Journal Article

FZJ-2020-04140

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Early treatment response assessment using $^{18}$F-FET PET compared to contrast-enhanced MRI in glioma patients after adjuvant temozolomide chemotherapy

Ceccon, G. ; Lohmann, P.FZJ* ; Werner, J.-M. ; Caroline, T. ; Dunkl, V. ; Stoffels, G.FZJ* ; Rosen, J. ; Rapp, M. ; Herrlinger, U. ; Schäfer, N. ; Shah, N. J.FZJ* ; Fink, G. R.FZJ* ; Langen, K.-J.FZJ* ; Galldiks, N. (Corresponding author)FZJ*

2021
Soc. New York, NY

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Please use a persistent id in citations: http://hdl.handle.net/2128/28689  doi:10.2967/jnumed.120.254243

Abstract: The goal of this study was to compare the value of contrast-enhanced MRI and O-(2-[18F]fluoroethyl)-l-tyrosine (18F-FET) PET for response assessment in glioma patients after adjuvant temozolomide chemotherapy (TMZ). Methods: After biopsy or resection and completion of radiotherapy with concomitant TMZ, 41 newly diagnosed and histomolecularly characterized glioma patients (glioblastoma, 90%; age range, 20–79 y) were subsequently treated with adjuvant TMZ. MR and 18F-FET PET imaging were performed at baseline and after the second cycle of adjuvant TMZ. We obtained 18F-FET metabolic tumor volumes (MTVs) as well as mean and maximum tumor-to-brain ratios (TBRmean and TBRmax, respectively). Threshold values of 18F-FET PET parameters to predict outcome were established by receiver-operating-characteristic analyses using a median progression-free survival (PFS) of ≥ 9 mo and overall survival (OS) of ≥ 15 mo as reference. MRI response assessment was based on the Response Assessment in Neuro-Oncology (RANO) working group criteria. The predictive value of changes of 18F-FET PET and MRI parameters on survival was evaluated subsequently using univariate and multivariate survival estimates. Results: After 2 cycles of adjuvant TMZ chemotherapy, a treatment-induced reduction of MTV and TBRmax predicted a significantly longer PFS and OS (both P ≤ 0.03; univariate survival analyses) whereas RANO criteria were not significant (P > 0.05). Multivariate survival analysis revealed that TBRmax changes predicted a prolonged PFS (P = 0.012) and changes of MTV a prolonged OS (P = 0.005) independent of O6-methylguanine-DNA-methyltransferase promoter methylation and other strong prognostic factors. Conclusion: Changes of 18F-FET PET parameters appear to be helpful for identifying responders to adjuvant TMZ early after treatment initiation.

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Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)
2. Physik der Medizinischen Bildgebung (INM-4)

Research Program(s):

1. 572 - (Dys-)function and Plasticity (POF3-572) (POF3-572)
2. 5253 - Neuroimaging (POF4-525) (POF4-525)

Appears in the scientific report 2021

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Database coverage:
; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Essential Science Indicators ; IF >= 5 ; JCR ; NCBI Molecular Biology Database ; PubMed Central ; SCOPUS ; Science Citation Index ; Science Citation Index Expanded ; Web of Science Core Collection

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