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. 2017 Dec 5;12(12):e0189093.
doi: 10.1371/journal.pone.0189093. eCollection 2017.

Does elevated glucose metabolism correlate with higher cell density in Neurofibromatosis type 1 associated peripheral nerve sheath tumors?

Dominik Berzaczy  1 , Marius E Mayerhoefer  1 , Amedeo A Azizi  2 , Alexander R Haug  3 , Daniela Senn  3 , Dietrich Beitzke  1 , Michael Weber  1 , Tatjana Traub-Weidinger  3
Affiliations

Does elevated glucose metabolism correlate with higher cell density in Neurofibromatosis type 1 associated peripheral nerve sheath tumors?

Dominik Berzaczy et al. PLoS One. .

Abstract

Purpose: To investigate whether elevated glucose metabolism in neurofibroma, determined by [F18]-FDG-PET, is correlated with cell density in MRI, as expressed through the apparent diffusion coefficient.

Materials and methods: Patients diagnosed with neurofibromatosis type 1 and peripheral nerve sheath tumors (PNST) were enrolled in this prospective, IRB-approved study. After a single [F18]-FDG injection, patients consecutively underwent [F18]-FDG-PET/CT and [F18]-FDG-PET/MRI on the same day. Maximum and mean standardized uptake values (SUVmax, SUVmean) on [F18]-FDG-PET/CT and [F18]-FDG-PET/MRI were compared, and correlated with minimum and mean apparent diffusion coefficients (ADCmean, ADCmin).

Results: A total of 12 (6 male/6 female, mean age was 16.2 ± 5.2 years) patients were prospectively included and analyzed on a per-lesion (n = 39) basis. The SUVmean of examined PNST showed a moderate negative correlation with the ADCmean (r = -.441) and ADCmin (r = -.477), which proved to be statistically significant (p = .005 and p = .002). The SUVmax of the respective lesions, however, showed a weaker negative correlation for ADCmean (r: -.311) and ADCmin (r: -.300) and did not reach statistical significance (p = .054 and p = .057). Lesion-based correlation between [F18]-FDG-PET/MRI and [F18]-FDG-PET/CT showed a moderate correlation for SUVmax (r = .353; p = .027) and a strong one for SUVmean (r = .879; p = .001)). Patient-based liver uptake (SUVmax and mean) of [F18]-FDG-PET/MRI and [F18]-FDG-PET/CT were strongly positively correlated (r = .827; p < .001 and r = .721; p < .001) but differed significantly (p < .001).

Conclusions: We found a statistically significant, negative correlation between glucose metabolism and cell density in PNST. Thus, ADCmean and ADCmin could possibly add complimentary information to the SUVmax and SUVmean and may serve as a potential determinant of malignant transformation of PNST.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Correlation of glucose metabolism and cell density in PET/MRI.
(A and B) SUVmean showed a moderate, inverse correlation to ADC mean and min. (C and D) SUVmax showed a weak inverse correlation for and ADC mean and min.
Fig 2
Fig 2. Correlation of the PET component of PET/MRI and PET/CT.
(A) SUVmean showed a strong positive correlation and (B) SUVmax a moderate positive correlation for PET/MRI and PET/CT. (C and D) SUV mean and max showed a strong positive correlation for patient-based liver uptake.
Fig 3
Fig 3. PNST in a 17-year male patient.
(A) Peripheral nerve sheath tumor depicted on CE-CT image with (B) increased glucose metabolism. (C) Corresponding T1w image. (D) [18F]-FDG-PET depicting increased glucose uptake and corresponding restricted diffusion on (E) DWI (b800) image with (F) lowered signal on the ADC map.
Fig 4
Fig 4. PNST in a 22 -year male patient.
(A) CE-CT image and corresponding (B) PET image with no pathological glucose uptake. (C) T1w image and corresponding (D) PET images with also no abnormal focal tracer uptake. (E) DWI (b800) and (F) ADC maps showing restricted diffusion but high signal on the ADC map.
See this image and copyright information in PMC

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