Hybrid MR-PET of brain tumours using amino acid PET and chemical exchange saturation transfer MRI

• Published in: European journal of nuclear medicine and molecular imaging Vol. 45; no. 6; pp. 1031 - 1040
• Main Authors: da Silva, N. A., Lohmann, P., Fairney, J., Magill, A. W., Oros Peusquens, A.-M., Choi, C.-H., Stirnberg, R., Stoffels, G., Galldiks, N., Golay, X., Langen, K.-J., Jon Shah, N.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2018; Springer Nature B.V
• Subjects: Adult; Aged; Amino acids; Biopsy; Brain; Brain cancer; Brain Neoplasms - diagnostic imaging; Brain tumors; Cardiology; Female; Fluorine isotopes; Glioma; Glioma - diagnostic imaging; Humans; Imaging; Magnetic resonance imaging; Magnetization; Male; Medicine; Medicine & Public Health; Metastases; Middle Aged; Neuroimaging; NMR; Nuclear magnetic resonance; Nuclear Medicine; Oncology; Original Article; Orthopedics; Overhauser effect; Positron emission; Positron emission tomography; Proton Magnetic Resonance Spectroscopy; Protons; Radiology; Saturation; Semisolids; Statistical analysis; Tomography; Tumors; Tyrosine; Young Adult; F-FET PET; Glioma; CEST; APT; Hybrid MR-PET; 18F-FET PET
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-018-3940-4

Purpose PET using radiolabelled amino acids has become a promising tool in the diagnostics of gliomas and brain metastasis. Current research is focused on the evaluation of amide proton transfer (APT) chemical exchange saturation transfer (CEST) MR imaging for brain tumour imaging. In this hybrid MR-PET study, brain tumours were compared using 3D data derived from APT-CEST MRI and amino acid PET using O-(2- 18 F-fluoroethyl)-L-tyrosine ( 18 F-FET). Methods Eight patients with gliomas were investigated simultaneously with 18 F-FET PET and APT-CEST MRI using a 3-T MR-BrainPET scanner. CEST imaging was based on a steady-state approach using a B 1 average power of 1μT. B 0 field inhomogeneities were corrected a Prametric images of magnetisation transfer ratio asymmetry (MTR asym ) and differences to the extrapolated semi-solid magnetisation transfer reference method, APT# and nuclear Overhauser effect (NOE#), were calculated. Statistical analysis of the tumour-to-brain ratio of the CEST data was performed against PET data using the non-parametric Wilcoxon test. Results A tumour-to-brain ratio derived from APT# and 18 F-FET presented no significant differences, and no correlation was found between APT# and 18 F-FET PET data. The distance between local hot spot APT# and 18 F-FET were different (average 20 ± 13 mm, range 4–45 mm). Conclusion For the first time, CEST images were compared with 18 F-FET in a simultaneous MR-PET measurement. Imaging findings derived from 18 F-FET PET and APT CEST MRI seem to provide different biological information. The validation of these imaging findings by histological confirmation is necessary, ideally using stereotactic biopsy.