Abstract
Imaging techniques such as positron emission tomography (PET) and magnetic resonance imaging (MRI) provide valuable information about brain tumor patients. Particularly amino acid PET, advanced MRI techniques, and combinations thereof are of great interest for the non-invasive assessment of biological characteristics in patients with primary or secondary brain cancer. A methodological innovation that potentially advances research in patients with brain tumors is the increasing availability of hybrid PET/MRI systems, which enables the simultaneous acquisition of both imaging modalities. Furthermore, the advent of ultra-high field MRI scanners operating at magnetic field strengths of 7 T or more will allow further development of metabolic MR imaging at higher resolution. This review focuses on the combination of amino acid PET with MR spectroscopic imaging, perfusion- and diffusion-weighted imaging, as well as chemical exchange saturation transfer in patients with high-grade gliomas, especially glioblastomas.
Highlights
At present, contrast-enhanced magnetic resonance imaging (MRI) is the method of choice for brain tumor diagnostics since MRI provides excellent soft tissue contrast, comparatively high resolution, and is widely available
Amino acid positron emission tomography (PET) has demonstrated its usefulness for the differentiation of tumor progression from treatment-related changes [7,8,9,10,11,12] and for various other indications, e.g., treatment monitoring, prognostication or tumor grading [4,5,6,13,14,15,16,17]
PWI in high-grade gliomas by Patel and co-workers [52] revealed a considerable heterogeneity of applied MR sequences, acquisition and post-processing parameters utilized in PWI studies of brain tumors thereby hampering comparability and reproducibility of results
Summary
Contrast-enhanced magnetic resonance imaging (MRI) is the method of choice for brain tumor diagnostics since MRI provides excellent soft tissue contrast, comparatively high resolution, and is widely available. Among amino acid tracers labelled with carbon-11 used for PET imaging in neuro-oncology,. The short half-life of carbon-11 (20 min) limits its use to centers with an on-site cyclotron To overcome such logistical limitations, amino acid tracers have been labeled with fluorine-18, which has a longer half-life of 110 min [4,6]. FET has become the most widely used radiotracer for brain tumor diagnostics, especially in Western Europe Another fluorine-18 labeled amino acid tracer is. The combination of MRI and PET, especially if hybrid PET/MR scanners are used, offers great potential for brain tumor diagnostics. This technology is attractive when ultra-high field. This review focuses on the combination of amino acid PET with MR spectroscopy (MRS), perfusionand diffusion-weighted imaging (PWI, DWI), and chemical exchange saturation transfer (CEST) in patients with glioblastoma (GBM)
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