Universität zu Köln

Bauer, Elena K., Stoffels, Gabriele, Blau, Tobias, Reifenberger, Guido, Felsberg, Joerg, Werner, Jan M., Lohmann, Philipp ORCID: 0000-0002-5360-046X, Rosen, Jurij, Ceccon, Garry, Tscherpel, Caroline, Rapp, Marion, Sabel, Michael, Filss, Christian P., Shah, Nadim J., Neumaier, Bernd, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Langen, Karl-Josef and Galldiks, Norbert ORCID: 0000-0002-2485-1796 (2020). Prediction of survival in patients with IDH-wildtype astrocytic gliomas using dynamic O-(2-[F-18]-fluoroethyl)-l-tyrosine PET. Eur. J. Nucl. Med. Mol. Imaging, 47 (6). S. 1486 - 1496. NEW YORK: SPRINGER. ISSN 1619-7089

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Abstract

Purpose Integrated histomolecular diagnostics of gliomas according to the World Health Organization (WHO) classification of 2016 has refined diagnostic accuracy and prediction of prognosis. This study aimed at exploring the prognostic value of dynamic O-(2-[F-18]-fluoroethyl)-l-tyrosine (FET) PET in newly diagnosed, histomolecularly classified astrocytic gliomas of WHO grades III or IV. Methods Before initiation of treatment, dynamic FET PET imaging was performed in patients with newly diagnosed glioblastoma (GBM) and anaplastic astrocytoma (AA). Static FET PET parameters such as maximum and mean tumour/brain ratios (TBRmax/mean), the metabolic tumour volume (MTV) as well as the dynamic FET PET parameters time-to-peak (TTP) and slope, were obtained. The predictive ability of FET PET parameters was evaluated concerning the progression-free and overall survival (PFS, OS). Using ROC analyses, threshold values for FET PET parameters were obtained. Subsequently, univariate Kaplan-Meier and multivariate Cox regression survival analyses were performed to assess the predictive power of these parameters for survival. Results Sixty patients (45 GBM and 15 AA patients) of two university centres were retrospectively identified. Patients with isocitrate dehydrogenase (IDH)-mutant or O-6-methylguanine-DNA-methyltransferase (MGMT) promoter-methylated tumours had a significantly longer PFS and OS (both P < 0.001). Furthermore, ROC analysis of IDH-wildtype glioma patients (n = 45) revealed that a TTP > 25 min (AUC, 0.90; sensitivity, 90%; specificity, 87%; P < 0.001) was highly prognostic for longer PFS (13 vs. 7 months; P = 0.005) and OS (29 vs. 12 months; P < 0.001). In contrast, at a lower level of significance, TBRmax, TBRmean, and MTV were only prognostic for longer OS (P = 0.004, P = 0.038, and P = 0.048, respectively). Besides complete resection and a methylated MGMT promoter, TTP remained significant in multivariate survival analysis (all P <= 0.02), indicating an independent predictor for OS. Conclusions Our data suggest that dynamic FET PET allows the identification of patients with longer OS among patients with newly diagnosed IDH-wildtype GBM and AA.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bauer, Elena K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Blau, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Reifenberger, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Felsberg, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Werner, Jan M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lohmann, Philipp UNSPECIFIED orcid.org/0000-0002-5360-046X UNSPECIFIED Rosen, Jurij UNSPECIFIED UNSPECIFIED UNSPECIFIED Ceccon, Garry UNSPECIFIED UNSPECIFIED UNSPECIFIED Tscherpel, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Rapp, Marion UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabel, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Filss, Christian P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah, Nadim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Neumaier, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Langen, Karl-Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-345272
DOI:	10.1007/s00259-020-04695-0
Journal or Publication Title:	Eur. J. Nucl. Med. Mol. Imaging
Volume:	47
Number:	6
Page Range:	S. 1486 - 1496
Date:	2020
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1619-7089
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language F-18-FET PET; ANAPLASTIC ASTROCYTOMAS; INTRATUMORAL HOMOGENEITY; PROGNOSTIC-SIGNIFICANCE; RESPONSE ASSESSMENT; MALIGNANT GLIOMA; UPTAKE KINETICS; MUTANT DIFFUSE; GLIOBLASTOMA; TEMOZOLOMIDE Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34527