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@ARTICLE{Wollring:910206,
author = {Wollring, Michael M and Werner, Jan-Michael and Bauer,
Elena K and Tscherpel, Caroline and Ceccon, Garry S and
Lohmann, Philipp and Stoffels, Gabriele and Langen,
Karl-Josef and Kabbasch, Christoph and Goldbrunner, Roland
and Fink, Gereon R and Galldiks, Norbert},
title = {{P}rediction of response to lomustine-based chemotherapy in
glioma patients at recurrence using {MRI} and {FET} {PET}},
journal = {Neuro-Oncology},
volume = {25},
number = {5},
issn = {1522-8517},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {FZJ-2022-03683},
pages = {984–994},
year = {2023},
abstract = {BackgroundWe evaluated O-(2-[18F]fluoroethyl)-l-tyrosine
(FET) PET and MRI for early response assessment in recurrent
glioma patients treated with lomustine-based
chemotherapy.MethodsThirty-six adult patients with WHO CNS
grade 3 or 4 gliomas (glioblastoma, $69\%)$ at recurrence
(median number of recurrences, 1; range, 1–3) were
retrospectively identified. Besides MRI, serial FET PET
scans were performed at baseline and early after
chemotherapy initiation (not later than two cycles).
Tumor-to-brain ratios (TBR), metabolic tumor volumes (MTV),
the occurrence of new distant hotspots with a mean TBR >1.6
at follow-up, and the dynamic parameter time-to-peak were
derived from all FET PET scans. PET parameter thresholds
were defined using ROC analyses to predict PFS of ≥6
months and OS of ≥12 months. MRI response assessment was
based on RANO criteria. The predictive values of FET PET
parameters and RANO criteria were subsequently evaluated
using univariate and multivariate survival
estimates.ResultsAfter treatment initiation, the median
follow-up time was 11 months (range, 3–71 months).
Relative changes of TBR, MTV, and RANO criteria predicted a
significantly longer PFS (all P ≤ .002) and OS (all P ≤
.045). At follow-up, the occurrence of new distant hotspots
(n ≥ 1) predicted a worse outcome, with significantly
shorter PFS (P = .005) and OS (P < .001). Time-to-peak
changes did not predict a significantly longer survival.
Multivariate survival analyses revealed that new distant
hotspots at follow-up FET PET were most potent in predicting
non-response (P < .001; HR, 8.578).ConclusionsData suggest
that FET PET provides complementary information to RANO
criteria for response evaluation of lomustine-based
chemotherapy early after treatment initiation.},
cin = {INM-4 / INM-3},
ddc = {610},
cid = {I:(DE-Juel1)INM-4-20090406 / I:(DE-Juel1)INM-3-20090406},
pnm = {5253 - Neuroimaging (POF4-525) / 5251 - Multilevel Brain
Organization and Variability (POF4-525) / 5252 - Brain
Dysfunction and Plasticity (POF4-525)},
pid = {G:(DE-HGF)POF4-5253 / G:(DE-HGF)POF4-5251 /
G:(DE-HGF)POF4-5252},
typ = {PUB:(DE-HGF)16},
pubmed = {36215231},
UT = {WOS:000881636600001},
doi = {10.1093/neuonc/noac229},
url = {https://juser.fz-juelich.de/record/910206},
}