TY - JOUR
T1 - Association of Tumor [18F]FDG Activity and Diffusion Restriction with Clinical Outcomes of Rhabdomyosarcomas
AU - Pourmehdi Lahiji, Arian
AU - Jackson, Tatianie
AU - Nejadnik, Hossein
AU - von Eyben, Rie
AU - Rubin, Daniel
AU - Spunt, Sheri L.
AU - Quon, Andrew
AU - Daldrup-Link, Heike
N1 - Publisher Copyright:
© 2018, World Molecular Imaging Society.
PY - 2019/6/17
Y1 - 2019/6/17
N2 - Purpose: To evaluate whether the extent of restricted diffusion and 2-deoxy-2-[18F] fluoro-d-glucose ([18F]FDG) uptake of pediatric rhabdomyosarcomas (RMS) on positron emission tomography (PET)/magnetic resonance (MR) images provides prognostic information. Procedure: In a retrospective, IRB-approved study, we evaluated [18F]FDG PET/CT and diffusion-weighted (DW) MR imaging studies of 21 children and adolescents (age 1–20 years) with RMS of the head and neck. [18F]FDG PET and DW MR scans at the time of the initial tumor diagnosis were fused using MIM software. Quantitative measures of the tumor mass with restricted diffusion, [18F]FDG hypermetabolism, or both were dichotomized at the median and tested for significance using Gray’s test. Data were analyzed using a survival analysis and competing risk model with death as the competing risk. Results: [18F]FDG PET/MR images demonstrated a mismatch between tumor areas with increased [18F]FDG uptake and restricted diffusion. The DWI, PET, and DWI + PET tumor volumes were dichotomized at their median values, 23.7, 16.4, and 9.5 cm3, respectively, and were used to estimate survival. DWI, PET, and DWI + PET overlap tumor volumes above the cutoff values were associated with tumor recurrence, regardless of post therapy COG stage (p = 0.007, p = 0.04, and p = 0.07, respectively). Conclusion: The extent of restricted diffusion within RMS and overlap of hypermetabolism plus restricted diffusion predict unfavorable clinical outcomes.
AB - Purpose: To evaluate whether the extent of restricted diffusion and 2-deoxy-2-[18F] fluoro-d-glucose ([18F]FDG) uptake of pediatric rhabdomyosarcomas (RMS) on positron emission tomography (PET)/magnetic resonance (MR) images provides prognostic information. Procedure: In a retrospective, IRB-approved study, we evaluated [18F]FDG PET/CT and diffusion-weighted (DW) MR imaging studies of 21 children and adolescents (age 1–20 years) with RMS of the head and neck. [18F]FDG PET and DW MR scans at the time of the initial tumor diagnosis were fused using MIM software. Quantitative measures of the tumor mass with restricted diffusion, [18F]FDG hypermetabolism, or both were dichotomized at the median and tested for significance using Gray’s test. Data were analyzed using a survival analysis and competing risk model with death as the competing risk. Results: [18F]FDG PET/MR images demonstrated a mismatch between tumor areas with increased [18F]FDG uptake and restricted diffusion. The DWI, PET, and DWI + PET tumor volumes were dichotomized at their median values, 23.7, 16.4, and 9.5 cm3, respectively, and were used to estimate survival. DWI, PET, and DWI + PET overlap tumor volumes above the cutoff values were associated with tumor recurrence, regardless of post therapy COG stage (p = 0.007, p = 0.04, and p = 0.07, respectively). Conclusion: The extent of restricted diffusion within RMS and overlap of hypermetabolism plus restricted diffusion predict unfavorable clinical outcomes.
KW - Diffusion-weighted MR
KW - PET/MR
KW - Rhabdomyosarcoma
KW - [F]FDG
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U2 - 10.1007/s11307-018-1272-1
DO - 10.1007/s11307-018-1272-1
M3 - Article
C2 - 30187233
AN - SCOPUS:85053435069
SN - 1536-1632
VL - 21
SP - 591
EP - 598
JO - Molecular Imaging and Biology
JF - Molecular Imaging and Biology
IS - 3
ER -