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Diagnostic accuracy of intraoperative perfusion-weighted MRI and 5-aminolevulinic acid in relation to contrast-enhanced intraoperative MRI and 11C-methionine positron emission tomography in resection of glioblastoma: a prospective study.
Pala, Andrej; Reske, Sven N; Eberhardt, Nina; Scheuerle, Angelika; König, Ralph; Schmitz, Bernd; Beer, Ambros J; Wirtz, Christian R; Coburger, Jan.
Afiliação
  • Pala A; Department of Neurosurgery, University of Ulm, Ludwig-Heilmeyerstr. 2, 89312, Günzburg, Germany. andrej.pala@uni-ulm.de.
  • Reske SN; Department of Nuclear Medicine, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
  • Eberhardt N; Department of Nuclear Medicine, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
  • Scheuerle A; Department of Neuropathology, University of Ulm, Ludwig-Heilmeyerstr. 2, 89312, Günzburg, Germany.
  • König R; Department of Neurosurgery, University of Ulm, Ludwig-Heilmeyerstr. 2, 89312, Günzburg, Germany.
  • Schmitz B; Department of Neuroradiology, University of Ulm, Ludwig-Heilmeyerstr. 2, 89312, Günzburg, Germany.
  • Beer AJ; Department of Nuclear Medicine, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
  • Wirtz CR; Department of Neurosurgery, University of Ulm, Ludwig-Heilmeyerstr. 2, 89312, Günzburg, Germany.
  • Coburger J; Department of Neurosurgery, University of Ulm, Ludwig-Heilmeyerstr. 2, 89312, Günzburg, Germany.
Neurosurg Rev ; 42(2): 471-479, 2019 Jun.
Article em En | MEDLINE | ID: mdl-29808321
The aim of our study was to compare depicted pre-, intra-, and postoperative tumor volume of met-PET, perfusion-weighed MRI (PWI), and Gd-DTPA MRI. Further, to assess their sensitivity and specificity in correlation with histopathological specimen. Inclusion criteria of the prospective study were histological confirmed glioblastoma (GB), age > 18, and eligible for gross total resection (GTR). Met-PET was performed before and after surgery. Gd-DTPA MRI and PWI were performed before, during, and after surgery. A combined 5-aminolevulinic acid (5-ALA) and iMRI-guided surgery was performed. Volumetric analysis was evaluated for all imaging modalities except for 5-ALA. A total of 59 navigated biopsies were taken. Sensitivity and specificity were calculated for Gd-DTPA MRI, PWI, met-PET, and 5-ALA according to the histology of specimen. Met-PET depicted significantly larger tumor volume before surgery (p = 0.01) compared to PWI and Gd-DTPI MRI. We found no significant difference in tumor volume between met-PET and PWI after surgery (p = 0.059). Both PWI and met-PET showed significantly larger tumor volume after surgery when compared to Gd-DTPA (p = 0.018 and p = 0.003, respectively). Intraoperative PWI reading was impaired in 33.3% due to artifacts. Met-PET showed the highest sensitivity for detection of GB with 95%. The lowest sensitivity was found with Gd-DTPA MRI (50%), while 5-ALA and intraoperative PWI showed similar results (69 and 67%). Met-Pet is the imaging modality with the highest sensitivity to detect a residual tumor in GB. Intraoperative PWI seems to have a synergistic effect to Gd-DTPA and 5-ALA. However, its value may be limited by artifacts. Both pre- and intraoperative PWI cannot substitute met-PET in tumor detection.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Imageamento por Ressonância Magnética / Glioblastoma / Tomografia por Emissão de Pósitrons Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neurosurg Rev Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Imageamento por Ressonância Magnética / Glioblastoma / Tomografia por Emissão de Pósitrons Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neurosurg Rev Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Alemanha