgical Systems, Inc., San Carlos, CA, USA.,Department of Neurosurgery, Stanford University, Stanford, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| |
Collapse
|
5
|
Miletich RS. Positron Emission Tomography and Single-Photon Emission Computed Tomography in Neurology. Continuum (Minneap Minn) 2018; 22:1636-1654. [PMID: 27740992 DOI: 10.1212/con.0000000000000389] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are now available for routine clinical applications in neurology. This article discusses their diagnostic use in dementia, brain tumors, epilepsy, parkinsonism, cerebrovascular disease, and traumatic brain injury. RECENT FINDINGS Neuromolecular imaging, also known as nuclear neurology, involves clinical imaging of both basal regional physiology (perfusion, metabolism, and transport mechanisms) and specific neurochemical physiology (currently, only the dopamine transporter). This article serves as an introduction to neuromolecular imaging, reviewing the literature supplemented by the author's experience. SUMMARY Neurologic PET and SPECT are no longer restricted to the research realm. These modalities have high diagnostic accuracy.
Collapse
|
6
|
Nuclear medicine in pediatric refractory epilepsy. Clin Transl Imaging 2016. [DOI: 10.1007/s40336-016-0167-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
7
|
Walker AJ, Ruzevick J, Malayeri AA, Rigamonti D, Lim M, Redmond KJ, Kleinberg L. Postradiation imaging changes in the CNS: how can we differentiate between treatment effect and disease progression? Future Oncol 2015; 10:1277-97. [PMID: 24947265 DOI: 10.2217/fon.13.271] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
A familiar challenge for neuroradiologists and neuro-oncologists is differentiating between radiation treatment effect and disease progression in the CNS. Both entities are characterized by an increase in contrast enhancement on MRI and present with similar clinical signs and symptoms that may occur either in close temporal proximity to the treatment or later in the disease course. When radiation-related imaging changes or clinical deterioration are mistaken for disease progression, patients may be subject to unnecessary surgery and/or a change from otherwise effective therapy. Similarly, when disease progression is mistaken for treatment effect, a potentially ineffective therapy may be continued in the face of progressive disease. Here we describe the three types of radiation injury to the brain based on the time to development of signs and symptoms--acute, subacute and late--and then review specific imaging changes after intensity-modulated radiation therapy, stereotactic radiosurgery and brachytherapy. We provide an overview of these phenomena in the treatment of a wide range of malignant and benign CNS illnesses. Finally, we review the published data regarding imaging techniques under investigation to address this well-known problem.
Collapse
Affiliation(s)
- Amanda J Walker
- Department of Radiation Oncology & Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | | | | | | | | | | | | |
Collapse
|
8
|
Imaging biomarkers in primary brain tumours. Eur J Nucl Med Mol Imaging 2014; 42:597-612. [PMID: 25520293 DOI: 10.1007/s00259-014-2971-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 12/03/2014] [Indexed: 12/18/2022]
Abstract
We are getting used to referring to instrumentally detectable biological features in medical language as "imaging biomarkers". These two terms combined reflect the evolution of medical imaging during recent decades, and conceptually comprise the principle of noninvasive detection of internal processes that can become targets for supplementary therapeutic strategies. These targets in oncology include those biological pathways that are associated with several tumour features including independence from growth and growth-inhibitory signals, avoidance of apoptosis and immune system control, unlimited potential for replication, self-sufficiency in vascular supply and neoangiogenesis, acquired tissue invasiveness and metastatic diffusion. Concerning brain tumours, there have been major improvements in neurosurgical techniques and radiotherapy planning, and developments of novel target drugs, thus increasing the need for reproducible, noninvasive, quantitative imaging biomarkers. However, in this context, conventional radiological criteria may be inappropriate to determine the best therapeutic option and subsequently to assess response to therapy. Integration of molecular imaging for the evaluation of brain tumours has for this reason become necessary, and an important role in this setting is played by imaging biomarkers in PET and MRI. In the current review, we describe most relevant techniques and biomarkers used for imaging primary brain tumours in clinical practice, and discuss potential future developments from the experimental context.
Collapse
|
9
|
Fontana EJ, Benzinger T, Cobbs C, Henson J, Fouke SJ. The evolving role of neurological imaging in neuro-oncology. J Neurooncol 2014; 119:491-502. [PMID: 25081974 DOI: 10.1007/s11060-014-1505-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 06/11/2014] [Indexed: 11/30/2022]
Abstract
Neuroimaging has played a critical role in the management of patients with neurological disease, since the first ventriculogram was performed in 1918 by Walter Dandy (Mezger et al. Langenbecks Arch Surg 398(4):501-514, 2013). Over the last century, technology has evolved significantly, and within the last decade, the role of imaging in the management of patients with neuro-oncologic disease has shifted from a tool for gross identification of intracranial pathology, to an integral part of real-time neurological surgery. Current neurological imaging provides detailed information about anatomical structure, neurological function, and metabolic and metabolism-important characteristics that help clinicians and surgeons non-invasively manage patients with brain tumors. It is valuable to review the evolution of neurological imaging over the past several decades, focusing on its role in the management of patients with intracranial tumors. Novel neuro-imaging tools and developing technology with the potential to further transform clinical practice will be discussed, as will the key role neurological imaging plays in neurosurgical planning and intraoperative navigation. With increasingly complex imaging modalities creating growing amounts of raw data, validation of techniques, data analysis, and integrating various pieces of imaging data into individual patient management plans, remain significant challenges for clinicians. We thus suggest mechanisms that might ultimately allow for evidence based integration of imaging in the management of patients with neuro-oncologic disease.
