Go Back This article was viewed 25 times

Technical innovations in imaging sciences


Normalized Subtraction of Serial Brain Magnetic Resonance Images and Fludeoxyglucose-Positron Emission Tomography Images for Tumor Treatment Monitoring: Case Report and Method Description.

Nghi C Nguyen1Medhat M Osman2
1Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, 2Department of Radiology, Saint Louis University, Saint Louis, Missouri, United States
Date of Submission: 05-Mar-2018, Date of Acceptance: 19-Apr-2018, Date of Web Publication: 28-Jun-2018.
Corresponding Author:
Corresponding Author

Nghi C Nguyen

Department of Radiology, University of Pittsburgh/UPMC Presbyterian, 200 Lothrop Street, East Wing,Suite 200, Pittsburgh, PA, USA.
E-mail: nncc.nguyen@gmail.com

Corresponding Author:
Corresponding Author

Nghi C Nguyen

Department of Radiology, University of Pittsburgh/UPMC Presbyterian, 200 Lothrop Street, East Wing,Suite 200, Pittsburgh, PA, USA.
E-mail: nncc.nguyen@gmail.com

DOI: 10.4103/jcis.JCIS_14_18 Facebook Twitter Google Linkedin

ABSTRACT


A 60-year-old Caucasian male with a long history of cigarette smoking was diagnosed with epidermal growth factor receptor-mutation negative lung adenocarcinoma. The single cerebral metastasis in the right frontal lobe was treated with stereotactic radiosurgery and systemic chemotherapies. Normalized subtraction (NS) method was used to evaluate the serial brain magnetic resonance (MR) and fludeoxyglucose-positron emission tomography (FDG-PET) findings retrospectively, and the potential benefit of concurrent NS of serial MR images (MRIs) and PET images was demonstrated. MIM 4.1 (MIM Software Inc., Cleveland, OH) was used to co-register MRI with PET data and to perform NS on the serial MRI and PET data. MIM 4.1 provides fully automated alignment of imaging data by maximization of mutual information. Cortical regions distant from the brain lesion were used to adjust for the intensity differences between scans, so the voxel differences in normal brain regions were near zero in the NS images. A difference of 15% or greater in voxel densities was used for both MRI and PET, above or below which a change in MR signal intensity and FDG avidity was considered significant. The use of NS, in this case, allowed for an enhanced correlation of morphologic and functional information, which may have added value in the early treatment monitoring of brain tumors and help distinguish recurrent tumor from postradiation changes.
Keywords: Brain tumor, fludeoxyglucose positron emission tomography, magnetic resonance imaging, normalized subtraction, treatment monitoring

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.