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Title: Relationship of computed tomography perfusion and positron emission tomography to tumour progression in malignant glioma

Introduction: This study aimed to explore the potential for computed tomography (CT) perfusion and 18-Fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting sites of future progressive tumour on a voxel-by-voxel basis after radiotherapy and chemotherapy. Methods: Ten patients underwent pre-radiotherapy magnetic resonance (MR), FDG-PET and CT perfusion near the end of radiotherapy and repeated post-radiotherapy follow-up MR scans. The relationships between these images and tumour progression were assessed using logistic regression. Cross-validation with receiver operating characteristic (ROC) analysis was used to assess the value of these images in predicting sites of tumour progression. Results: Pre-radiotherapy MR-defined gross tumour; near-end-of-radiotherapy CT-defined enhancing lesion; CT perfusion blood flow (BF), blood volume (BV) and permeability-surface area (PS) product; FDG-PET standard uptake value (SUV); and SUV:BF showed significant associations with tumour progression on follow-up MR imaging (P < 0.0001). The mean sensitivity (±standard deviation), specificity and area under the ROC curve (AUC) of PS were 0.64 ± 0.15, 0.74 ± 0.07 and 0.72 ± 0.12 respectively. This mean AUC was higher than that of the pre-radiotherapy MR-defined gross tumour and near-end-of-radiotherapy CT-defined enhancing lesion (both AUCs = 0.6 ± 0.1, P ≤ 0.03). The multivariate model using BF, BV, PS and SUV had a meanmore » AUC of 0.8 ± 0.1, but this was not significantly higher than the PS only model. Conclusion: PS is the single best predictor of tumour progression when compared to other parameters, but voxel-based prediction based on logistic regression had modest sensitivity and specificity.« less
Authors:
 [1] ;  [2] ;  [2] ;  [1] ;  [2] ;  [2] ;  [3] ;  [2] ;  [2] ;  [4] ;  [2] ;  [1] ;  [2] ;  [2] ;  [5] ; ;  [1] ;  [2] ;  [1] ;  [2] more »;  [2] ;  [1] ;  [2] ;  [2] « less
  1. London Regional Cancer Program, London Health Sciences Centre, Ontario, Canada, N6A 4L6 (Canada)
  2. (Canada)
  3. Robarts Research Institute, The University of Western Ontario, Ontario, Canada, N6A 5B7 (Canada)
  4. (Australia)
  5. Department of Statistical and Actuarial Sciences, The University of Western Ontario, Ontario, Canada, N6A 5B7 (Canada)
Publication Date:
OSTI Identifier:
22402339
Resource Type:
Journal Article
Resource Relation:
Journal Name: Journal of Medical Radiation Sciences (Print); Journal Volume: 61; Journal Issue: 1; Other Information: PMCID: PMC4175825; PMID: 26229630; OAI: oai:pubmedcentral.nih.gov:4175825; Copyright (c) 2014 Journal of Medical Radiation Sciences published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology; This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
Australia
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AUC; BLOOD FLOW; CHEMOTHERAPY; DIAGRAMS; FORECASTING; IMAGES; PATIENTS; PERMEABILITY; RADIOTHERAPY; SENSITIVITY; SPECIFICITY; SURFACE AREA; UPTAKE; VALIDATION