Universität zu Köln

Rosen, Jurij, Stoffels, Gabriele, Lohmann, Philipp ORCID: 0000-0002-5360-046X, Bauer, Elena K., Werner, Jan-Michael ORCID: 0000-0001-7147-4594, Wollring, Michael ORCID: 0000-0003-2177-6708, Rapp, Marion, Felsberg, Joerg, Kocher, Martin, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Langen, Karl-Josef and Galldiks, Norbert (2021). Prognostic value of pre-irradiation FET PET in patients with not completely resectable IDH-wildtype glioma and minimal or absent contrast enhancement. Sci Rep, 11 (1). BERLIN: NATURE PORTFOLIO. ISSN 2045-2322

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Abstract

In glioma patients, complete resection of the contrast-enhancing portion is associated with improved survival, which, however, cannot be achieved in a considerable number of patients. Here, we evaluated the prognostic value of O-(2-[F-18]-fluoroethyl)-L-tyrosine (FET) PET in not completely resectable glioma patients with minimal or absent contrast enhancement before temozolomide chemoradiation. Dynamic FET PET scans were performed in 18 newly diagnosed patients with partially resected (n = 8) or biopsied (n = 10) IDH-wildtype astrocytic glioma before initiation of temozolomide chemoradiation. Static and dynamic FET PET parameters, as well as contrast-enhancing volumes on MRI, were calculated. Using receiver operating characteristic analyses, threshold values for which the product of paired values for sensitivity and specificity reached a maximum were obtained. Subsequently, the prognostic values of FET PET parameters and contrast-enhancing volumes on MRI were evaluated using univariate Kaplan-Meier and multivariate Cox regression (including the MTV, age, MGMT promoter methylation, and contrast-enhancing volume) survival analyses for progression-free and overall survival (PFS, OS). On MRI, eight patients had no contrast enhancement; the remaining patients had minimal contrast-enhancing volumes (range, 0.2-5.3 mL). Univariate analyses revealed that smaller pre-irradiation FET PET tumor volumes were significantly correlated with a more favorable PFS (7.9 vs. 4.2 months; threshold, 14.8 mL; P = 0.012) and OS (16.6 vs. 9.0 months; threshold, 23.8 mL; P = 0.002). In contrast, mean tumor-to-brain ratios and time-to-peak values were only associated with a longer PFS (P = 0.048 and P = 0.045, respectively). Furthermore, the pre-irradiation FET PET tumor volume remained significant in multivariate analyses (P = 0.043), indicating an independent predictor for OS. Our results suggest that pre-irradiation FET PET parameters have a prognostic impact in this subgroup of patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rosen, Jurij UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Lohmann, Philipp UNSPECIFIED orcid.org/0000-0002-5360-046X UNSPECIFIED Bauer, Elena K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Werner, Jan-Michael UNSPECIFIED orcid.org/0000-0001-7147-4594 UNSPECIFIED Wollring, Michael UNSPECIFIED orcid.org/0000-0003-2177-6708 UNSPECIFIED Rapp, Marion UNSPECIFIED UNSPECIFIED UNSPECIFIED Felsberg, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Langen, Karl-Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-593001
DOI:	10.1038/s41598-021-00193-x
Journal or Publication Title:	Sci Rep
Volume:	11
Number:	1
Date:	2021
Publisher:	NATURE PORTFOLIO
Place of Publication:	BERLIN
ISSN:	2045-2322
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language O-(2-F-18-FLUOROETHYL)-L-TYROSINE PET; ADJUVANT TEMOZOLOMIDE; MALIGNANT GLIOMA; RESECTION; TUMOR; NEUROONCOLOGY; EXTENT; CLASSIFICATION; SURVIVAL; IMPROVES Multiple languages Multidisciplinary Sciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59300