Page 28 - 磁共振成像2024年7期电子刊

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 特别关注｜｜Special Focus
PET/MR专题｜｜临床研究
一体化 F-FET PET/MR术前评估成人胶质瘤患者
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MGMT基因启动子甲基化状态

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韩青青 ，李拓 ，林增萍 ，李恩慧 ，杨阳 ，刘家惠 ，邢浩 ，王裕 ，程欣 ，霍力 1, 5*
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作者单位 1.中国医学科学院 北京协和医学院 北京协和医院核医学科，北京 100730；2.上海联影医疗高新技术研究院有限公司，
上海 201807；3. 北京联影智能影像技术研究院，北京 100094；4. 中国医学科学院 北京协和医学院 北京协和医院神经外科，北京
100730；5.核医学分子靶向诊疗北京市重点实验室，北京 100730
* 通信作者 霍力，E-mail: huoli@pumch.cn
中图分类号 R445.2；R739.41；R817.4 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.004
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本文引用格式 韩青青, 李拓, 林增萍, 等 . 一体化 F-FET PET/MR术前评估成人胶质瘤患者 MGMT基因启动子甲基化状态[J]. 磁
共振成像, 2024, 15(7): 21-26.
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[摘要] 目的 旨在研究一体化 F-氟乙基酪氨酸（ F-fluoroethyltyrosine, F-FET）正电子发射断层成像（positron emission
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tomography, PET）/MR 对成人胶质瘤的 O6-甲基鸟嘌呤 DNA 甲基转移酶（O6-methylguanine DNA methyltransferase, MGMT）基
因启动子甲基化状态的鉴别能力。材料与方法 回顾性分析未经活检或治疗的胶质瘤患者资料 16例，均完成一体化 PET/MR扫
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描，包括 F-FET PET、常规 MRI及体素内不相干运动（intravoxel incoherent motion, IVIM）成像。以靶本比（target-background
ratio, TBR）=1.6为阈值对 PET图像进行感兴趣体积（volume of interest, VOI）分割，通过刚性配准获得肿瘤 VOI对应的 IVIM图
及 其 参 数 表 观 扩 散 系 数 （apparent diffusion coefficient, ADC）、 真 实 扩 散 系 数 （true diffusion coefficient, D）、 伪 扩 散 系 数
（pseudo diffusion coefficient, D ）、灌注分数（perfusion fraction, f）、分布扩散系数（distributed diffusion coefficient, DDC）和异质
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性指数（heterogeneity index, α），使用 pyradiomics对各参数进行特征提取，获得对应的一阶灰度直方图特征。计算每个 IVIM 参
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数图对应的特征值与 F-FET PET 参数的关系，并利用组间比较和受试者工作特征 （receive operating characteristic, ROC）曲线
分析探究 PET 和 IVIM 参数对 MGMT 启动子甲基化的区分能力。结果 IVIM-α 的两个特征值 90 分位值（r=0.526，P<0.05）和
最 大 值 （r=0.520， P<0.05） 与 PET 参 数 平 均 标 准 摄 取 值 （mean standard uptake value, SUVmean） 呈 正 相 关 ； IVIM- α 和
SUVmean 在 MGMT 启动子甲基化状态阳性和阴性两组之间的差异有统计学意义（P<0.05），阳性组的 IVIM-α 均值和 SUVmean
显著高于阴性组；融合 IVIM-α均值和 SUVmean对 MGMT启动子甲基化状态进行区分的曲线下面积（area under the curve, AUC）
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为0.77。结论 基于一体化PET/MR的 F-FET PET和IVIM参数能够有效预测胶质瘤的MGMT启动子甲基化状态。
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[关键词] 胶质瘤；O6-甲基鸟嘌呤-DNA 甲基转移酶启动子甲基化； F-氟乙基酪氨酸正电子发射断层成像；正电子发射断层
成像/磁共振；体素内不相干运动；磁共振成像
Preoperative assessment of MGMT gene promoter methylation status in adult high-grade glioma
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patients by integrated F-FET PET/MR
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HAN Qingqing , LI Tuo , LIN Zengping , LI Enhui , YANG Yang , LIU Jiahui , XING Hao , WANG Yu , CHENG Xin , HUO Li 1, 5*
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1 Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union
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Medical College, Beijing 100730, China; Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai 201807,
China; Beijing United Imaging Research Institute of Intelligent Imaging, Beijing 100094, China; Department of Neurosurgery, Peking
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Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
5 Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China
* Correspondence to HUO L, E-mail: huoli@pumch.cn
Received 27 Feb 2024, Accepted 8 Jul 2024; DOI 10.12015/issn.1674-8034.2024.07.004
ACKNOWLEDGMENTS Peking Union Medical College Hospital Centralized High-level Hospital Clinical Research Special Project
(No. 2022-PUMCH-A-019).
Cite this article as HAN Q Q, LI T, LIN Z P, et al. Preoperative assessment of MGMT gene promoter methylation status in adult
high-grade glioma patients by integrated F-FET PET/MR[J]. Chin J Magn Reson Imaging, 2024, 15(7): 21-26.
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Abstract Objective: To investigate the discriminative ability of integrated F-fluoroethyltyrosine ( F-FET) positron emission

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tomography (PET)/MR for O6-methylguanine DNA methyltransferase (MGMT) gene promoter methylation status in adult gliomas.
Materials and Methods: A total of 16 patients with unbiopsied or untreated gliomas were retrospectively enrolled to complete integrated
PET/MR scans, including F-FET PET, conventional MRI and intravoxel incoherent motion (IVIM) imaging. The volume of interest
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(VOI) segmentation of PET images was performed using target-background ratio (TBR) =1.6 as a threshold, and IVIM maps
corresponding to tumor VOI and their parameters, apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo diffusion
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coefficient (D ), perfusion fraction (f), distributed diffusion coefficient (DDC), and heterogeneity index (α), were obtained by rigid
alignment, and the corresponding first-order gray-scale histogram features were obtained by feature extraction of each parameter using
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pyradiomics. The eigenvalues corresponding to each IVIM parameter map were calculated in relation to the F-FET PET parameters, and
the ability of PET and IVIM parameters to discriminate MGMT promoter methylation was explored using between-group comparisons
and receiver operating characteristic (ROC) curve analysis. Results: The two eigenvalues 90th percentile (r=0.526, P<0.05) and
maximum (r=0.520, P<0.05) of IVIM-α were positively correlated with mean standard uptake value (SUVmean) of PET parameter; The
differences between IVIM- α and SUVmean in the two groups of positive and negative MGMT promoter methylation status were
收稿日期 2024-02-27 接受日期 2024-07-08
基金项目 北京协和医院中央高水平医院临床科研专项（编号：2022-PUMCH-A-019）
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