1. Population Pharmacokinetic Approach Applied to Positron Emission Tomography: Computed Tomography for Tumor Tissue Identification in Patients with Glioma.
- Author
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Gandia, Peggy, Jaudet, Cyril, Everaert, Hendrik, Heemskerk, Johannes, Vanbinst, Anne, Mey, Johan, Duerinck, Johnny, Neyns, Bart, Ridder, Mark, Chatelut, Etienne, Concordet, Didier, Vanbinst, Anne Marie, de Mey, Johan, and de Ridder, Mark
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PHARMACOKINETICS , *CANCER tomography , *POSITRON emission tomography , *GLIOMAS , *RADIOPHARMACEUTICALS , *COMPUTED tomography , *PATIENTS , *TYROSINE metabolism , *BRAIN tumors , *COMPARATIVE studies , *MAGNETIC resonance imaging , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *TYROSINE , *EVALUATION research , *RETROSPECTIVE studies , *TUMOR grading - Abstract
Background and Aims: 18F-fluoro-ethyl-tyrosine (FET) is a radiopharmaceutical used in positron emission tomography (PET)-computed tomography in patients with glioma. We propose an original approach combining a radiotracer-pharmacokinetic exploration performed at the voxel level (three-dimensional pixel) and voxel classification to identify tumor tissue. Our methodology was validated using the standard FET-PET approach and magnetic resonance imaging (MRI) data acquired according to the current clinical practices.Methods: FET-PET and MRI data were retrospectively analyzed in ten patients presenting with progressive high-grade glioma. For FET-PET exploration, radioactivity acquisition started 15 min after radiotracer injection, and was measured each 5 min during 40 min. The tissue segmentation relies on population pharmacokinetic modeling with dependent individuals (voxels). This model can be approximated by a linear mixed-effects model. The tumor volumes estimated by our approach were compared with those determined with the current clinical techniques, FET-PET standard approach (i.e., a cumulated value of FET signal is computed during a time interval) and MRI sequences (T1 and T2/fluid-attenuated inversion recovery [FLAIR]), used as references. The T1 sequence is useful to identify highly vascular tumor and necrotic tissues, while the T2/FLAIR sequence is useful to isolate infiltration and edema tissue located around the tumor.Results: With our kinetic approach, the volumes of tumor tissue were larger than the tissues identified by the standard FET-PET and MRI T1, while they were smaller than those determined with MRI T2/FLAIR.Conclusion: Our results revealed the presence of suspected tumor voxels not identified by the standard PET approach. [ABSTRACT FROM AUTHOR]- Published
- 2017
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