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Radiation Oncology
Published in: Radiation Oncology 1/2021

Open Access 01-12-2021 | Glioblastoma | Research

FET-PET radiomics in recurrent glioblastoma: prognostic value for outcome after re-irradiation?

Authors: Montserrat Carles, Ilinca Popp, Michael Maximilian Starke, Michael Mix, Horst Urbach, Tanja Schimek-Jasch, Franziska Eckert, Maximilian Niyazi, Dimos Baltas, Anca L. Grosu

Published in: Radiation Oncology | Issue 1/2021

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Abstract

Purpose

The value of O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-positron emission tomography (PET)-radiomics in the outcome assessment of patients with recurrent glioblastoma (rGBM) has not been evaluated until now. The aim of this study was to evaluate whether a prognostic model based on FET-PET radiomics features (RF) is feasible and can identify rGBM patients that would most benefit from re-irradiation.

Methods

We prospectively recruited rGBM patients who underwent FET-PET before re-irradiation (GLIAA-Pilot trial, DRKS00000633). Tumor volume was delineated using a semi-automatic method with a threshold of 1.8 times the standardized-uptake-value of the background. 135 FET-RF (histogram parameters, shape and texture features) were extracted. The analysis involved the characterization of tumor and non-tumor tissue with FET-RF and the evaluation of the prognostic value of FET-RF for time-to-progression (TTP), overall survival (OS) and recurrence location (RL).

Results

Thirty-two rGBM patients constituted our cohort. FET-RF discriminated significantly between tumor and non-tumor. The texture feature Small-Zone-Low-Gray-Level-Emphasis (SZLGE) showed the best performance for the prediction of TTP (p = 0.001, satisfying Bonferroni-multiple-test significance level). Additionally, two radiomics signatures could predict TTP (TTP-radiomics-signature, p = 0.001) and OS (OS-radiomics-signature, p = 0.038). SZLGE and the TTP-radiomics-signature additionally predicted RL. Specifically, high values for TTP-radiomics-signature and for SZLGE indicated not only earlier progression, but also a RL within the initial FET-PET active volume.

Conclusion

Our findings suggest that FET-PET radiomics could contribute to the prognostic assessment and selection of rGBM-patients benefiting from re-irradiation.
Trial registration DRKS00000633. Registered on 8th of December in 2010.
Appendix
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Metadata
Title
FET-PET radiomics in recurrent glioblastoma: prognostic value for outcome after re-irradiation?
Authors
Montserrat Carles
Ilinca Popp
Michael Maximilian Starke
Michael Mix
Horst Urbach
Tanja Schimek-Jasch
Franziska Eckert
Maximilian Niyazi
Dimos Baltas
Anca L. Grosu
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2021
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-020-01744-8

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