Journal Article

FZJ-2025-03929

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Prediction of progression-free andoverall survival following temozolomide chemoradiation using FET PET-base,d parameter.s including radiomics in patients with glio blastorna

Stetter, I. ; Werner, J.-M. ; Wollring, M. ; Ceccon, G. ; Ciantar, K. G.FZJ* ; Stoffels, G.FZJ* ; Mottaghy, F. M.FZJ* ; Fink, G. R.FZJ* ; Langen, K.-J.FZJ* ; Lohmann, P.FZJ* ; Galldiks, N. (Corresponding author)FZJ*

2025
Oxford University Press Oxford

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Please use a persistent id in citations: doi:10.1093/noajnl/vdaf196  doi:10.34734/FZJ-2025-03929

Abstract: Background: Early after surgery and completion of first-line radiotherapy with concomitant temozolomide, the prediction of progression-free and overall survival (PFS, OS) is of considerable interest for managing patients with glioblastoma.Methods: Sixty-three newly diagnosed patients with glioblastoma (age range, 19-82 years) who received PET imaging using the radiolabeled amino acid O-(2-[18F]fluoroethyl)-L-tyrosine (FET) after surgery or biopsy and completion of radiotherapy with concomitant temozolomide were evaluated. Static FET PET parameters, that is, maximum and mean tumor-to-brain ratios (TBRmax, TBRmean), metabolic tumor volumes (MTV), and the dynamic FET PET parameters time-to-peak (TTP) and slope were obtained. Additionally, n = 1,303 FET PET radiomics features were extracted per patient, of which 15 robust features were selected for further evaluation based on test-retest analysis. The prognostic values of FET PET parameters and radiomics features were evaluated using receiver-operating-characteristic (ROC) analyses regarding a favorable PFS and OS. Subsequently, univariate and multivariate survival estimates were performed to assess the prognostic value of these parameters in predicting a significantly longer PFS and OS.Results: ROC analyses revealed that static parameters (ie, TBRmax, MTV) and one radiomics feature were the most powerful parameters to predict a significantly longer PFS (all P = .002) and OS (all P ≤ .02). In addition, the dynamic parameter TTP predicted a significantly longer OS (P ≤ .03) but not PFS (P > .05). TBRmax, MTV, and one radiomics feature remained significant in multivariate survival analysis (all P ≤ .03).Conclusion: Our results suggest that FET PET parameters, including radiomics, are highly prognostic in patients with glioblastoma at an early stage of first-line therapy.Keywords: artificial intelligence; glioma; prognosis.

Note: supported by the Deutsche Forschungsgemeinschaft project number 428090865/SPP2177 (Norbert Galldiks, Philipp Lohmann, Keith George Ciantar)

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Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)

Research Program(s):

1. 5252 - Brain Dysfunction and Plasticity (POF4-525) (POF4-525)
2. DFG project G:(GEPRIS)428090865 - Radiomics basierend auf MRT und Aminosäure PET in der Neuroonkologie (428090865) (428090865)

Appears in the scientific report 2025

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