Correlation of 18F-FDG PET and MRI apparent Diffusion coefficient histogram metrics with survival in Diffuse intrinsic pontine glioma

A report from the peDiatric brain tumor consortium

Katherine A. Zukotynski, Sridhar Vajapeyam, Frederic H. Fahey, Mehmet Kocak, Douglas Brown, Kelsey I. Ricci, Arzu Onar-Thomas, Maryam FoulaDi, Tina Young Poussaint

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Abstract

The purpose of this study was to describe baseline 18F-FDG PET voxel characteristics in peDiatric Diffuse intrinsic pontine glioma (DiPG) and to correlate these metrics with baseline MRI apparent Diffusion coefficient (ADC) histogram metrics, progression-free survival (PFS), and overall survival. Methods: Baseline brain 18F-FDG PET and MRI scans were obtained in 33 children from PeDiatric Brain Tumor Consortium clinical DiPG trials. 18F-FDG PET images, postgadoliniumMR images, and ADC MR images were registered to baseline fluid attenuation inversion recovery MR images. Three-Dimensional regions of interest on fluid attenuation inversion recovery MR images and postgadolinium MR images and 18F-FDG PET and MR ADC histograms were generated. Metrics evaluated included peak number, skewness, and kurtosis. Correlation between PET and MR ADC histogram metrics was evaluated. PET pixel values within the region of interest for each tumor were plotted against MR ADC values. The association of these imaging markers with survival was described. Results: PET histograms were almost always unimodal (94%, vs. 6% bimodal). None of the PET histogram parameters (skewness or kurtosis) had a significant association with PFS, although a higher PET postgadolinium skewness tended toward a less favorable PFS (hazard ratio, 3.48; 95% confidence interval [CI], 0.75-16.28 [P 5 0.11]). There was a significant association between higher MR ADC postgadolinium skewness and shorter PFS (hazard ratio, 2.56; 95% CI, 1.11-5.91 [P 5 0.028]), and there was the suggestion that this also led to shorter overall survival (hazard ratio, 2.18; 95% CI, 0.95-5.04 [P 5 0.067]). Higher MR ADC postgadolinium kurtosis tended toward shorter PFS (hazard ratio, 1.30; 95% CI, 0.98-1.74 [P 5 0.073]). PET and MR ADC pixel values were negatively correlated using the Pearson correlation coefficient. Further, the level of PET and MR ADC correlation was significantly positively associated with PFS; tumors with higher values of ADC-PET correlation had more favorable PFS (hazard ratio, 0.17; 95% CI, 0.03-0.89 [P 5 0.036]), suggesting that a higher level of negative ADC-PET correlation leads to less favorable PFS. A more significant negative correlation may inDicate higher-grade elements within the tumor leaDing to poorer outcomes. Conclusion: 18F-FDG PET and MR ADC histogram metrics in peDiatric DiPG demonstrate Different characteristics with often a negative correlation between PET and MR ADC pixel values. A higher negative correlation is associated with a worse PFS, which may inDicate higher-grade elements within the tumor.

Original languageEnglish (US)
Pages (from-to)1264-1269
Number of pages6
JournalJournal of Nuclear Medicine
Volume58
Issue number8
DOIs
StatePublished - Aug 1 2017

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Diffusion Magnetic Resonance Imaging
Fluorodeoxyglucose F18
Brain Neoplasms
Glioma
Pediatrics
Disease-Free Survival
Confidence Intervals
Neoplasms
Positron-Emission Tomography
Magnetic Resonance Imaging

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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Correlation of 18F-FDG PET and MRI apparent Diffusion coefficient histogram metrics with survival in Diffuse intrinsic pontine glioma : A report from the peDiatric brain tumor consortium. / Zukotynski, Katherine A.; Vajapeyam, Sridhar; Fahey, Frederic H.; Kocak, Mehmet; Brown, Douglas; Ricci, Kelsey I.; Onar-Thomas, Arzu; FoulaDi, Maryam; Poussaint, Tina Young.

In: Journal of Nuclear Medicine, Vol. 58, No. 8, 01.08.2017, p. 1264-1269.

