Objective: To examine 11C methyl methionine (MET) accumulation on positron em ission tomographic (PET) imaging of glioblastoma multiforme to determine the dis tribution of metabolic abnormality compared with magnetic ...Objective: To examine 11C methyl methionine (MET) accumulation on positron em ission tomographic (PET) imaging of glioblastoma multiforme to determine the dis tribution of metabolic abnormality compared with magnetic resonance imaging (MRI ). Methods: Contemporaneous MRI was superimposed on corresponding MET PET image s in 10 patients with newly diagnosed glioblastoma multiforme before treatment. Differ ences between the extended area of MET accumulation on PET imaging (MET area), the gadolinium (Gd) enhanced area on T1 weighted images (Gd area), and th e abnormal high signal intensity area on T2 weighted images (T2 high area) were assessed. Results: The MET area was larger than the Gd area and included the en tire Gd area. The discrepancy in volume between the MET and Gd areas became grea ter with increasing tumour diameter. On average, 58.6%of the METareawas located within the Gd area, 90.1%within 10 mm outside the Gd area, 98.1%within 20 mm, and 99.8%within 30 mm. A newly developed Gd area had emerged in five of the 10 cases up to the time of study. In three of the five cases this was in the MET a rea even after complete surgical resection of the Gd area on the initial MRI; in the remaining two it originated in the residual Gd area after surgery. In all c ases, the T2 high area was larger than the MET area. The MET area extended part ly beyond the T2 high area in nine cases, and was completely within it in one. Conclusions: Glioblastoma multiforme cells may extend over the Gd area and more widely with increasing tumour size on Gd MRI. The T2 high area includes the gr eater part of the tumour but not its entire area. The methods reported may be us eful in planning surgical resection, biopsy, or radiosurgery.展开更多
Whereas the effect of interferons (IFNs) on magnetic resonance imaging (MRI) outcome measures in patients with multiple sclerosis (MS) has been convincingly shown, little work has been done to define the between-patie...Whereas the effect of interferons (IFNs) on magnetic resonance imaging (MRI) outcome measures in patients with multiple sclerosis (MS) has been convincingly shown, little work has been done to define the between-patient heterogeneity of treatment response. Our aim was to assess the distribution of the effect of IFNβ - 1b in terms of reduction of active T2 lesions in patients with MS. Using a fixed and a random effects model, we investigated the distribution of active T2 lesions reduction over a three-year follow up in response to treatment with 250 mcg IFNβ -1b every other day in 695 patients with a complete MRI data-set of the 718 (97 % ) enrolled in the European, multicenter, randomised, double-blind, placebo-controlled trial of secondary progressive MS. The two statistical models consistently showed that the between-patient response to IFNβ -1b, in terms of reduction of active T2 lesions, is highly heterogeneous. Whereas treated patients have a high probability (more than 65 % ) of showing an active T2 lesion reduction equal to or greater than 60 % , there is also a 7 % probability for treated patients not to show any reduction of MRI-detected disease activity during the course of the trial or even to have an increase of T2 active lesions. This study might be regarded as a first step toward the definition of markers potentially useful to identify IFNβ treatment responders and non-responders with regard to T2 lesion activity.展开更多
文摘Objective: To examine 11C methyl methionine (MET) accumulation on positron em ission tomographic (PET) imaging of glioblastoma multiforme to determine the dis tribution of metabolic abnormality compared with magnetic resonance imaging (MRI ). Methods: Contemporaneous MRI was superimposed on corresponding MET PET image s in 10 patients with newly diagnosed glioblastoma multiforme before treatment. Differ ences between the extended area of MET accumulation on PET imaging (MET area), the gadolinium (Gd) enhanced area on T1 weighted images (Gd area), and th e abnormal high signal intensity area on T2 weighted images (T2 high area) were assessed. Results: The MET area was larger than the Gd area and included the en tire Gd area. The discrepancy in volume between the MET and Gd areas became grea ter with increasing tumour diameter. On average, 58.6%of the METareawas located within the Gd area, 90.1%within 10 mm outside the Gd area, 98.1%within 20 mm, and 99.8%within 30 mm. A newly developed Gd area had emerged in five of the 10 cases up to the time of study. In three of the five cases this was in the MET a rea even after complete surgical resection of the Gd area on the initial MRI; in the remaining two it originated in the residual Gd area after surgery. In all c ases, the T2 high area was larger than the MET area. The MET area extended part ly beyond the T2 high area in nine cases, and was completely within it in one. Conclusions: Glioblastoma multiforme cells may extend over the Gd area and more widely with increasing tumour size on Gd MRI. The T2 high area includes the gr eater part of the tumour but not its entire area. The methods reported may be us eful in planning surgical resection, biopsy, or radiosurgery.
文摘Whereas the effect of interferons (IFNs) on magnetic resonance imaging (MRI) outcome measures in patients with multiple sclerosis (MS) has been convincingly shown, little work has been done to define the between-patient heterogeneity of treatment response. Our aim was to assess the distribution of the effect of IFNβ - 1b in terms of reduction of active T2 lesions in patients with MS. Using a fixed and a random effects model, we investigated the distribution of active T2 lesions reduction over a three-year follow up in response to treatment with 250 mcg IFNβ -1b every other day in 695 patients with a complete MRI data-set of the 718 (97 % ) enrolled in the European, multicenter, randomised, double-blind, placebo-controlled trial of secondary progressive MS. The two statistical models consistently showed that the between-patient response to IFNβ -1b, in terms of reduction of active T2 lesions, is highly heterogeneous. Whereas treated patients have a high probability (more than 65 % ) of showing an active T2 lesion reduction equal to or greater than 60 % , there is also a 7 % probability for treated patients not to show any reduction of MRI-detected disease activity during the course of the trial or even to have an increase of T2 active lesions. This study might be regarded as a first step toward the definition of markers potentially useful to identify IFNβ treatment responders and non-responders with regard to T2 lesion activity.
