%0 Journal Article
%A Galldiks, N.
%A Langen, K.J.
%A Holy, R.
%A Pinkawa, M.
%A Stoffels, G.
%A Nolte, K.W.
%A Kaiser, H.J.
%A Filss, C.P.
%A Fink, G.R.
%A Coenen, H.H.
%A Eble, M.J.
%A Piroth, M.D.
%T Assessment of treatment response in patients with glioblastoma using [18F]Fluoroethyl-L-Tyrosine PET in comparison to MRI
%J Journal of nuclear medicine
%V 53
%N 7
%@ 0161-5505
%C New York, NY
%I Society of Nuclear Medicine
%M PreJuSER-21886
%P 1048-1057
%D 2012
%Z Record converted from VDB: 12.11.2012
%X The assessment of treatment response in glioblastoma is difficult with MRI because reactive blood-brain barrier alterations with contrast enhancement can mimic tumor progression. In this study, we investigated the predictive value of PET using O-(2-(18)F-fluoroethyl)-l-tyrosine ((18)F-FET PET) during treatment.In a prospective study, 25 patients with glioblastoma were investigated by MRI and (18)F-FET PET after surgery (MRI-/FET-1), early (7-10 d) after completion of radiochemotherapy with temozolomide (RCX) (MRI-/FET-2), and 6-8 wk later (MRI-/FET-3). Maximum and mean tumor-to-brain ratios (TBR(max) and TBR(mean), respectively) were determined by region-of-interest analyses. Furthermore, gadolinium contrast-enhancement volumes on MRI (Gd-volume) and tumor volumes in (18)F-FET PET images with a tumor-to-brain ratio greater than 1.6 (T(vol 1.6)) were calculated using threshold-based volume-of-interest analyses. The patients were grouped into responders and nonresponders according to the changes of these parameters at different cutoffs, and the influence on progression-free survival and overall survival was tested using univariate and multivariate survival analyses and by receiver-operating-characteristic analyses.Early after completion of RCX, a decrease of both TBR(max) and TBR(mean) was a highly significant and independent statistical predictor for progression-free survival and overall survival. Receiver-operating-characteristic analysis showed that a decrease of the TBR(max) between FET-1 and FET-2 of more than 20% predicted poor survival, with a sensitivity of 83% and a specificity of 67% (area under the curve, 0.75). Six to eight weeks later, the predictive value of TBR(max) and TBR(mean) was less significant, but an association between a decrease of T(vol 1.6) and PFS was noted. In contrast, Gd-volume changes had no significant predictive value for survival.In contrast to Gd-volumes on MRI, changes in (18)F-FET PET may be a valuable parameter to assess treatment response in glioblastoma and to predict survival time.
%K Adult
%K Aged
%K Brain Neoplasms: radionuclide imaging
%K Brain Neoplasms: therapy
%K Chemoradiotherapy
%K Contrast Media
%K Disease Progression
%K Disease-Free Survival
%K Female
%K Gadolinium
%K Glioblastoma: radionuclide imaging
%K Glioblastoma: therapy
%K Humans
%K Kaplan-Meier Estimate
%K Magnetic Resonance Imaging
%K Male
%K Middle Aged
%K Neurosurgical Procedures
%K Positron-Emission Tomography
%K Prognosis
%K Proportional Hazards Models
%K Prospective Studies
%K Radiopharmaceuticals: diagnostic use
%K Survival Analysis
%K Treatment Outcome
%K Tyrosine: analogs & derivatives
%K Tyrosine: diagnostic use
%K (18F)fluoroethyltyrosine (NLM Chemicals)
%K Contrast Media (NLM Chemicals)
%K Radiopharmaceuticals (NLM Chemicals)
%K Tyrosine (NLM Chemicals)
%K Gadolinium (NLM Chemicals)
%K J (WoSType)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:22645298
%U <Go to ISI:>//WOS:000306164600020
%R 10.2967/jnumed.111.098590
%U https://juser.fz-juelich.de/record/21886