Universität zu Köln

Maurer, Gabriele D., Brucker, Daniel P., Stoffels, Gabriele, Filipski, Katharina, Filss, Christian P., Mottaghy, Felix M., Galldiks, Norbert ORCID: 0000-0002-2485-1796, Steinbach, Joachim P., Hattingen, Elke ORCID: 0000-0002-8392-9004 and Langen, Karl-Josef ORCID: 0000-0003-1101-5075 (2020). F-18-FET PET Imaging in Differentiating Glioma Progression from Treatment-Related Changes: A Single-Center Experience. J. Nucl. Med., 61 (4). S. 505 - 512. RESTON: SOC NUCLEAR MEDICINE INC. ISSN 1535-5667

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Abstract

In glioma patients, differentiation between tumor progression (TP) and treatment-related changes (TRCs) remains challenging. Difficulties in classifying imaging alterations may result in a delay or an unnecessary discontinuation of treatment. PET using O-(2-F-18-fluoroethyl)-L-tyrosine (F-18-FET) has been shown to be a useful tool for detecting TP and TRCs. Methods: We retrospectively evaluated 127 consecutive patients with World Health Organization grade II-IV glioma who underwent F-18-FET PET imaging to distinguish between TP and TRCs. F-18-FET PET findings were verified by neuropathology (40 patients) or clinicoradiologic follow-up (87 patients). Maximum tumor-to-brain ratios (TBRmax) of F-18-FET uptake and the slope of the time-activity curves (20-50 min after injection) were determined. The diagnostic accuracy of F-18-FET PET parameters was evaluated by receiver-operating-characteristic analysis and chi(2) testing. The prognostic value of F-18-FET PET was estimated using the Kaplan-Meier method. Results: TP was diagnosed in 94 patients (74%) and TRCs in 33 (26%). For differentiating TP from TRCs, receiver-operating-characteristic analysis yielded an optimal F-18-FET TBRmax cutoff of 1.95 (sensitivity, 70%; specificity, 71%; accuracy, 70%; area under the curve, 0.75 +/- 0.05). The highest accuracy was achieved by a combination of TBRmax and slope (sensitivity, 86%; specificity, 67%; accuracy, 81%). However, accuracy was poorer when tumors harbored isocitrate dehydrogenase (IDH) mutations (91% in IDH-wild-type tumors, 67% in IDH-mutant tumors, P, 0.001). F-18-FET PET results correlated with overall survival (P, 0.001). Conclusion: In our neurooncology department, the diagnostic performance of F-18-FET PET was convincing but slightly inferior to that of previous reports.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maurer, Gabriele D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brucker, Daniel P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Filipski, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Filss, Christian P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mottaghy, Felix M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Steinbach, Joachim P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hattingen, Elke UNSPECIFIED orcid.org/0000-0002-8392-9004 UNSPECIFIED Langen, Karl-Josef UNSPECIFIED orcid.org/0000-0003-1101-5075 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-338455
DOI:	10.2967/jnumed.119.234757
Journal or Publication Title:	J. Nucl. Med.
Volume:	61
Number:	4
Page Range:	S. 505 - 512
Date:	2020
Publisher:	SOC NUCLEAR MEDICINE INC
Place of Publication:	RESTON
ISSN:	1535-5667
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RESPONSE ASSESSMENT CRITERIA; HIGH-GRADE GLIOMAS; PSEUDOPROGRESSION; DIAGNOSIS; NEUROONCOLOGY; GLIOBLASTOMA; RECURRENCE; PSEUDORESPONSE; TUMORS; MRI Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33845