Ort, Jonas ORCID: 0000-0002-4895-9398, Hamou, Hussam Aldin, Kernbach, Julius M., Hakvoort, Karlijn, Blume, Christian, Lohmann, Philipp ORCID: 0000-0002-5360-046X, Galldiks, Norbert, Heiland, Dieter Henrik, Mottaghy, Felix M., Clusmann, Hans, Neuloh, Georg, Langen, Karl-Josef and Delev, Daniel (2021). F-18-FET-PET-guided gross total resection improves overall survival in patients with WHO grade III/IV glioma: moving towards a multimodal imaging-guided resection. J. Neuro-Oncol., 155 (1). S. 71 - 81. NEW YORK: SPRINGER. ISSN 1573-7373

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Abstract

Purpose PET using radiolabeled amino acid [F-18]-fluoro-ethyl-(L)-tyrosine (FET-PET) is a well-established imaging modality for glioma diagnostics. The biological tumor volume (BTV) as depicted by FET-PET often differs in volume and location from tumor volume of contrast enhancement (CE) in MRI. Our aim was to investigate whether a gross total resection of BTVs defined as < 1 cm(3) of residual BTV (PET GTR) correlates with better oncological outcome. Methods We retrospectively analyzed imaging and survival data from patients with primary and recurrent WHO grade III or IV gliomas who underwent FET-PET before surgical resection. Tumor overlap between FET-PET and CE was evaluated. Completeness of FET-PET resection (PET GTR) was calculated after superimposition and semi-automated segmentation of pre-operative FET-PET and postoperative MRI imaging. Survival analysis was performed using the Kaplan-Meier method and the log-rank test. Results From 30 included patients, PET GTR was achieved in 20 patients. Patients with PET GTR showed improved median OS with 19.3 compared to 13.7 months for patients with residual FET uptake (p = 0.007; HR 0.3; 95% CI 0.12-0.76). This finding remained as independent prognostic factor after performing multivariate analysis (HR 0.19, 95% CI 0.06-0.62, p = 0.006). Other survival influencing factors such as age, IDH-mutation, MGMT promotor status, and adjuvant treatment modalities were equally distributed between both groups. Conclusion Our results suggest that PET GTR improves the OS in patients with WHO grade III or IV gliomas. A multimodal imaging approach including FET-PET for surgical planning in newly diagnosed and recurrent tumors may improve the oncological outcome in glioma patients.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Ort, JonasUNSPECIFIEDorcid.org/0000-0002-4895-9398UNSPECIFIED
Hamou, Hussam AldinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kernbach, Julius M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hakvoort, KarlijnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blume, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lohmann, PhilippUNSPECIFIEDorcid.org/0000-0002-5360-046XUNSPECIFIED
Galldiks, NorbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heiland, Dieter HenrikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mottaghy, Felix M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Clusmann, HansUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neuloh, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Langen, Karl-JosefUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Delev, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-595197
DOI: 10.1007/s11060-021-03844-1
Journal or Publication Title: J. Neuro-Oncol.
Volume: 155
Number: 1
Page Range: S. 71 - 81
Date: 2021
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1573-7373
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
POSITRON-EMISSION-TOMOGRAPHY; CENTRAL-NERVOUS-SYSTEM; GLIOBLASTOMA-MULTIFORME; PET; EXTENT; TUMORS; BRAIN; ASSOCIATION; TISSUE; MRIMultiple languages
Oncology; Clinical NeurologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/59519

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