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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleAdult Brain
Open Access

Utility of Dynamic Susceptibility Contrast Perfusion-Weighted MR Imaging and 11C-Methionine PET/CT for Differentiation of Tumor Recurrence from Radiation Injury in Patients with High-Grade Gliomas

Z. Qiao, X. Zhao, K. Wang, Y. Zhang, D. Fan, T. Yu, H. Shen, Q. Chen and L. Ai
American Journal of Neuroradiology February 2019, 40 (2) 253-259; DOI: https://doi.org/10.3174/ajnr.A5952
Z. Qiao
aFrom the Departments of Nuclear Medicine (Z.Q., X.Z., K.W., Y.Z., D.F., Q.C., L.A.)
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  • ORCID record for Z. Qiao
X. Zhao
aFrom the Departments of Nuclear Medicine (Z.Q., X.Z., K.W., Y.Z., D.F., Q.C., L.A.)
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K. Wang
aFrom the Departments of Nuclear Medicine (Z.Q., X.Z., K.W., Y.Z., D.F., Q.C., L.A.)
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Y. Zhang
aFrom the Departments of Nuclear Medicine (Z.Q., X.Z., K.W., Y.Z., D.F., Q.C., L.A.)
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D. Fan
aFrom the Departments of Nuclear Medicine (Z.Q., X.Z., K.W., Y.Z., D.F., Q.C., L.A.)
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T. Yu
cDepartment of Medical Imaging (T.Y.), Cancer Hospital of China Medical University, Shenyang, China
dDepartment of Medical Imaging (T.Y.), Liaoning Cancer Hospital and Institute, Shenyang, China.
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H. Shen
bRadiology (H.S.), Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
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Q. Chen
aFrom the Departments of Nuclear Medicine (Z.Q., X.Z., K.W., Y.Z., D.F., Q.C., L.A.)
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L. Ai
aFrom the Departments of Nuclear Medicine (Z.Q., X.Z., K.W., Y.Z., D.F., Q.C., L.A.)
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    Fig 1.

    Receiver operating curves for perfusion-weighted MR imaging and MET PET/CT parameters for the differentiation of recurrence and radiation injury in patients with high-grade gliomas.

  • Fig 2.
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    Fig 2.

    Contrast-enhanced T1-weighted MR image (A) and a relative CBV map (B) and an MET PET/CT image (C) for a 41-year-old woman with recurrent glioblastoma. The lesion in the right frontal lobe (arrow) shows enhancement (A) and positive findings on both the rCBV map (B) and MET PET/CT image (C). The lesion localized in the left frontal lobe (chevron) might be a meningioma, which has been stable for several years.

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    Fig 3.

    Contrast-enhanced T1-weighted MR image (A) and relative CBV map (B) and MET PET/CT image (C) for a 44-year-old man with necrosis. The lesion in the right parietal lobe (arrow) shows enhancement (A) and negative findings on both the rCBV map (B) and the MET PET/CT image (C).

Tables

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    Table 1:

    Results of visual assessments of MET PET/CT for patients with HGGs

    Final DiagnosisVisual AssessmentTotal
    PositiveEquivocalNegative
    Recurrence303033
    Radiation injury4329
    Total346242
    • View popup
    Table 2:

    Results of visual assessments of PWI for patients with HGGs

    Final DiagnosisVisual AssessmentTotal
    PositiveEquivocalNegative
    Recurrence228333
    Radiation injury2169
    Total249942
    • View popup
    Table 3:

    Results of semiquantitative analysis of MET PET/CT and PWI parameters for the differentiation of recurrence from radiation injury in patients with HGGs

    Final DiagnosisP Valuea
    RecurrenceRadiation Injury
    SUVmax5.10 ± 2.412.41 ± 1.67.003
    SUVmean2.83 ± 1.271.39 ± 0.9.003
    TBRSUVmax3.48 ± 1.171.96 ± 0.96.003
    rCBVmean2.68 ± 1.141.33 ± 0.77.004
    • ↵a All P values for discrimination between recurrence and radiation injury are significant.

    • View popup
    Table 4:

    Comparison of patients with recurrence with patients with radiation injury, according to cutoff values for TBRSUVmax and rCBVmean

    PETRecurrence PWIRadiation Injury PWI
    +−Total+−Total
    +25732033
    −101156
    Total26733189
    • Note:—+ indicates TBRSUVmax ≥ 1.85 or rCBVmean ≥ 1.83; −, TBRSUVmax < 1.85 or rCBVmean < 1.83.

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American Journal of Neuroradiology: 40 (2)
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Z. Qiao, X. Zhao, K. Wang, Y. Zhang, D. Fan, T. Yu, H. Shen, Q. Chen, L. Ai
Utility of Dynamic Susceptibility Contrast Perfusion-Weighted MR Imaging and 11C-Methionine PET/CT for Differentiation of Tumor Recurrence from Radiation Injury in Patients with High-Grade Gliomas
American Journal of Neuroradiology Feb 2019, 40 (2) 253-259; DOI: 10.3174/ajnr.A5952

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Utility of Dynamic Susceptibility Contrast Perfusion-Weighted MR Imaging and 11C-Methionine PET/CT for Differentiation of Tumor Recurrence from Radiation Injury in Patients with High-Grade Gliomas
Z. Qiao, X. Zhao, K. Wang, Y. Zhang, D. Fan, T. Yu, H. Shen, Q. Chen, L. Ai
American Journal of Neuroradiology Feb 2019, 40 (2) 253-259; DOI: 10.3174/ajnr.A5952
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