TY  - JOUR
AU  - Galldiks, Norbert
AU  - Dunkl, Veronika
AU  - Ceccon, Garry
AU  - Tscherpel, Caroline
AU  - Stoffels, Gabriele
AU  - Law, Ian
AU  - Henriksen, Otto M.
AU  - Muhic, Aida
AU  - Poulsen, Hans S.
AU  - Steger, Jan
AU  - Bauer, Elena K.
AU  - Lohmann, Philipp
AU  - Schmidt, Matthias
AU  - Shah, Nadim J.
AU  - Fink, Gereon R.
AU  - Langen, Karl-Josef
TI  - Early treatment response evaluation using FET PET compared to MRI in glioblastoma patients at first progression treated with bevacizumab plus lomustine
JO  - European journal of nuclear medicine and molecular imaging
VL  - 45
IS  - 13
SN  - 0340-6997
CY  - Heidelberg [u.a.]
PB  - Springer-Verl.
M1  - FZJ-2018-04047
SP  - 2377–2386
PY  - 2018
AB  - BackgroundThe 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.
LB  - PUB:(DE-HGF)16
C6  - pmid:29982845
UR  - <Go to ISI:>//WOS:000450713500016
DO  - DOI:10.1007/s00259-018-4082-4
UR  - https://juser.fz-juelich.de/record/849952
ER  -