Chang Y, Donglan Y, Xinchong S, Ganhua L, Bing Z, Yao L, Rutong Z, Qiao H, Xiangsong Z. One-day protocol for
18F-FDG and
13N-ammonia PET/CT with uptake decoupling score in differentiating untreated low-grade glioma from inflammation.
Rev Esp Med Nucl Imagen Mol 2020;
39:68-74. [PMID:
32005511 DOI:
10.1016/j.remn.2019.08.001]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/27/2019] [Accepted: 08/27/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE
Accurate identification of low-grade gliomas (LGGs; World Health Organization grades I and II) and their differentiation from brain inflammation lesions (BILs) remains difficult; however, it is essential for treatment. This study assessed whether a one-day protocol for voxel-wise 18F-FDG and 13N-ammonia PET/CT with uptake decoupling analysis could differentiate LGGs from BILs.
MATERIALS AND METHODS
Twenty-eight patients with LGGs and 16 patients with BILs underwent 18F-FDG and 13N-ammonia PET/CT on the same day before any type of therapy. The decoupling score and tumor-to-normal tissue (T/N) ratio of 18F-FDG and 13N-ammonia were calculated at each location. Student's t-test was used to compare values, and ROC curve analysis was used to establish a cut-off value for the T/N ratio and decoupling score. Area under the curve (AUC) was calculated to evaluate differential efficacy.
RESULTS
Significant differences were observed in 13N-ammonia T/N ratio (p=0.018) and decoupling score (p=0.003) between LGGs and BILs; however, the 18F-FDG T/N ratio did not show any differences (p=0.413). Optimal cut-off values for 18F-FDG T/N ratio, 13N-ammonia T/N ratio, and decoupling score were 0.73, 0.97, and 2.31, respectively, with corresponding AUCs of 0.48, 0.68, and 0.77. The respective sensitivity, specificity, and accuracy parameters using these cut-off values were 53.6%, 62.5%, and 56.8%, respectively, for 18F-FDG; 50.0%, 75.0%, and 59.1%, respectively, for 13N-ammonia; and 60.7%, 93.8%, and 72.7%, respectively, for decoupling score.
CONCLUSIONS
18F-FDG/13N-ammonia uptake decoupling score can be used to discriminate between LGGs and BILs. Use of a decoupling map of these two tracers can improve visual analysis and diagnostic accuracy.
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