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:
CreatorsEmailORCIDORCID Put Code
Galldiks, NorbertUNSPECIFIEDorcid.org/0000-0002-2485-1796UNSPECIFIED
Dunkl, VeronikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ceccon, GarryUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tscherpel, CarolineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stoffels, GabrieleUNSPECIFIEDorcid.org/0000-0001-7114-1941UNSPECIFIED
Law, IanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Henriksen, Otto M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muhic, AidaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Poulsen, Hans S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steger, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bauer, Elena K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lohmann, PhilippUNSPECIFIEDorcid.org/0000-0002-5360-046XUNSPECIFIED
Schmidt, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shah, Nadim J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fink, Gereon R.UNSPECIFIEDorcid.org/0000-0002-8230-1856UNSPECIFIED
Langen, Karl-JosefUNSPECIFIEDorcid.org/0000-0003-1101-5075UNSPECIFIED
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:
KeywordsLanguage
POSITRON-EMISSION-TOMOGRAPHY; RECURRENT MALIGNANT GLIOMA; AMINO-ACID PET; ANTIANGIOGENIC THERAPY; BRAIN; CRITERIAMultiple languages
Radiology, Nuclear Medicine & Medical ImagingMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/16368

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