Correlation of Simultaneously Acquired Diffusion-Weighted Imaging and 2-Deoxy-[18F] fluoro-2-D-glucose Positron Emission Tomography of Pulmonary Lesions in a Dedicated Whole-Body Magnetic Resonance/Positron Emission Tomography System

Schmidt, Holger; Brendle, Cornelia; Schraml, Christina; Martirosian, Petros; Bezrukov, Ilja; Hetzel, Jürgen; Müller, Mark; Sauter, Alexander; Claussen, Claus D.; Pfannenberg, Christina; Schwenzer, Nina F.

doi:10.1097/rli.0b013e31828d56a1

Cited by 70 publications

(59 citation statements)

References 40 publications

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“…A positive correlation between ADC and 18 F-FDG SUV could seem, at first glance, inconsistent with findings from Schmidt et al, who have reported a negative correlation between SUV max and ADC min (17). However, in accordance with Schmidt et al, the intratumor correlation coefficient is mostly negative for all tumors and becomes more negative as the total tumor volume increases (Supplemental Fig.…”

Section: Discussioncontrasting

confidence: 53%

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A Population-Based Gaussian Mixture Model Incorporating ¹⁸F-FDG PET and Diffusion-Weighted MRI Quantifies Tumor Tissue Classes

et al. 2015

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The aim of our study was to create a novel Gaussian mixture modeling (GMM) pipeline to model the complementary information derived from 18 F-FDG PET and diffusion-weighted MRI (DW-MRI) to separate the tumor microenvironment into relevant tissue compartments and follow the development of these compartments longitudinally. Methods: Serial 18 F-FDG PET and apparent diffusion coefficient (ADC) maps derived from DW-MR images of NCI-H460 xenograft tumors were coregistered, and a population-based GMM was implemented on the complementary imaging data. The tumor microenvironment was segmented into 3 distinct regions and correlated with histology. ANCOVA was applied to gauge how well the total tumor volume was a predictor for the ADC and 18 F-FDG, or if ADC was a good predictor of 18 F-FDG for average values in the whole tumor or average necrotic and viable tissues. Results: The coregistered PET/MR images were in excellent agreement with histology, both visually and quantitatively, and allowed for validation of the last-time-point measurements. Strong correlations were found for the necrotic (r 5 0.88) and viable fractions (r 5 0.87) between histology and clustering. The GMM provided probabilities for each compartment with uncertainties expressed as a mixture of tissues in which the resolution of scans was inadequate to accurately separate tissues. The ANCOVA suggested that both ADC and 18 F-FDG in the whole tumor (P 5 0.0009, P 5 0.02) as well as necrotic (P 5 0.008, P 5 0.02) and viable (P 5 0.003, P 5 0.01) tissues were a positive, linear function of total tumor volume. ADC proved to be a positive predictor of 18 F-FDG in the whole tumor (P 5 0.001) and necrotic (P 5 0.02) and viable (P 5 0.0001) tissues. Conclusion: The complementary information of 18 F-FDG and ADC longitudinal measurements in xenograft tumors allows for segmentation into distinct tissues when using the novel GMM pipeline. Leveraging the power of multiparametric PET/MRI in this manner has the potential to take the assessment of disease outcome beyond RECIST and could provide an important impact to the field of precision medicine.

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Section: Discussioncontrasting

confidence: 53%

“…Recently, Schmidt et al have reported on the correlation of ADC and 18 F-FDG inside of NSCLC tumors using a hybrid PET/MR (17). They applied a Gaussian mixture model (GMM) (18) and theorized that it separated the tumors into distinct and relevant tissue classes.…”

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confidence: 99%

A Population-Based Gaussian Mixture Model Incorporating ¹⁸F-FDG PET and Diffusion-Weighted MRI Quantifies Tumor Tissue Classes

et al. 2015

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“…This is of interest, because only the image pattern, but not the underlying information (i.e., tumor property) assessed is similar between the two techniques: DWI visualizes intercellular space narrowing, and thus, cell density (35); whereas 18F-FDG-PET visualizes glucose metabolism, which in turn has been shown to correlate with cell proliferation (36,37). We hypothesize that the reason for our findings is that, at least in the FDG-avid lymphomas included in the present study, there is more glucose consumption in areas of higher cell density, such a correlation between cell density and glucose metabolism has already been reported for malignant lung nodules and pancreatic adenocarcinoma (38,39). In other, very slowly growing lymphomas (e.g., in a certain percentage of MALT lymphomas and SLL/CLL), there may, however, be no such association between cellularity and glucose metabolism.…”

