Differentiation of Recurrent/Residual Glioma From Radiation Necrosis Using Semi Quantitative 99mTc MDM (Bis-Methionine-DTPA) Brain SPECT/CT and Dynamic Susceptibility Contrast-Enhanced MR Perfusion

Rani, Nisha; Singh, Baljinder; Kumar, Narendra; Singh, Paramjit; Hazari, Puja Panwar; Singh, Harpreet; Kumar, Ganesh K.; Radotra, Bishan Das; Kumar, Mukesh; Bhattacharya, Anish; Sharma, Rajnish; Kohli, Adarsh; Chhabra, Rajesh; Gupta, Sunil; Mishra, Anil K.

doi:10.1097/rlu.0000000000001943

Cited by 20 publications

(17 citation statements)

References 31 publications

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“…In a meta-analysis that evaluated the diagnostic ability of SPECT in differentiating glioma recurrence from radiation necrosis, the pooled sensitivity was 89% and the specificity 88% [58]. Other promising tracers for SPECT to differentiate tumor recurrence from radiation necrosis include pentavalent technetium-99m dimercaptosuccinic acid (Tc-99m (V) DMSA) [59], bis-methionine-DTPA (Tc MDM) [60], and 99m-technetium glucoheptonate ( 99m Tc-GHA) [61].…”

Section: Diagnostic Imaging Modalitiesmentioning

confidence: 99%

Radiation Necrosis, Pseudoprogression, Pseudoresponse, and Tumor Recurrence: Imaging Challenges for the Evaluation of Treated Gliomas

Zikou

Sioka

Alexiou

et al. 2018

Contrast Media & Molecular Imaging

175

131

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Glioblastoma (GBM) is the most common primary malignant type of brain neoplasm in adults and carries a dismal prognosis. The current standard of care for GBM is surgical excision followed by radiation therapy (RT) with concurrent and adjuvant temozolomide-based chemotherapy (TMZ) by six additional cycles. In addition, antiangiogenic therapy with an antivascular endothelial growth factor (VEGF) agent has been used for recurrent glioblastoma. Over the last years, new posttreatment entities such as pseudoprogression and pseudoresponse have been recognized, apart from radiation necrosis. This review article focuses on the role of different imaging techniques such as conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), dynamic contrast enhancement (DCE-MRI) and dynamic susceptibility contrast (DSE-MRI) perfusion, magnetic resonance spectroscopy (MRS), and PET/SPECT in differentiation of such treatment-related changes from tumor recurrence.

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Section: Diagnostic Imaging Modalitiesmentioning

confidence: 99%

Radiation Necrosis, Pseudoprogression, Pseudoresponse, and Tumor Recurrence: Imaging Challenges for the Evaluation of Treated Gliomas

Zikou

Sioka

Alexiou

et al. 2018

Contrast Media & Molecular Imaging

175

131

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“…Generally, in traditional nuclear medicine imaging, single photon emission computed tomography (SPECT) modality has been used for qualitative diagnosis by visual evaluation of radioactive distribution. For quantitative analysis, the target/nontarget (T/NT) ratio calculated from counts of their regions of interest (ROI) was widely used in SPECT modality, which was known as the semiquantitative analysis [1, 2]. Positron emission tomography (PET) was regarded as the only modality capable of absolute quantitative analysis in the past [3–5].…”

Section: Introductionmentioning

confidence: 99%

Standardized Uptake Value Using Thyroid Quantitative SPECT/CT for the Diagnosis and Evaluation of Graves’ Disease: A Prospective Multicenter Study

Dong

Bian

et al. 2019

BioMed Research International

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The clinical applications of the quantitative single photon emission computed tomography (SPECT)/computed tomography (CT) are being expanded to a variety of fields of nuclear medicine. However, clinical application of quantitative SPECT/CT for the evaluation of Graves’ disease (GD) still needs further investigation. Our aim was to investigate the feasibility of standard uptake value (SUV) of the thyroid for the clinical diagnosis and evaluation of GD. In this prospective multicenter study, 116 patients diagnosed with GD (Graves group) and 74 healthy volunteers (control group) were enrolled from 8 different hospitals. All patients underwent technetium pertechnetate (TcO99m4-) SPECT/CT imaging with Q.Metrix quantitative software and 24-hour thyroid radioactive iodine uptake (24h-RAIU) test. The SUVmax and SUVmean in Graves group were significantly higher than those of control group (P<0.01). Cut-off values of SUVmax and SUVmean to predict GD were 231.425 and 116.66 by ROC curves, respectively. The SUVmax and SUVmean in Graves patients were significantly related to serum thyroxine level with correlation coefficient of 0.493 and 0.512 for FT3 and 0.449 and 0.464 for FT4, respectively (all P<0.01). Additionally, the SUVmax and SUVmean in GD positively correlated with 24h-RAIU with a coefficient of 0.832 and 0.830, respectively (P<0.01). The volumes determined by Q.Metrix (35.65 ± 20.56ml) of 72 subjects also positively correlated with that from ultrasound (36.67 ± 21.00ml) with a coefficient of 0.927 (P<0.01). SUV measurements derived from thyroid SPECT/CT may be useful for the clinical diagnosis and evaluation of GD.

