%0 Journal Article
%A Ceccon, G.
%A Lohmann, Philipp
%A Werner, Jan-Michael
%A Caroline, Tscherpel
%A Dunkl, Veronika
%A Stoffels, Gabriele
%A Rosen, Jurij
%A Rapp, Marion
%A Herrlinger, Ulrich
%A Schäfer, Niklas
%A Shah, N. J.
%A Fink, Gereon Rudolf
%A Langen, Karl-Josef
%A Galldiks, Norbert
%T Early treatment response assessment using $^{18}$F-FET PET compared to contrast-enhanced MRI in glioma patients after adjuvant temozolomide chemotherapy
%J Journal of nuclear medicine
%V 62
%N 7
%@ 0022-3123
%C New York, NY
%I Soc.
%M FZJ-2020-04140
%P 918-925
%D 2021
%X 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.
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:33158907
%U <Go to ISI:>//WOS:000709477900011
%R 10.2967/jnumed.120.254243
%U https://juser.fz-juelich.de/record/885860