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Radiation Oncology

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Open Access 01-12-2019 | Glioblastoma | Research

Prognostic value of subventricular zone involvement in relation to tumor volumes defined by fused MRI and O-(2-[¹⁸F]fluoroethyl)-L-tyrosine (FET) PET imaging in glioblastoma multiforme

Authors: Maciej Harat, Bogdan Małkowski, Krzysztof Roszkowski

Published in: Radiation Oncology | Issue 1/2019

Abstract

Background

Subventricular zone (SVZ) involvement is associated with a dismal prognosis in patients with glioblastoma multiforme (GBM). Dual-time point (dtp) O-(2-[¹⁸F]fluoroethyl)-L-tyrosine (FET) PET/CT (PET) may be a time- and cost-effective alternative to dynamic FET PET, but its prognostic value, particularly with respect to SVZ involvement, is unknown.

Methods

Thirty-five patients had two scans 5–15 and 50–60 min after i.v. FET injection to define tumor volumes and SVZ involvement before starting radiotherapy. Associations between clinical progression markers, MRI- and dtp FET PET-based tumor volumes, or SVZ involvement and progression-free (PFS) and overall survival (OS) were assessed in univariable and multivariable analyses.

Results

The extent of resection was not related to outcomes. Albeit non-significant, dtp FET PET detected more SVZ infiltration than MRI (60% vs. 51%, p = 0.25) and was significantly associated with poor survival (p < 0.03), but PET-T1-Gad volumes were larger in this group (p < 0.002). Survival was shorter in patients with larger MRI tumor volumes, larger PET tumor volumes, and worse Karnofsky performance status (KPS), with fused PET-T1-Gad and KPS significant in multivariable analysis (p < 0.03). Uptake kinetics was not associated with treatment outcomes.

Conclusions

FET PET-based tumor volumes may be useful for predicting worse prognosis glioblastoma. Although the presence of SVZ infiltration is linked to higher PET/MRI-based tumor volumes, the independent value of dtp FET PET parameters and SVZ infiltration as prognostic markers pre-irradiation has not been confirmed.

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Title: Prognostic value of subventricular zone involvement in relation to tumor volumes defined by fused MRI and O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET imaging in glioblastoma multiforme
Authors: Maciej Harat
Bogdan Małkowski
Krzysztof Roszkowski
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Glioblastoma
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Glioblastoma
Glioblastoma
Published in: Radiation Oncology / Issue 1/2019
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-019-1241-0

At a glance: The STEP trials

Springer Medicine

Prognostic value of subventricular zone involvement in relation to tumor volumes defined by fused MRI and O-(2-[¹⁸F]fluoroethyl)-L-tyrosine (FET) PET imaging in glioblastoma multiforme

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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