Universität zu Köln

Werner, Jan-Michael, Stoffels, Gabriele, Lichtenstein, Thorsten, Borggrefe, Jan ORCID: 0000-0003-2908-7560, Lohmann, Philipp ORCID: 0000-0002-5360-046X, Ceccon, Garry, Shah, Nadim J., Fink, Gereon R. ORCID: 0000-0002-8230-1856, Langen, Karl-Josef ORCID: 0000-0003-1101-5075, Kabbasch, Christoph and Galldiks, Norbert ORCID: 0000-0002-2485-1796 (2019). Differentiation of treatment-related changes from tumour progression: a direct comparison between dynamic FET PET and ADC values obtained from DWI MRI. Eur. J. Nucl. Med. Mol. Imaging, 46 (9). S. 1889 - 1902. NEW YORK: SPRINGER. ISSN 1619-7089

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Abstract

BackgroundFollowing brain cancer treatment, the capacity of anatomical MRI to differentiate neoplastic tissue from treatment-related changes (e.g., pseudoprogression) is limited. This study compared apparent diffusion coefficients (ADC) obtained by diffusion-weighted MRI (DWI) with static and dynamic parameters of O-(2-[F-18]fluoroethyl)-L-tyrosine (FET) PET for the differentiation of treatment-related changes from tumour progression.Patients and methodsForty-eight pretreated high-grade glioma patients with anatomical MRI findings suspicious for progression (median time elapsed since last treatment was 16weeks) were investigated using DWI and dynamic FET PET. Maximum and mean tumour-to-brain ratios (TBRmax, TBRmean) as well as dynamic parameters (time-to-peak and slope values) of FET uptake were calculated. For mean ADC calculation, regions-of-interest analyses were performed on ADC maps calculated from DWI coregistered with the contrast-enhanced MR image. Diagnoses were confirmed neuropathologically (21%) or clinicoradiologically. Diagnostic performance was evaluated using receiver-operating-characteristic analyses or Fisher's exact test for a combinational approach.ResultsTen of 48 patients had treatment-related changes (21%). The diagnostic performance of FET PET was significantly higher (threshold for both TBRmax and TBRmean, 1.95; accuracy, 83%; AUC, 0.890.05; P<0.001) than that of ADC values (threshold ADC, 1.09x10(-3)mm(2)/s; accuracy, 69%; AUC, 0.73 +/- 0.09; P=0.13). The addition of static FET PET parameters to ADC values increased the latter's accuracy to 89%. The highest accuracy was achieved by combining static and dynamic FET PET parameters (93%). Moreover, in contrast to ADC values, TBRs <1.95 at suspected progression predicted a significantly longer survival (P=0.01).Conclusions Data suggest that static and dynamic FET PET provide valuable information concerning the differentiation of early treatment-related changes from tumour progression and outperform ADC measurement for this highly relevant clinical question.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Werner, Jan-Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Lichtenstein, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Lohmann, Philipp UNSPECIFIED orcid.org/0000-0002-5360-046X UNSPECIFIED Ceccon, Garry UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah, Nadim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Langen, Karl-Josef UNSPECIFIED orcid.org/0000-0003-1101-5075 UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-134012
DOI:	10.1007/s00259-019-04384-7
Journal or Publication Title:	Eur. J. Nucl. Med. Mol. Imaging
Volume:	46
Number:	9
Page Range:	S. 1889 - 1902
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1619-7089
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITRON-EMISSION-TOMOGRAPHY; HIGH-GRADE GLIOMAS; BRAIN-TUMOR; RADIATION-THERAPY; TRUE PROGRESSION; O-(2-F-18-FLUOROETHYL)-L-TYROSINE UPTAKE; CONCOMITANT TEMOZOLOMIDE; EUROPEAN ASSOCIATION; DIAGNOSTIC-ACCURACY; RESPONSE ASSESSMENT Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13401