TY  - JOUR
AU  - Ceccon, G.
AU  - Lohmann, Philipp
AU  - Werner, Jan-Michael
AU  - Caroline, Tscherpel
AU  - Dunkl, Veronika
AU  - Stoffels, Gabriele
AU  - Rosen, Jurij
AU  - Rapp, Marion
AU  - Herrlinger, Ulrich
AU  - Schäfer, Niklas
AU  - Shah, N. J.
AU  - Fink, Gereon Rudolf
AU  - Langen, Karl-Josef
AU  - Galldiks, Norbert
TI  - Early treatment response assessment using $^{18}$F-FET PET compared to contrast-enhanced MRI in glioma patients after adjuvant temozolomide chemotherapy
JO  - Journal of nuclear medicine
VL  - 62
IS  - 7
SN  - 0022-3123
CY  - New York, NY
PB  - Soc.
M1  - FZJ-2020-04140
SP  - 918-925
PY  - 2021
AB  - 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.
LB  - PUB:(DE-HGF)16
C6  - pmid:33158907
UR  - <Go to ISI:>//WOS:000709477900011
DO  - DOI:10.2967/jnumed.120.254243
UR  - https://juser.fz-juelich.de/record/885860
ER  -