Research output: Contribution to journalArticle

Zukotynski, Katherine A. ; Vajapeyam, Sridhar ; Fahey, Frederic H. ; Kocak, Mehmet ; Brown, Douglas ; Ricci, Kelsey I. ; Onar-Thomas, Arzu ; FoulaDi, Maryam ; Poussaint, Tina Young. / Correlation of 18F-FDG PET and MRI apparent Diffusion coefficient histogram metrics with survival in Diffuse intrinsic pontine glioma : A report from the peDiatric brain tumor consortium. In: Journal of Nuclear Medicine. 2017 ; Vol. 58, No. 8. pp. 1264-1269.
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title = "Correlation of 18F-FDG PET and MRI apparent Diffusion coefficient histogram metrics with survival in Diffuse intrinsic pontine glioma: A report from the peDiatric brain tumor consortium",
abstract = "The purpose of this study was to describe baseline 18F-FDG PET voxel characteristics in peDiatric Diffuse intrinsic pontine glioma (DiPG) and to correlate these metrics with baseline MRI apparent Diffusion coefficient (ADC) histogram metrics, progression-free survival (PFS), and overall survival. Methods: Baseline brain 18F-FDG PET and MRI scans were obtained in 33 children from PeDiatric Brain Tumor Consortium clinical DiPG trials. 18F-FDG PET images, postgadoliniumMR images, and ADC MR images were registered to baseline fluid attenuation inversion recovery MR images. Three-Dimensional regions of interest on fluid attenuation inversion recovery MR images and postgadolinium MR images and 18F-FDG PET and MR ADC histograms were generated. Metrics evaluated included peak number, skewness, and kurtosis. Correlation between PET and MR ADC histogram metrics was evaluated. PET pixel values within the region of interest for each tumor were plotted against MR ADC values. The association of these imaging markers with survival was described. Results: PET histograms were almost always unimodal (94{\%}, vs. 6{\%} bimodal). None of the PET histogram parameters (skewness or kurtosis) had a significant association with PFS, although a higher PET postgadolinium skewness tended toward a less favorable PFS (hazard ratio, 3.48; 95{\%} confidence interval [CI], 0.75-16.28 [P 5 0.11]). There was a significant association between higher MR ADC postgadolinium skewness and shorter PFS (hazard ratio, 2.56; 95{\%} CI, 1.11-5.91 [P 5 0.028]), and there was the suggestion that this also led to shorter overall survival (hazard ratio, 2.18; 95{\%} CI, 0.95-5.04 [P 5 0.067]). Higher MR ADC postgadolinium kurtosis tended toward shorter PFS (hazard ratio, 1.30; 95{\%} CI, 0.98-1.74 [P 5 0.073]). PET and MR ADC pixel values were negatively correlated using the Pearson correlation coefficient. Further, the level of PET and MR ADC correlation was significantly positively associated with PFS; tumors with higher values of ADC-PET correlation had more favorable PFS (hazard ratio, 0.17; 95{\%} CI, 0.03-0.89 [P 5 0.036]), suggesting that a higher level of negative ADC-PET correlation leads to less favorable PFS. A more significant negative correlation may inDicate higher-grade elements within the tumor leaDing to poorer outcomes. Conclusion: 18F-FDG PET and MR ADC histogram metrics in peDiatric DiPG demonstrate Different characteristics with often a negative correlation between PET and MR ADC pixel values. A higher negative correlation is associated with a worse PFS, which may inDicate higher-grade elements within the tumor.",
author = "Zukotynski, {Katherine A.} and Sridhar Vajapeyam and Fahey, {Frederic H.} and Mehmet Kocak and Douglas Brown and Ricci, {Kelsey I.} and Arzu Onar-Thomas and Maryam FoulaDi and Poussaint, {Tina Young}",
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T1 - Correlation of 18F-FDG PET and MRI apparent Diffusion coefficient histogram metrics with survival in Diffuse intrinsic pontine glioma

T2 - A report from the peDiatric brain tumor consortium

AU - Zukotynski, Katherine A.

AU - Vajapeyam, Sridhar

AU - Fahey, Frederic H.

AU - Kocak, Mehmet

AU - Brown, Douglas

AU - Ricci, Kelsey I.

