| Title: | 18F-fluoromisonidazole positron emission tomography can predict pathological necrosis of brain tumors |
| Authors: | Toyonaga, Takuya Browse this author |
| Hirata, Kenji Browse this author →KAKEN DB |
| Yamaguchi, Shigeru Browse this author |
| Hatanaka, Kanako C. Browse this author |
| Yuzawa, Sayaka Browse this author |
| Manabe, Osamu Browse this author →KAKEN DB |
| Kobayashi, Kentaro Browse this author |
| Watanabe, Shiro Browse this author |
| Shiga, Tohru Browse this author →KAKEN DB |
| Terasaka, Shunsuke Browse this author →KAKEN DB |
| Kobayashi, Hiroyuki Browse this author |
| Kuge, Yuji Browse this author →KAKEN DB |
| Tamaki, Nagara Browse this author →KAKEN DB |
| Keywords: | Necrosis |
| FMISO PET |
| Hypoxia |
| Brain tumor |
| Biopsy |
| Histology |
| Issue Date: | Jul-2016 |
| Publisher: | Springer |
| Journal Title: | European Journal of Nuclear Medicine and Molecular Imaging |
| Volume: | 43 |
| Issue: | 8 |
| Start Page: | 1469 |
| End Page: | 1476 |
| Publisher DOI: | 10.1007/s00259-016-3320-x |
| PMID: | 26841941 |
| Abstract: | Purpose: Tumour necrosis is one of the indicators of tumour aggressiveness. 18F-fluoromisonidazole (FMISO) is the most widely used positron emission tomography (PET) tracer to evaluate severe hypoxia in vivo. Because severe hypoxia causes necrosis, we hypothesized that intratumoural necrosis can be detected by FMISO PET in brain tumours regardless of their histopathology. We applied FMISO PET to various types of brain tumours before tumour resection and evaluated the correlation between histopathological necrosis and FMISO uptake. Methods: This study included 59 brain tumour patients who underwent FMISO PET/computed tomography before any treatments. According to the pathological diagnosis, the brain tumours were divided into three groups: astrocytomas (group 1), neuroepithelial tumours except for astrocytomas (group 2), and others (group 3). Two experienced neuropathologists evaluated the presence of necrosis in consensus. FMISO uptake in the tumour was evaluated visually and semi-quantitatively using the tumour-to-normal cerebellum ratio (TNR). Results: In visual analyses, 26/27 cases in the FMISO-positive group presented with necrosis, whereas 28/32 cases in the FMISO-negative group did not show necrosis. Mean TNRs with and without necrosis were 3.49 ± 0.97 and 1.43 ± 0.42 (p < 0.00001) in group 1, 2.91 ± 0.83 and 1.44 ± 0.20 (p < 0.005) in group 2, and 2.63 ± 1.16 and 1.35 ± 0.23 (p < 0.05) in group 3, respectively. Using a cut-off value of TNR=1.67, which was calculated by normal reference regions of interest, we could predict necrosis with sensitivity, specificity, and accuracy of 96.7%, 93.1%, and 94.9%, respectively. Conclusions: FMISO uptake within the lesion indicated the presence of histological micro-necrosis. When we used a TNR of 1.67 as the cut-off value, intratumoural micro-necrosis was sufficiently predictable. Because the presence of necrosis implies a poor prognosis, our results suggest that FMISO PET could provide important information for treatment decisions or surgical strategies of any type of brain tumour. |
| Rights: | The final publication is available at link.springer.com |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/66417 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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