マルヤマ　タカシ   MARUYAMA Takashi   丸山　隆志    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Differentiation of astrocytoma between grades II and III using a combination of methionine positron emission tomography and magnetic resonance spectroscopy.
掲載誌名	正式名：World neurosurgery: X 略　 称：World Neurosurg X ISSNコード：25901397/25901397
掲載区分	国外
巻・号・頁	19,pp.100193
著者・共著者	YANO Hirohito†, MIWA Kazuhiro, NAKAYAMA Noriyuki, MARUYAMA Takashi, OHE Naoyuki, IKUTA Soko, IKEGAME Yuka, YAMADA Tetsuya, TAKEI Hiroaki, OWASHI Etsuko, OHMURA Kazufumi, YOKOYAMA Kazutoshi, KUMAGAI Morio, MURAGAKI Yoshihiro, IWAMA Toru , SHINODA Jun
発行年月	2023/07
概要	OBJECTIVE:This study aimed to establish a method for differentiating between grades II and III astrocytomas using preoperative imaging.METHODS:We retrospectively analyzed astrocytic tumors, including 18 grade II astrocytomas (isocitrate dehydrogenase (IDH)-mutant: IDH-wildtype = 8:10) and 56 grade III anaplastic astrocytomas (37:19). We recorded the maximum methionine (MET) uptake ratios (tumor-to-normal: T/N) on positron emission tomography (PET) and three MRS peak ratios: choline (Cho)/creatine (Cr), N-acetyl aspartate (NAA)/Cr, and Cho/NAA, between June 2015 and June 2020. We then evaluated the cut-off values to differentiate between grades II and III. We compared the grading results between contrast enhancement effects on MR and combinational diagnostic methods (CDM) on a scatter chart using the cutoff values of the T/N ratio and MRS parameters.RESULTS:The IDH-mutant group showed significant differences in the Cho/NAA ratio between grades II and III using univariate analysis; however, multiple regression analysis results negated this. The IDH-wildtype group showed no significant differences between the groups. Contrast enhancement effects also showed no significant differences in IDH status. Accordingly, regardless of the IDH status, no statistically independent factors differentiated between grades II and III. However, CDMs showed higher sensitivity and negative predictive value in distinguishing them than MRI contrast examinations for both IDH statuses. We demonstrated a significantly higher diagnostic rate of grade III than of grade II with CDM, which was more striking in the IDH-mutant group than in the wild-type group.CONCLUSIONS:CDM could be valuable in differentiating between grade II and III astrocytic tumors.
DOI	10.1016/j.wnsx.2023.100193
PMID	37123626