Universität zu Köln

Galldiks, Norbert ORCID: 0000-0002-2485-1796, Dunkl, Veronika, Ceccon, Garry, Tscherpel, Caroline, Stoffels, Gabriele ORCID: 0000-0001-7114-1941, Law, Ian, Henriksen, Otto M., Muhic, Aida, Poulsen, Hans S., Steger, Jan, Bauer, Elena K., Lohmann, Philipp ORCID: 0000-0002-5360-046X, Schmidt, Matthias, Shah, Nadim J., Fink, Gereon R. ORCID: 0000-0002-8230-1856 and Langen, Karl-Josef ORCID: 0000-0003-1101-5075 (2018). Early treatment response evaluation using FET PET compared to MRI in glioblastoma patients at first progression treated with bevacizumab plus lomustine. Eur. J. Nucl. Med. Mol. Imaging, 45 (13). S. 2377 - 2387. NEW YORK: SPRINGER. ISSN 1619-7089

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Abstract

BackgroundThe goal of this prospective study was to compare the value of both conventional MRI and O-(2-F-18-fluoroethyl)-L-tyrosine (FET) PET for response evaluation in glioblastoma patients treated with bevacizumab plus lomustine (BEV/LOM) at first progression.MethodsAfter chemoradiation with concomitant and adjuvant temozolomide, 21 IDH wild-type glioblastoma patients at first progression (age range, 33-75years; MGMT promoter unmethylated, 81%) were treated with BEV/LOM. Contrast-enhanced MRI and FET-PET scans were performed at baseline and after 8-10weeks. We obtained FET metabolic tumor volumes (MTV) and tumor/brain ratios. Threshold values of FET-PET parameters for treatment response were established by ROC analyses using the post-progression overall survival (OS) />9months as the reference. MRI response assessment was based on RANO criteria. The predictive ability of FET-PET thresholds and MRI changes on early response assessment was evaluated subsequently concerning OS using uni- and multivariate survival estimates.ResultsEarly treatment response as assessed by RANO criteria was not predictive for an OS>9months (P=0.203), whereas relative reductions of all FET-PET parameters significantly predicted an OS>9months (P<0.05). The absolute MTV at follow-up enabled the most significant OS prediction (sensitivity, 85%; specificity, 88%; P=0.001). Patients with an absolute MTV below 5ml at follow-up survived significantly longer (12 vs. 6months, P<0.001), whereas early responders defined by RANO criteria lived only insignificantly longer (9 vs. 6months; P=0.072). The absolute MTV at follow-up remained significant in the multivariate survival analysis (P=0.006).ConclusionsFET-PET appears to be useful for identifying responders to BEV/LOM early after treatment initiation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Dunkl, Veronika UNSPECIFIED UNSPECIFIED UNSPECIFIED Ceccon, Garry UNSPECIFIED UNSPECIFIED UNSPECIFIED Tscherpel, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED orcid.org/0000-0001-7114-1941 UNSPECIFIED Law, Ian UNSPECIFIED UNSPECIFIED UNSPECIFIED Henriksen, Otto M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Muhic, Aida UNSPECIFIED UNSPECIFIED UNSPECIFIED Poulsen, Hans S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Steger, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauer, Elena K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lohmann, Philipp UNSPECIFIED orcid.org/0000-0002-5360-046X UNSPECIFIED Schmidt, Matthias 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
URN:	urn:nbn:de:hbz:38-163688
DOI:	10.1007/s00259-018-4082-4
Journal or Publication Title:	Eur. J. Nucl. Med. Mol. Imaging
Volume:	45
Number:	13
Page Range:	S. 2377 - 2387
Date:	2018
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; RECURRENT MALIGNANT GLIOMA; AMINO-ACID PET; ANTIANGIOGENIC THERAPY; BRAIN; CRITERIA Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16368