Section: Discussionsupporting

confidence: 51%

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

Mayerhoefer

Karanikas

Kletter

et al. 2015

Clinical Cancer Research

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Purpose: To determine the value of diffusion-weighted MRI (DWI-MRI) for treatment response assessment in 2-[18F]fluoro-2-deoxy-D-glucose (FDG)-avid lymphoma.Experimental Design: Patients with FDG-avid Hodgkin (HL) or non-Hodgkin lymphoma (NHL) at pretherapeutic 18F-FDG-PET/CT, who had also undergone pretherapeutic whole-body DWI-MRI, were included in this prospective study. Depending on the histologic lymphoma subtype, patients received different systemic treatment regimens, and follow-up DWI-MRI and 18F-FDG-PET/CT were performed at one or more time points, depending on the clinical course. For each follow-up DWI-MRI, regionbased rates of agreement, and rates of agreement in terms of treatment response (complete remission, partial remission, stable disease, or progressive disease), relative to the corresponding 18F-FDG-PET/CT, were calculated.Results: Sixty-four patients were included: 10 with HL, 22 with aggressive NHL, and 32 with indolent NHL. The overall region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.4%. For the 51 interim examinations (performed after 1-3 therapy cycles), region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.2%, and for the 48 end-oftreatment examinations, agreement was 99.8%. No significant differences, in terms of region-based agreement between DWI-MRI and 18F-FDG-PET/CT, were observed between the three lymphoma groups (HL, aggressive NHL, indolent NHL; P ¼ 0.25), or between interim and end-of-treatment examinations (P ¼ 0.21). With regard to treatment response assessment, DWI-MRI agreed with 18F-FDG-PET/CT in 99 of 102 follow-up examinations (97.1%), with a k value of 0.94 (P < 0.0001).Conclusions: In patients with FDG-avid lymphoma, DWI-MRI may be a feasible alternative to 18F-FDG-PET/CT for follow-up and treatment response assessment. Clin Cancer Res; 21(11); 2506-13.Ó2015 AACR.

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“…Preliminary results are available in recent literature on direct comparison between PET/MRI and PET/CT in the staging of lung cancer, mostly non-small-cell lung cancer (NSCLC) [17,[37][38][39][40]; however, many of these studies are limited by small sample size.…”

Section: Lung Cancermentioning

confidence: 99%

“…The performance of PET/MRI has also been studied for the detection of pulmonary nodules [28,40,42 • ]. With use of simultaneous PET and MRI acquisition and a freebreathing radial volumetric interpolated breath-hold examination, the detection of pulmonary nodules was compared with that in PET/CT.…”

Section: Lung Cancermentioning

confidence: 99%

PET/MRI: Applications in Clinical Imaging

et al. 2013

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PET/MRI is a new hybrid modality which is increasingly being used in clinical settings, although both clinical evaluation and technical optimization are still an ongoing process. Initial experience with this new imaging device proves promising for oncologic applications. Other clinical indications in the field of cardiac imaging and neuroimaging are also being explored. This article aims to review the current status of PET/MRI and its value in oncologic applications, and summarizes our own preliminary experience in this field.

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Correlation of Simultaneously Acquired Diffusion-Weighted Imaging and 2-Deoxy-[18F] fluoro-2-D-glucose Positron Emission Tomography of Pulmonary Lesions in a Dedicated Whole-Body Magnetic Resonance/Positron Emission Tomography System

Cited by 70 publications

References 40 publications

A Population-Based Gaussian Mixture Model Incorporating ¹⁸F-FDG PET and Diffusion-Weighted MRI Quantifies Tumor Tissue Classes

A Population-Based Gaussian Mixture Model Incorporating ¹⁸F-FDG PET and Diffusion-Weighted MRI Quantifies Tumor Tissue Classes

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

PET/MRI: Applications in Clinical Imaging

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Correlation of Simultaneously Acquired Diffusion-Weighted Imaging and 2-Deoxy-[18F] fluoro-2-D-glucose Positron Emission Tomography of Pulmonary Lesions in a Dedicated Whole-Body Magnetic Resonance/Positron Emission Tomography System

Cited by 70 publications

References 40 publications

A Population-Based Gaussian Mixture Model Incorporating 18F-FDG PET and Diffusion-Weighted MRI Quantifies Tumor Tissue Classes

A Population-Based Gaussian Mixture Model Incorporating 18F-FDG PET and Diffusion-Weighted MRI Quantifies Tumor Tissue Classes

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

PET/MRI: Applications in Clinical Imaging

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A Population-Based Gaussian Mixture Model Incorporating ¹⁸F-FDG PET and Diffusion-Weighted MRI Quantifies Tumor Tissue Classes

A Population-Based Gaussian Mixture Model Incorporating ¹⁸F-FDG PET and Diffusion-Weighted MRI Quantifies Tumor Tissue Classes