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“…However, these high-dimensional features were reduced by a stepwise forward feature selection scheme that reduces each of the initial feature sets to only 25 different features through the gain equation (2). Third, the dataset used in this study was relatively small, which was also the problem identified in previous studies [1, 38–42]. Therefore, a large patient cohort was necessary to create a more robust model.…”

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

“…Gliomas are the most common and aggressive brain tumors in adults and have an approximate 5-year survival rate of 10% in their highest grade (e.g., glioblastoma multiforme) [1]. The conventional therapy for gliomas is surgery followed by conventional radiotherapy/chemotherapy [1, 2]. However, this combinatory therapy usually leads to radiation necrosis, which is the most common side effect in gliomas within 2 years after treatment [3, 4].…”

Section: Introductionmentioning

confidence: 99%

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Differentiation of Recurrence from Radiation Necrosis in Gliomas Based on the Radiomics of Combinational Features and Multimodality MRI Images

Zhang

Cao

Zhang

et al. 2019

Computational and Mathematical Methods in Medicine

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Purpose To classify radiation necrosis versus recurrence in glioma patients using a radiomics model based on combinational features and multimodality MRI images. Methods Fifty-one glioma patients who underwent radiation treatments after surgery were enrolled in this study. Sixteen patients revealed radiation necrosis while 35 patients showed tumor recurrence during the follow-up period. After treatment, all patients underwent T1-weighted, T1-weighted postcontrast, T2-weighted, and fluid-attenuated inversion recovery scans. A total of 41,284 handcrafted and 24,576 deep features were extracted for each patient. The 0.623 + bootstrap method and the area under the curve (denoted as 0.632 + bootstrap AUC) metric were used to select the features. The stepwise forward method was applied to construct 10 logistic regression models based on different combinations of image features. Results For handcrafted features on multimodality MRI, model 7 with seven features yielded the highest AUC of 0.9624, sensitivity of 0.8497, and specificity of 0.9083 in the validation set. These values were higher than the accuracy of using handcrafted features on single-modality MRI (paired t-test, p < 0.05, except sensitivity). For combined handcrafted and AlexNet features on multimodality MRI, model 6 with six features achieved the highest AUC of 0.9982, sensitivity of 0.9941, and specificity of 0.9755 in the validation set. These values were higher than the accuracy of using handcrafted features on multimodality MRI (paired t-test, p < 0.05). Conclusions Handcrafted and deep features extracted from multimodality MRI images reflecting the heterogeneity of gliomas can provide useful information for glioma necrosis/recurrence classification.

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Differentiation of Recurrent/Residual Glioma From Radiation Necrosis Using Semi Quantitative 99mTc MDM (Bis-Methionine-DTPA) Brain SPECT/CT and Dynamic Susceptibility Contrast-Enhanced MR Perfusion

Abstract: Thus, combining MDM SPECT with DSCE MRI may provide an accurate method for differentiation of tumor recurrence from radiation-induced necrosis in glioma patients.

Cited by 20 publications

References 31 publications

Radiation Necrosis, Pseudoprogression, Pseudoresponse, and Tumor Recurrence: Imaging Challenges for the Evaluation of Treated Gliomas

Radiation Necrosis, Pseudoprogression, Pseudoresponse, and Tumor Recurrence: Imaging Challenges for the Evaluation of Treated Gliomas

Standardized Uptake Value Using Thyroid Quantitative SPECT/CT for the Diagnosis and Evaluation of Graves’ Disease: A Prospective Multicenter Study

Differentiation of Recurrence from Radiation Necrosis in Gliomas Based on the Radiomics of Combinational Features and Multimodality MRI Images

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