AU - Onar-Thomas, Arzu

AU - FoulaDi, Maryam

AU - Poussaint, Tina Young

PY - 2017/8/1

Y1 - 2017/8/1

N2 - The purpose of this study was to describe baseline 18F-FDG PET voxel characteristics in peDiatric Diffuse intrinsic pontine glioma (DiPG) and to correlate these metrics with baseline MRI apparent Diffusion coefficient (ADC) histogram metrics, progression-free survival (PFS), and overall survival. Methods: Baseline brain 18F-FDG PET and MRI scans were obtained in 33 children from PeDiatric Brain Tumor Consortium clinical DiPG trials. 18F-FDG PET images, postgadoliniumMR images, and ADC MR images were registered to baseline fluid attenuation inversion recovery MR images. Three-Dimensional regions of interest on fluid attenuation inversion recovery MR images and postgadolinium MR images and 18F-FDG PET and MR ADC histograms were generated. Metrics evaluated included peak number, skewness, and kurtosis. Correlation between PET and MR ADC histogram metrics was evaluated. PET pixel values within the region of interest for each tumor were plotted against MR ADC values. The association of these imaging markers with survival was described. Results: PET histograms were almost always unimodal (94%, vs. 6% bimodal). None of the PET histogram parameters (skewness or kurtosis) had a significant association with PFS, although a higher PET postgadolinium skewness tended toward a less favorable PFS (hazard ratio, 3.48; 95% confidence interval [CI], 0.75-16.28 [P 5 0.11]). There was a significant association between higher MR ADC postgadolinium skewness and shorter PFS (hazard ratio, 2.56; 95% CI, 1.11-5.91 [P 5 0.028]), and there was the suggestion that this also led to shorter overall survival (hazard ratio, 2.18; 95% CI, 0.95-5.04 [P 5 0.067]). Higher MR ADC postgadolinium kurtosis tended toward shorter PFS (hazard ratio, 1.30; 95% CI, 0.98-1.74 [P 5 0.073]). PET and MR ADC pixel values were negatively correlated using the Pearson correlation coefficient. Further, the level of PET and MR ADC correlation was significantly positively associated with PFS; tumors with higher values of ADC-PET correlation had more favorable PFS (hazard ratio, 0.17; 95% CI, 0.03-0.89 [P 5 0.036]), suggesting that a higher level of negative ADC-PET correlation leads to less favorable PFS. A more significant negative correlation may inDicate higher-grade elements within the tumor leaDing to poorer outcomes. Conclusion: 18F-FDG PET and MR ADC histogram metrics in peDiatric DiPG demonstrate Different characteristics with often a negative correlation between PET and MR ADC pixel values. A higher negative correlation is associated with a worse PFS, which may inDicate higher-grade elements within the tumor.

AB - The purpose of this study was to describe baseline 18F-FDG PET voxel characteristics in peDiatric Diffuse intrinsic pontine glioma (DiPG) and to correlate these metrics with baseline MRI apparent Diffusion coefficient (ADC) histogram metrics, progression-free survival (PFS), and overall survival. Methods: Baseline brain 18F-FDG PET and MRI scans were obtained in 33 children from PeDiatric Brain Tumor Consortium clinical DiPG trials. 18F-FDG PET images, postgadoliniumMR images, and ADC MR images were registered to baseline fluid attenuation inversion recovery MR images. Three-Dimensional regions of interest on fluid attenuation inversion recovery MR images and postgadolinium MR images and 18F-FDG PET and MR ADC histograms were generated. Metrics evaluated included peak number, skewness, and kurtosis. Correlation between PET and MR ADC histogram metrics was evaluated. PET pixel values within the region of interest for each tumor were plotted against MR ADC values. The association of these imaging markers with survival was described. Results: PET histograms were almost always unimodal (94%, vs. 6% bimodal). None of the PET histogram parameters (skewness or kurtosis) had a significant association with PFS, although a higher PET postgadolinium skewness tended toward a less favorable PFS (hazard ratio, 3.48; 95% confidence interval [CI], 0.75-16.28 [P 5 0.11]). There was a significant association between higher MR ADC postgadolinium skewness and shorter PFS (hazard ratio, 2.56; 95% CI, 1.11-5.91 [P 5 0.028]), and there was the suggestion that this also led to shorter overall survival (hazard ratio, 2.18; 95% CI, 0.95-5.04 [P 5 0.067]). Higher MR ADC postgadolinium kurtosis tended toward shorter PFS (hazard ratio, 1.30; 95% CI, 0.98-1.74 [P 5 0.073]). PET and MR ADC pixel values were negatively correlated using the Pearson correlation coefficient. Further, the level of PET and MR ADC correlation was significantly positively associated with PFS; tumors with higher values of ADC-PET correlation had more favorable PFS (hazard ratio, 0.17; 95% CI, 0.03-0.89 [P 5 0.036]), suggesting that a higher level of negative ADC-PET correlation leads to less favorable PFS. A more significant negative correlation may inDicate higher-grade elements within the tumor leaDing to poorer outcomes. Conclusion: 18F-FDG PET and MR ADC histogram metrics in peDiatric DiPG demonstrate Different characteristics with often a negative correlation between PET and MR ADC pixel values. A higher negative correlation is associated with a worse PFS, which may inDicate higher-grade elements within the tumor.

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