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Correlation of MRI-Derived Apparent Diffusion Coefficients in Newly Diagnosed Gliomas with [18F]-Fluoro-L-Dopa PET: What Are We Really Measuring with Minimum ADC?
MedLine Citation:
PMID:  23079407     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE:There is significant interest in whether diffusion-weighted MR imaging indices, such as the minimum apparent diffusion coefficient, may be useful clinically for preoperative tumor grading and treatment planning. To help establish the pathologic correlate of minimum ADC, we undertook a study investigating the relationship between minimum ADC and maximum FDOPA PET uptake in patients with newly diagnosed glioblastoma multiforme.MATERIALS AND METHODS:MR imaging and FDOPA PET data were acquired preoperatively from 15 patients who were subsequently diagnosed with high-grade brain tumor (WHO grade III or IV) by histopathologic analysis. ADC and SUVR normalized FDOPA PET maps were registered to the corresponding CE MR imaging. Regions of minimum ADC within the FDOPA-defined tumor volume were anatomically correlated with areas of maximum FDOPA SUVR uptake.RESULTS:Minimal anatomic overlap was found between regions exhibiting minimum ADC (a putative marker of tumor cellularity) and maximum FDOPA SUVR uptake (a marker of tumor infiltration and proliferation). FDOPA SUVR measures for tumoral regions exhibiting minimum ADC (1.36 ± 0.22) were significantly reduced compared with those with maximum FDOPA uptake (2.45 ± 0.88, P = .0001).CONCLUSIONS:There was a poor correlation between minimum ADC and the most viable/aggressive component of high-grade gliomas. This study suggests that other factors, such as tissue compression and ischemia, may be contributing to restricted diffusion in GBM. Caution should be exercised in the clinical use of minimum ADC as a marker of tumor grade and the use of this index for guiding tumor biopsies preoperatively.
Authors:
S Rose; M Fay; P Thomas; P Bourgeat; N Dowson; O Salvado; Y Gal; A Coulthard; S Crozier
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-18
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  -     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Centre for Clinical Research, Centre for Medical Diagnostic Technologies in Queensland, and Discipline of Medical Imaging, University of Queensland, St Lucia, Brisbane, Australia; and Department of Radiation Oncology, Queensland PET Service, Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organization; and Department of Medical Imaging, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia.
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