Multimodal Imaging of Nonenhancing Glioblastoma Regions

Simple item page
dc.contributor.authorJohn, Floraen
dc.contributor.authorRobinette, Natasha L.en
dc.contributor.authorAmit-Yousif, Alit J.en
dc.contributor.authorBosnyak, Editen
dc.contributor.authorBarger, Geoffrey R.en
dc.contributor.authorShah, Keval D.en
dc.contributor.authorMittal, Sandeepen
dc.contributor.authorJuhász, Csabaen
dc.contributor.departmentSchool of Neuroscienceen
dc.contributor.departmentVirginia Tech Carilion School of Medicineen
dc.date.accessioned2020-02-06T18:02:04Zen
dc.date.available2020-02-06T18:02:04Zen
dc.date.issued2019-11-13en
dc.description.abstractBackground: Clinical glioblastoma treatment mostly focuses on the contrast-enhancing tumor mass. Amino acid positron emission tomography (PET) can detect additional, nonenhancing glioblastoma-infiltrated brain regions that are difficult to distinguish on conventional magnetic resonance imaging (MRI). We combined MRI with perfusion imaging and amino acid PET to evaluate such nonenhancing glioblastoma regions. Methods: Structural MRI, relative cerebral blood volume (rCBV) maps from perfusion MRI, and alpha-[C-11]-methyl-l-tryptophan (AMT)-PET images were analyzed in 20 patients with glioblastoma. The AMT uptake and rCBV (expressed as tumor to normal [T/N] ratios) were compared in nonenhancing tumor portions showing increased signal on T2/fluid-attenuated inversion recovery (T2/FLAIR) images. Results: Thirteen (65%) tumors showed robust heterogeneity in nonenhancing T2/FLAIR hyperintense areas on AMT-PET, whereas the nonenhancing regions in the remaining 7 cases had homogeneous AMT uptake (low in 6, high in 1). AMT and rCBV T/N ratios showed only a moderate correlation in the nonenhancing regions (r = 0.41, P = .017), but regions with very low rCBV (<0.79 T/N ratio) had invariably low AMT uptake. Conclusions: The findings demonstrate the metabolic and perfusion heterogeneity of nonenhancing T2/FLAIR hyperintense glioblastoma regions. Amino acid PET imaging of such regions can detect glioma-infiltrated brain for treatment targeting; however, very low rCBV values outside the contrast-enhancing tumor mass make increased AMT uptake in nonenhancing glioblastoma regions unlikely.en
dc.description.notesThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by grants from the National Cancer Institute (R01 CA123451 and P30 CA022453).en
dc.description.sponsorshipNational Cancer InstituteUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Cancer Institute (NCI) [R01 CA123451, P30 CA022453]en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1177/1536012119885222en
dc.identifier.issn1536-0121en
dc.identifier.otherUNSP 1536012119885222en
dc.identifier.pmid31736437en
dc.identifier.urihttp://hdl.handle.net/10919/96743en
dc.identifier.volume18en
dc.language.isoenen
dc.rightsCreative Commons Attribution-NonCommercial 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectpositron emission tomographyen
dc.subjectamino aciden
dc.subjectperfusion MRIen
dc.subjectglioblastomaen
dc.titleMultimodal Imaging of Nonenhancing Glioblastoma Regionsen
dc.title.serialMolecular Imagingen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.dcmitypeStillImageen

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
1536012119885222.pdf
Size:
526.24 KB
Format:
Adobe Portable Document Format
Description:
Download

Collections

Scholarly Works, Virginia Tech Carilion School of Medicine (VTCSOM)
Destination Area: Adaptive Brain and Behavior (ABB)
Scholarly Works, School of Neuroscience