Universität zu Köln

Galldiks, Norbert ORCID: 0000-0002-2485-1796, Dunkl, Veronika, Stoffels, Gabriele ORCID: 0000-0001-7114-1941, Hutterer, Markus, Rapp, Marion, Sabel, Michael, Reifenberger, Guido, Kebir, Sied, Dorn, Franziska ORCID: 0000-0001-9093-8307, Blau, Tobias, Herrlinger, Ulrich, Hau, Peter ORCID: 0000-0003-3894-5053, Ruge, Maximilian I., Kocher, Martin, Goldbrunner, Roland, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Drzezga, Alexander, Schmidt, Matthias and Langen, Karl-Josef ORCID: 0000-0003-1101-5075 (2015). Diagnosis of pseudoprogression in patients with glioblastoma using O-(2-[F-18]fluoroethyl)-L-tyrosine PET. Eur. J. Nucl. Med. Mol. Imaging, 42 (5). S. 685 - 696. NEW YORK: SPRINGER. ISSN 1619-7089

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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:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Dunkl, Veronika UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED orcid.org/0000-0001-7114-1941 UNSPECIFIED Hutterer, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Rapp, Marion UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabel, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Reifenberger, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Kebir, Sied UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED Blau, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrlinger, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Hau, Peter UNSPECIFIED orcid.org/0000-0003-3894-5053 UNSPECIFIED Ruge, Maximilian I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Drzezga, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Langen, Karl-Josef UNSPECIFIED orcid.org/0000-0003-1101-5075 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-408969
DOI:	10.1007/s00259-014-2959-4
Journal or Publication Title:	Eur. J. Nucl. Med. Mol. Imaging
Volume:	42
Number:	5
Page Range:	S. 685 - 696
Date:	2015
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1619-7089
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language 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 Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40896