Universität zu Köln

Roelcke, Ulrich, Wyss, Matthias T., Nowosielski, Martha, Ruda, Roberta, Roth, Patrick ORCID: 0000-0003-3897-214X, Hofer, Silvia, Galldiks, Norbert ORCID: 0000-0002-2485-1796, Crippa, Flavio, Weller, Michael ORCID: 0000-0002-1748-174X and Soffietti, Riccardo (2016). Amino acid positron emission tomography to monitor chemotherapy response and predict seizure control and progression-free survival in WHO grade II gliomas. Neuro-Oncology, 18 (5). S. 744 - 752. CARY: OXFORD UNIV PRESS INC. ISSN 1523-5866

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Abstract

Background. Patients with WHO grade II glioma may respond to chemotherapy that is currently not standardized regarding timing and treatment duration. Metabolic changes during chemotherapy may precede structural tumor volume reductions. We therefore compared time courses of amino acid PET and MRI responses to temozolomide (TMZ) and assessed whether responses correlated with seizure control and progression-free survival (PFS). Methods. PET and MRI were performed before and during TMZ chemotherapy. Tumor volumes were calculated using regions-of-interest analysis. Amino acid uptake was also quantified as metabolically active tumor volume and tumor-to-cerebellum uptake ratio. Results. One hundred twenty-five PET and 125 MRI scans from 33 patients were analyzed. Twenty-five patients showed metabolic responses that exhibited an exponential time course with a 25% reduction of the active volume on average after 2.3 months. MRI responses followed a linear course with a 25% reduction after 16.8 months. Reduction of metabolically active tumor volumes, but not reduction of PET uptake ratios or MRI tumor volumes, correlated with improved seizure control following chemotherapy (P = .012). Receiver-operating-characteristic curve analysis showed that a decrease of the active tumor volume of >= 80.5% predicts a PFS of >= 60 months (P = .018) and a decrease of >= 64.5% a PFS of >= 48 months (P = .037). Conclusions. Amino acid PET is superior to MRI for evaluating TMZ responses in WHO grade II glioma patients. The response delay between both imaging modalities favors amino acid PET for individually tailoring the duration of chemotherapy. Additional studies should investigate whether this personalized approach is appropriate with regard to outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Roelcke, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Wyss, Matthias T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nowosielski, Martha UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruda, Roberta UNSPECIFIED UNSPECIFIED UNSPECIFIED Roth, Patrick UNSPECIFIED orcid.org/0000-0003-3897-214X UNSPECIFIED Hofer, Silvia UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Crippa, Flavio UNSPECIFIED UNSPECIFIED UNSPECIFIED Weller, Michael UNSPECIFIED orcid.org/0000-0002-1748-174X UNSPECIFIED Soffietti, Riccardo UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-276865
DOI:	10.1093/neuonc/nov282
Journal or Publication Title:	Neuro-Oncology
Volume:	18
Number:	5
Page Range:	S. 744 - 752
Date:	2016
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1523-5866
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PRIMARY BRAIN-TUMORS; F-18-FET PET; TEMOZOLOMIDE; NEUROONCOLOGY; MANAGEMENT Multiple languages Oncology; Clinical Neurology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27686