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@ARTICLE{Galldiks:849952,
author = {Galldiks, Norbert and Dunkl, Veronika and Ceccon, Garry and
Tscherpel, Caroline and Stoffels, Gabriele and Law, Ian and
Henriksen, Otto M. and Muhic, Aida and Poulsen, Hans S. and
Steger, Jan and Bauer, Elena K. and Lohmann, Philipp and
Schmidt, Matthias and Shah, Nadim J. and Fink, Gereon R. and
Langen, Karl-Josef},
title = {{E}arly treatment response evaluation using {FET} {PET}
compared to {MRI} in glioblastoma patients at first
progression treated with bevacizumab plus lomustine},
journal = {European journal of nuclear medicine and molecular imaging},
volume = {45},
number = {13},
issn = {0340-6997},
address = {Heidelberg [u.a.]},
publisher = {Springer-Verl.},
reportid = {FZJ-2018-04047},
pages = {2377–2386},
year = {2018},
abstract = {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.},
cin = {INM-3 / INM-4},
ddc = {610},
cid = {I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-4-20090406},
pnm = {572 - (Dys-)function and Plasticity (POF3-572)},
pid = {G:(DE-HGF)POF3-572},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:29982845},
UT = {WOS:000450713500016},
doi = {10.1007/s00259-018-4082-4},
url = {https://juser.fz-juelich.de/record/849952},
}