PMID- 26186719
OWN - NLM
STAT- MEDLINE
DCOM- 20160503
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 10
IP  - 7
DP  - 2015
TI  - Multiparametric MR and PET Imaging of Intratumoral Biological Heterogeneity in 
      Patients with Metastatic Lung Cancer Using Voxel-by-Voxel Analysis.
PG  - e0132386
LID - 10.1371/journal.pone.0132386 [doi]
LID - e0132386
AB  - OBJECTIVES: Diffusion-weighted magnetic resonance imaging (DW-MRI) and imaging of 
      glucose metabolism by positron emission tomography (FDG-PET) provide quantitative 
      information on tissue characteristics. Combining the two methods might provide 
      novel insights into tumor heterogeneity and biology. Here, we present a solution 
      to analyze and visualize the relationship between the apparent diffusion 
      coefficient (ADC) and glucose metabolism on a spatially resolved voxel-by-voxel 
      basis using dedicated quantitative software. MATERIALS AND METHODS: In 12 
      patients with non small cell lung cancer (NSCLC), the primary tumor or metastases 
      were examined with DW-MRI and PET using 18F-fluorodeoxyglucose (FDG). The ADC's 
      from DW-MRI were correlated with standardized-uptake-values on a voxel-by-voxel 
      basis using custom made software (Anima M3P). For cluster analysis, we used 
      prospectively defined thresholds for 18F-FDG and ADC to define tumor areas of 
      different biological activity. RESULTS: Combined analysis and visualization of 
      ADC maps and PET data was feasible in all patients. Spatial analysis showed 
      relatively homogeneous ADC values over the entire tumor area, whereas FDG showed 
      a decreasing uptake towards the tumor center. As expected, restricted water 
      diffusivity was notable in areas with high glucose metabolism but was also found 
      in areas with lower glucose metabolism. In detail, 72% of all voxels showed low 
      ADC values (<1.5x10(-3) mm2/s) and high tracer uptake of 18F-FDG (SUV>3.6). 
      However, 83% of the voxels with low FDG uptake also showed low ADC values, 
      increasingly towards the tumor center. CONCLUSIONS: Multiparametric analysis and 
      visualization of DW-MRI and FDG-PET is feasible on a spatially resolved 
      voxel-by-voxel respectively cluster basis using dedicated imaging software. Our 
      preliminary data suggest that water diffusivity and glucose metabolism in 
      metastatic NSCLC are not necessarily correlated in all tumor areas.
FAU - Metz, Stephan
AU  - Metz S
AD  - Department of Radiology of the Technische Universitaet Muenchen, Munich, Germany.
FAU - Ganter, Carl
AU  - Ganter C
AD  - Department of Radiology of the Technische Universitaet Muenchen, Munich, Germany.
FAU - Lorenzen, Sylvie
AU  - Lorenzen S
AD  - Department of Hemato-Oncology of the Technische Universitaet Muenchen, Munich, 
      Germany.
FAU - van Marwick, Sandra
AU  - van Marwick S
AD  - Departments of Nuclear Medicine of the Technische Universitaet Muenchen, Munich, 
      Germany.
FAU - Holzapfel, Konstantin
AU  - Holzapfel K
AD  - Department of Radiology of the Technische Universitaet Muenchen, Munich, Germany.
FAU - Herrmann, Ken
AU  - Herrmann K
AD  - Departments of Nuclear Medicine of the Technische Universitaet Muenchen, Munich, 
      Germany.
FAU - Rummeny, Ernst J
AU  - Rummeny EJ
AD  - Department of Radiology of the Technische Universitaet Muenchen, Munich, Germany.
FAU - Wester, Hans-Jurgen
AU  - Wester HJ
AD  - Departments of Nuclear Medicine of the Technische Universitaet Muenchen, Munich, 
      Germany; Institute for Radiopharmaceutical Chemistry, Technische Universitaet 
      Muenchen, Garching, Germany.
FAU - Schwaiger, Markus
AU  - Schwaiger M
AD  - Departments of Nuclear Medicine of the Technische Universitaet Muenchen, Munich, 
      Germany.
FAU - Nekolla, Stephan G
AU  - Nekolla SG
AD  - Departments of Nuclear Medicine of the Technische Universitaet Muenchen, Munich, 
      Germany.
FAU - Beer, Ambros J
AU  - Beer AJ
AD  - Departments of Nuclear Medicine of the Technische Universitaet Muenchen, Munich, 
      Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150717
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Non-Small-Cell Lung/*diagnosis/diagnostic imaging/secondary
MH  - Cluster Analysis
MH  - *Diffusion Magnetic Resonance Imaging
MH  - Female
MH  - Fluorodeoxyglucose F18
MH  - Glucose/metabolism
MH  - Humans
MH  - *Image Processing, Computer-Assisted
MH  - Lung Neoplasms/*diagnosis/diagnostic imaging/*secondary
MH  - Male
MH  - Middle Aged
MH  - *Multimodal Imaging
MH  - *Positron-Emission Tomography
PMC - PMC4506136
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2015/07/18 06:00
MHDA- 2016/05/04 06:00
PMCR- 2015/07/17
CRDT- 2015/07/18 06:00
PHST- 2014/08/24 00:00 [received]
PHST- 2015/06/13 00:00 [accepted]
PHST- 2015/07/18 06:00 [entrez]
PHST- 2015/07/18 06:00 [pubmed]
PHST- 2016/05/04 06:00 [medline]
PHST- 2015/07/17 00:00 [pmc-release]
AID - PONE-D-14-36717 [pii]
AID - 10.1371/journal.pone.0132386 [doi]
PST - epublish
SO  - PLoS One. 2015 Jul 17;10(7):e0132386. doi: 10.1371/journal.pone.0132386. 
      eCollection 2015.