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综   述||Reviews                       磁共振成像  2024年7月第15卷第7期  Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7


           胶质瘤氨基酸PET/MR多模态影像的

           肿瘤体积及空间分布研究进展

                1, 2
           李笑然 ,卢洁    1, 2*

           作者单位  1.首都医科大学宣武医院放射与核医学科,北京 100053;2.磁共振成像脑信息学北京市重点实验室,北京 100053
           * 通信作者  卢洁,E-mail: imaginglu@hotmail.com
           中图分类号  R445.2;R739.41;R817.4  文献标识码  A  DOI  10.12015/issn.1674-8034.2024.07.027
           本文引用格式  李笑然, 卢洁 . 胶质瘤氨基酸 PET/MR 多模态影像的肿瘤体积及空间分布研究进展[J]. 磁共振成像, 2024, 15(7):
           158-164.
           [摘要]  脑胶质瘤是成人最常见的原发恶性脑肿瘤,基于结构磁共振(magnetic resonance, MR)成像导航肿瘤手术切除是常规
           治疗方案。然而结构 MR 成像难以精准显示肿瘤的体积及空间分布,导致的肿瘤术后残留会缩短患者生存期。氨基酸正电子发
           射断层/磁共振(positron emission tomography/magnetic resonance, PET/MR)多模态影像显示的胶质瘤体积及空间分布存在重叠
           及差异,本文通过综述氨基酸 PET 与 MR 的结构、血流灌注及分子成像显示的胶质瘤体积及空间分布差异,探讨了多模态影像
           的肿瘤空间分布异质性,比较不同模态影像显示肿瘤空间分布的准确性,辅助临床制订 PET/MR 导航胶质瘤手术的最佳多模态
           影像组合,实现肿瘤最大化安全切除,提高患者预后生存质量,并且为未来进一步研究胶质瘤的分子生物学机制介导 PET/MR
           影像空间分布表征提供思路。
           [关键词]  胶质瘤;氨基酸正电子发射断层成像;磁共振成像;多模态影像;肿瘤体积;肿瘤空间分布
           Research progress of glioma volume and spatial distribution in amino acid PET/MR multimodal
           imaging
                   1, 2
           LI Xiaoran , LU Jie 1, 2*
                                                                                                     2
           1 Department  of  Radiology  and  Nuclear  Medicine,  Xuanwu  Hospital,  Capital  Medical  University,  Beijing  10053,  China;  Beijing  Key
           Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 10053, China
           * Correspondence to  LU J, E-mail: imaginglu@hotmail.com
           Received  24 May 2024, Accepted  6 Jul 2024; DOI  10.12015/issn.1674-8034.2024.07.027
           ACKNOWLEDGMENTS  National Key Research and Development Program of China (No. 2022YFC2406900).
           Cite this article as  LI X R, LU J. Research progress of glioma volume and spatial distribution in amino acid PET/MR multimodal
           imaging[J]. Chin J Magn Reson Imaging, 2024, 15(7): 158-164.

           Abstract  Gliomas  are  the  most  common  primary  malignant  brain  tumors  in  adults,  and  resection  of  tumours  based  on  structural
           magnetic resonance (MR) imaging is the conventional treatment. However, structural MR imaging is difficult to accurately demonstrate
           the volume and spatial distribution of the glioma, which leads to postoperative tumour residuals that may shorten the survival of patients.
           There are overlaps and differences in the volume and spatial distribution of gliomas shown by amino acid positron emission tomography/
           magnetic  resonance  (PET/MR)  multimodal  imaging.  This  paper  reviewed  the  differences  in  the  volume  and  spatial  distribution  of
           gliomas shown by amino acid PET and structure, perfusion, and molecular images of MR to explore the heterogeneity of tumour spatial
           distribution in multimodal images and compare the accuracy of spatial distribution of tumours in different modal images. It will assist
           developing the optimal multimodal image combination based on PET/MR for guiding glioma surgery, to maximize the safe resection of
           the  tumour  and  improve  the  prognosis  of  glioma  patients,  as  well  as  to  provide  insights  for  further  research  on  spatial  distribution
           characterization of PET/MR images mediated by the molecular biological mechanism of glioma.
           Key  words  gliomas;  amino  acid  positron  emission  tomography;  magnetic  resonance  imaging;  multimodal  imaging;  tumor  volume;
           tumor spatial distribution


           0 引言                                                瘤手术边界对改善患者预后至关重要                  [2-4] 。
               脑胶质瘤是成人最常见的原发恶性脑肿瘤,每                                 氨 基 酸 类 正 电 子 发 射 断 层(positron  emission
           10 万人约有 22.52 人患有原发性脑肿瘤,其中胶质瘤                       tomography, PET)成像的示踪剂能被胶质瘤细胞表
           在 20~59 岁原发脑肿瘤群体的占比约 31.1% 。基于                      面高表达的 L 型氨基酸转运体(L-type amino acid
                                                  [1]
           结构磁共振(magnetic resonance, MR)成像制订的手                 transporter, LAT)特异性摄取,且不受血脑屏障的限
           术切除范围(extent of resection, EOR)不能完全覆盖               制,具有高肿瘤靶本比(tumor background ratio, TBR)的
                                                                        [5-6]
           肿 瘤 活 性 区 域 ,导 致 异 柠 檬 酸 脱 氢 酶(isocitrate           显像特点 。基于氨基酸PET的多模态影像被广泛应
           dehydrogenase, IDH)野生型侵袭性胶质瘤患者仅有                    用于鉴别恶性脑肿瘤与非肿瘤病变、精准定位肿瘤生
                                                                                                      [7-9]
           14~17 个月中位生存期,但过度扩大化切除会影响神                          物活性区、预测胶质瘤分子分型及疗效评价 。近期
           经功能恢复,降低生存质量,因此术前精准定位胶质                             国内外学者也逐渐开展基于氨基酸PET的影像组学及


           收稿日期  2024-05-24  接受日期  2024-07-06
           基金项目  国家重点研发计划项目(编号:2022YFC2406900)

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