Universität zu Köln

Kebir, Sied, Fimmers, Rolf, Galldiks, Norbert ORCID: 0000-0002-2485-1796, Schaefer, Niklas, Mack, Frederic, Schaub, Christina, Stuplich, Moritz, Niessen, Michael, Tzaridis, Theophilos, Simon, Matthias, Stoffels, Gabriele ORCID: 0000-0001-7114-1941, Langen, Karl-Josef ORCID: 0000-0003-1101-5075, Scheffler, Bjoern, Glas, Martin and Herrlinger, Ulrich (2016). Late Pseudoprogression in Glioblastoma: Diagnostic Value of Dynamic O-(2-[F-18]fluoroethyl)-L-Tyrosine PET. Clin. Cancer Res., 22 (9). S. 2190 - 2197. PHILADELPHIA: AMER ASSOC CANCER RESEARCH. ISSN 1557-3265

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Abstract

Purpose: Pseudoprogression (PsP) is characterized by therapy-associated but not tumor growth-associated increases of contrast-enhancing glioblastoma lesions on MRI. Although typically occurring during the first 3 months after radiochemotherapy, PsP may occur later in the course of the disease and may then be particularly difficult to distinguish from true tumor progression. We explored PET using O-(2-[F-18] fluoroethyl)-L-tyrosine (F-18-FET-PET) to approach the diagnostic dilemma. Experimental Design: Twenty-six patients with glioblastoma that presented with increasing contrast-enhancing lesions later than 3 months after completion of radiochemotherapy underwent F-18-FET-PET. Maximum and mean tumor/ brain ratios (TBRmax and TBRmean) of F-18-FET uptake as well as time-to-peak (TTP) and patterns of the time-activity curves were determined. The final diagnosis of true progression versus late PsP was based on follow-up MRI using RANO criteria. Results: Late PsP occurred in 7 patients with a median time from radiochemotherapy completion of 24 weeks while the remaining patients showed true tumor progression. TBRmax and TBRmean were significantly higher in patients with true progression than in patients with late PsP (TBRmax 2.4 +/- 0.1 vs. 1.5 +/- 0.2, P = 0.003; TBRmean 2.1 +/- 0.1 vs. 1.5 +/- 0.2, P = 0.012) whereas TTP was significantly shorter (mean TTP 25 +/- 2 vs. 40 +/- 2 min, P < 0.001). ROC analysis yielded an optimal cutoff value of 1.9 for TBRmax to differentiate between true progression and late PsP (sensitivity 84%, specificity 86%, accuracy 85%, P = 0.015). Conclusions: O-(2-[F-18] fluoroethyl)-L-tyrosine PET provides valuable information in assessing the elusive phenomenon of late PsP. 6. (C) 2015 AACR.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kebir, Sied UNSPECIFIED UNSPECIFIED UNSPECIFIED Fimmers, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Schaefer, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Mack, Frederic UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaub, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Stuplich, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Niessen, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Tzaridis, Theophilos UNSPECIFIED UNSPECIFIED UNSPECIFIED Simon, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED orcid.org/0000-0001-7114-1941 UNSPECIFIED Langen, Karl-Josef UNSPECIFIED orcid.org/0000-0003-1101-5075 UNSPECIFIED Scheffler, Bjoern UNSPECIFIED UNSPECIFIED UNSPECIFIED Glas, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrlinger, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-276981
DOI:	10.1158/1078-0432.CCR-15-1334
Journal or Publication Title:	Clin. Cancer Res.
Volume:	22
Number:	9
Page Range:	S. 2190 - 2197
Date:	2016
Publisher:	AMER ASSOC CANCER RESEARCH
Place of Publication:	PHILADELPHIA
ISSN:	1557-3265
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FET PET; MALIGNANT GLIOMA; F-18-FET PET; RADIOTHERAPY; TEMOZOLOMIDE; PROGRESSION; NEUROONCOLOGY; CONCOMITANT; TOOL Multiple languages Oncology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27698