Galldiks, Norbert and Dunkl, Veronika and Stoffels, Gabriele and Hutterer, Markus and Rapp, Marion and Sabel, Michael and Reifenberger, Guido and Kebir, Sied and Dorn, Franziska and Blau, Tobias and Herrlinger, Ulrich and Hau, Peter and Ruge, Maximilian I. and Kocher, Martin and Goldbrunner, Roland and Fink, Gereon R. and Drzezga, Alexander and Schmidt, Matthias and Langen, Karl-Josef (2015) Diagnosis of pseudoprogression in patients with glioblastoma using O-(2-[F-18]fluoroethyl)-L-tyrosine PET. EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 42 (5). pp. 685-695. ISSN 1619-7070, 1619-7089
Full text not available from this repository. (Request a copy)Abstract
Purpose The follow-up of glioblastoma patients after radiochemotherapy with conventional MRI can be difficult since reactive alterations to the blood-brain barrier with contrast enhancement may mimic tumour progression (i.e. pseudoprogression, PsP). The aim of this study was to assess the clinical value of O-(2-F-18-fluoroethyl)-L-tyrosine (F-18-FET) PET in the differentiation of PsP and early tumour progression (EP) after radiochemotherapy of glioblastoma. Methods A group of 22 glioblastoma patients with new contrast-enhancing lesions or lesions showing increased enhancement (>25%) on standardMRI within the first 12 weeks after completion of radiochemotherapy with concomitant temozolomide (median 7 weeks) were additionally examined using amino acid PET with F-18-FET. Maximum and mean tumour-to-brain ratios (TBRmax, TBRmean) were determined. F-18-FET uptake kinetic parameters (i.e. patterns of time-activity curves, TAC) were also evaluated. Classification as PsP or EP was based on the clinical course (no treatment change at least for 6 months), follow-up MR imaging and/or histopathological findings. Imaging results were also related to overall survival (OS). Results PsP was confirmed in 11 of the 22 patients. In patients with PsP, F-18-FET uptake was significantly lower than in patients with EP (TBRmax 1.9 +/- 0.4 vs. 2.8 +/- 0.5, TBRmean 1.8 +/- 0.2 vs. 2.3 +/- 0.3; both P<0.001) and presence of MGMT promoter methylation was significantly more frequent (P=0.05). Furthermore, a TAC type II or III was more frequently present in patients with EP (P=0.04). Receiver operating characteristic analysis showed that the optimal F-18-FET TBRmax cut-off value for identifying PsP was 2.3 (sensitivity 100 %, specificity 91 %, accuracy 96 %, AUC 0.94 +/- 0.06; P<0.001). Univariate survival analysis showed that a TBRmax <2.3 predicted a significantly longer OS (median OS 23 vs. 12 months; P=0.046). Conclusion F-18-FET PET may facilitate the diagnosis of PsP following radiochemotherapy of glioblastoma.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HIGH-GRADE GLIOMA; O-(2-F-18-FLUOROETHYL)-L-TYROSINE PET; F-18-FET PET; RESPONSE ASSESSMENT; HISTOGRAM ANALYSIS; BRAIN-TUMORS; AMINO-ACID; TEMOZOLOMIDE; MRI; DIFFERENTIATION; Pseudoprogression; Tumour progression; Glioblastoma; FET PET |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 22 Jul 2019 13:50 |
| Last Modified: | 22 Jul 2019 13:50 |
| URI: | https://pred.uni-regensburg.de/id/eprint/5757 |
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