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- Title
<sup>18</sup>F-FET-PET as a biomarker for therapy response in non-contrast enhancing glioma following chemotherapy.
- Authors
Suchorska, Bogdana; Unterrainer, Marcus; Biczok, Annamaria; Sosnova, Marketa; Forbrig, Robert; Bartenstein, Peter; Tonn, Jörg-Christian; Albert, Nathalie Lisa; Kreth, Friedrich-Wilhelm
- Abstract
Background: Monitoring treatment response after chemotherapy of gadolinium-(Gd)-negative gliomas is challenging as conventional MRI often indicates no radiological changes. We hypothesize that 18F-FET-PET can be used as a biomarker for response assessment in Gd-negative gliomas undergoing chemotherapy.Methods: Sixty-one patients harboring Gd-negative WHO grade II or III glioma receiving alkylating agents (temozolomide or CCNU/procarbacine) were included. All patients underwent MRI and 18F-FET-PET before chemotherapy and 6 months later. We calculated T2-volume, 18F-FET-PET based biological tumour volume (BTV) and maximal tumour-to-brain ratio (TBRmax). Moreover, dynamic PET acquisition was performed using time-activity-curves (TACs) analysis. For MRI-based response assessment, RANO criteria for low-grade glioma were used. For 18F-FET-PET, following classification scheme was tested: responsive disease (RD) when a decrease in either BTV ≥ 25% and/or TBRmax ≥ 10% occurred, an increase in BTV ≥ 25% and/or TBRmax increase > 10% characterized progressive disease (PD), minor changes ± 25% for BTV and ± 10% for TBRmax were regarded as stable disease (SD). Post-chemotherapy survival (PCS) and time-to-treatment failure (TTF) were calculated using the Kaplan-Meier method.Results: 18F-FET-PET based response has shown patients with RD to have the longest TTF time (78.5 vs 24.6 vs 24.1 months, p = 0.001), while there was no significant difference between patients with a SD and PD. A comparable pattern was observed for PCS (p < 0.001). T2-volume based assessment was not associated with outcome.Conclusion: 18F-FET-PET is a promising biomarker for early response assessment in Gd-negative gliomas undergoing chemotherapy. It might be helpful for a timely adjustment of potentially ineffective treatment concepts and overcomes limitations of conventional structural imaging.
- Subjects
GLIOMA treatment; FLUORODEOXYGLUCOSE F18; POSITRON emission tomography; CANCER chemotherapy; GLIOMAS; MAGNETIC resonance imaging; DIAGNOSIS
- Publication
Journal of Neuro-Oncology, 2018, Vol 139, Issue 3, p721
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-018-2919-0