Collapse
Affiliation(s)
- E J Fontana
- Swedish Neuroscience Institute, 550 17th Ave, Seattle, WA, 98122, USA
| | | | | | | | | |
Collapse
|
10
|
Obenaus A. Neuroimaging biomarkers for epilepsy: advances and relevance to glial cells. Neurochem Int 2013; 63:712-8. [PMID: 23665337 DOI: 10.1016/j.neuint.2013.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 04/24/2013] [Accepted: 05/01/2013] [Indexed: 12/11/2022]
Abstract
Glial cells play an important role in normal brain function and emerging evidence would suggest that their dysfunction may be responsible for some epileptic disease states. Neuroimaging of glial cells is desirable, but there are no clear methods to assess neither their function nor localization. Magnetic resonance imaging (MRI) is now part of a standardized epilepsy imaging protocol to assess patients. Structural volumetric and T2-weighted imaging changes can assist in making a positive diagnosis in a majority of patients. The alterations reported in structural and T2 imaging is predominantly thought to reflect early neuronal loss followed by glial hypertrophy. MR spectroscopy for myo-inositol is a being pursued to identify glial alterations along with neuronal markers. Diffusion weighted imaging (DWI) is ideal for acute epileptiform events, but is not sensitive to either glial cells or neuronal long-term changes found in epilepsy. However, DWI variants such as diffusion tensor imaging or q-space imaging may shed additional light on aberrant glial function in the future. The sensitivity and specificity of PET radioligands, including those targeting glial cells (translocator protein) hold promise in being able to image glial cells. As the role of glial function/dysfunction in epilepsy becomes more apparent neuroimaging methods will evolve to assist the clinician and researcher in visualizing their location and function.
Collapse
Affiliation(s)
- Andre Obenaus
- Department of Pediatrics, School of Medicine, Loma Linda University, Loma Linda, CA, USA; Division of Interdisciplinary Studies, School of Behavioral Health, Loma Linda University, Loma Linda, CA, USA; Cell and Molecular Development and Biology Program, University of California, Riverside, CA, USA; Neuroscience Graduate Program, University of California, Riverside, CA, USA.
| |
Collapse
|
11
|
Sarantopoulos A, Beziere N, Ntziachristos V. Optical and Opto-Acoustic Interventional Imaging. Ann Biomed Eng 2012; 40:346-66. [DOI: 10.1007/s10439-011-0501-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 12/23/2011] [Indexed: 12/20/2022]
|
12
|
Petrirena GJ, Goldman S, Delattre JY. Advances in PET imaging of brain tumors: a referring physician's perspective. Curr Opin Oncol 2011; 23:617-23. [PMID: 21825989 DOI: 10.1097/cco.0b013e32834aa752] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW To highlight the most recent advances in PET imaging of brain tumors, aiming at expanding the referring physician's knowledge in the field, the sine qua non for translating PET into the practice of neuro-oncology. RECENT FINDINGS The role of PET with amino acid tracers in the setting of brain lesions of unknown significance has been better defined, reducing the need for invasive procedures. The impact of PET-guided resection of high-grade glioma using ¹¹C-methionine (¹¹C-MET) has been strongly documented. [¹⁸F]Fluoroethyl-L-tyrosine is currently available for glioma management; advances in targeting glial tumor biopsy and monitoring response to standard chemoradiation of malignant glioma have been remarkable. 2-(2-nitro-1H-imidazol-1-yl)-N-(2,2,3,3,3-penta-fluoropropyl)-acetamide is a rationally designed radiotracer with potential for imaging hypoxia in glioblastoma. New insights regarding the predictive value of 3-deoxy-3-[¹⁸F]fluorothymidine in outcome of recurrent malignant glioma treated with bevacizumab/irinotecan have been provided. First steps are being made toward apoptosis PET imaging for early assessment of radiotherapy response in brain metastases. SUMMARY The use of ¹¹C-MET and ¹⁸F-labeled PET tracers is getting a more precise position in the management of brain tumors. Advances hold promises in routine decision-making and in the design and conduct of clinical trials.
Collapse
Affiliation(s)
- Gregorio J Petrirena
- Service de Neurologie Mazarin, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
| | | | | |
Collapse
|