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000849952 1001_ $$0P:(DE-Juel1)143792$$aGalldiks, Norbert$$b0$$eCorresponding author
000849952 245__ $$aEarly treatment response evaluation using FET PET compared to MRI in glioblastoma patients at first progression treated with bevacizumab plus lomustine
000849952 260__ $$aHeidelberg [u.a.]$$bSpringer-Verl.$$c2018
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000849952 520__ $$aBackgroundThe goal of this prospective study was to compare the value of both conventional MRI and O-(2-18F-fluoroethyl)-L-tyrosine (FET) PET for response evaluation in glioblastoma patients treated with bevacizumab plus lomustine (BEV/LOM) at first progression.MethodsAfter chemoradiation with concomitant and adjuvant temozolomide, 21 IDH wild-type glioblastoma patients at first progression (age range, 33–75 years; MGMT promoter unmethylated, 81%) were treated with BEV/LOM. Contrast-enhanced MRI and FET-PET scans were performed at baseline and after 8–10 weeks. We obtained FET metabolic tumor volumes (MTV) and tumor/brain ratios. Threshold values of FET-PET parameters for treatment response were established by ROC analyses using the post-progression overall survival (OS) ≤/>9 months as the reference. MRI response assessment was based on RANO criteria. The predictive ability of FET-PET thresholds and MRI changes on early response assessment was evaluated subsequently concerning OS using uni- and multivariate survival estimates.ResultsEarly treatment response as assessed by RANO criteria was not predictive for an OS>9 months (P = 0.203), whereas relative reductions of all FET-PET parameters significantly predicted an OS>9 months (P < 0.05). The absolute MTV at follow-up enabled the most significant OS prediction (sensitivity, 85%; specificity, 88%; P = 0.001). Patients with an absolute MTV below 5 ml at follow-up survived significantly longer (12 vs. 6 months, P < 0.001), whereas early responders defined by RANO criteria lived only insignificantly longer (9 vs. 6 months; P = 0.072). The absolute MTV at follow-up remained significant in the multivariate survival analysis (P = 0.006).ConclusionsFET-PET appears to be useful for identifying responders to BEV/LOM early after treatment initiation.
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000849952 7001_ $$0P:(DE-Juel1)156211$$aDunkl, Veronika$$b1
000849952 7001_ $$0P:(DE-HGF)0$$aCeccon, Garry$$b2
000849952 7001_ $$0P:(DE-Juel1)171739$$aTscherpel, Caroline$$b3
000849952 7001_ $$0P:(DE-Juel1)131627$$aStoffels, Gabriele$$b4
000849952 7001_ $$0P:(DE-HGF)0$$aLaw, Ian$$b5
000849952 7001_ $$0P:(DE-HGF)0$$aHenriksen, Otto M.$$b6
000849952 7001_ $$0P:(DE-HGF)0$$aMuhic, Aida$$b7
000849952 7001_ $$0P:(DE-HGF)0$$aPoulsen, Hans S.$$b8
000849952 7001_ $$0P:(DE-HGF)0$$aSteger, Jan$$b9
000849952 7001_ $$0P:(DE-HGF)0$$aBauer, Elena K.$$b10
000849952 7001_ $$0P:(DE-Juel1)145110$$aLohmann, Philipp$$b11
000849952 7001_ $$0P:(DE-HGF)0$$aSchmidt, Matthias$$b12
000849952 7001_ $$0P:(DE-Juel1)131794$$aShah, Nadim J.$$b13
000849952 7001_ $$0P:(DE-Juel1)131720$$aFink, Gereon R.$$b14
000849952 7001_ $$0P:(DE-Juel1)131777$$aLangen, Karl-Josef$$b15
000849952 773__ $$0PERI:(DE-600)2098375-X$$a10.1007/s00259-018-4082-4$$n13$$p2377–2386$$tEuropean journal of nuclear medicine and molecular imaging$$v45$$x0340-6997$$y2018
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