The Study On The Application Of The Patterns Of Intcrgration With MRI And11C-methionine PET In Preoperation Estimetation And Neuronavigation Assisted Operation Of Glioma

Objectiv In this study, through analysis of the clinical data of twenty-five patients in suspect of gliomas, we aimed to evaluate the patterns of intergration of MRI and11C-methionine PET in preoperation to delineate the boundaries of gliomas and their relationship to the histological grade, and to accumulate clinical experience of this technology in the clinical diagnosis and treatment of gliomas.METhods From April2011to September2012, twenty-five patients in suspect of gliomas were examined with both MRI and11C-methionine PET in preoperative. Images were transferred to the treatment planning system, coregistered and fused (BrainLAB). Tumour delineation was performed by11C-methionine PET threshold (vPET) and manual segment ationover MRI (vMRI). In order to express the contribution of each modality to the tumour volume, the percentages of discrepancy-PET (vPET not included in vMRI) and discrepancy-MRI (vMRI not included invPET) were evaluated on the fusion images. In most cases, the intraoperatively detected tumor boundary was conformal to the information provide by pet. All the cases were class All cases were surgically treated. the surgeon determine the location of the tumor in the navigation to determine the boundaries of the tumor, according to the microscopic tumor tissue and normal brain tissue color, texture, blood supply, and imaging were compared to determine the tumor margin。histological classification was performed according to WHO grades.Results There are three PET/MRI integration patterns emerged after analysis of volumetric data. One group of eight patients [six WHO Ⅱ gliomas (6/7) and two WHO Ⅲ gliomas (2/10)] with a vPET included in vMRI with a low discrepancy-PET, and another group of fifteen patients [one WHO II gliomas (1/7), six WHO III glioams (6/10) and eight WHO Ⅳ gliomas (8/8)] almost all of whose vMRI was included in vPET with a low discrepancy-MRI. The third group of two patients [two WHO III gliomas (2/10)] was vMRI-different-vPET.Conclusion PET/MRI integration patterns was able to accurately delineate tumor boundary and sensitively targeting the regaion of high proliferation or metabolism. Differences in11C-methionine PET/MRI integration patterns can be assigned to tumour grades according to the WHO classification. This finding may improve tumour delineation and therapy planning for gliomas. PET/CT has acquired great achievements both in scientific research and clinics. MRI is better than CT in many ways, so the research of MRI has become a hot topic. PET/MRI is a combination of molecular, morphological and functional information. PET/MRI will have a profound influence to molecular imaging.