Patterns of failure for patients with glioblastoma following O-(2-[F]fluoroethyl)-L-tyrosine PET- and MRI-guided radiotherapy.

Radiother Oncol

Department of Oncology, Section of Radiotherapy, Rigshospitalet, Copenhagen University Hospital, København Ø, Denmark; Niels Bohr Institute, Department of Science, University of Copenhagen, København Ø, Denmark.

Published: March 2017

AI Article Synopsis

  • The study aimed to assess how well FET-PET imaging helps in defining treatment areas for radiotherapy in glioblastoma patients and patterns of recurrence post-treatment.
  • A total of 50 out of 66 patients with confirmed glioblastoma were monitored over a median follow-up of 45 months, revealing that most recurrences occurred centrally (82%), with varying degrees of overlap between FET-PET and MRI data.
  • The findings suggest that using a combination of MRI and FET-PET (MRPET) is more effective in predicting recurrence than using either method alone, especially in patients with specific tumor characteristics.

Article Abstract

Background And Purpose: To evaluate the patterns of failure following clinical introduction of amino-acid O-(2-[F]fluoroethyl)-L-tyrosine (FET)-PET-guided target definition for radiotherapy (RT) of glioblastoma patients.

Materials And Methods: The first 66 consecutive patients with confirmed histology, scanned using FET-PET/CT and MRI were selected for evaluation. Chemo-radiotherapy was delivered to a volume based on both MRI and FET-PET (PET). The volume of recurrence (RV) was defined on MRI data collected at the time of progression according to RANO criteria.

Results: Fifty patients were evaluable, with median follow-up of 45months. Central, in-field, marginal and distant recurrences were observed for 82%, 10%, 2%, and 6% of the patients, respectively. We found a volumetric overlap of 26%, 31% and 39% of the RV with the contrast-enhancing MR volume, PET and the composite MRPET, respectively. MGMT-methylation (p=0.03), larger PET (p<0.001), and less extensive surgery (p<0.001), were associated with larger PET overlap.

Conclusion: The combined MRPET had a stronger association with the recurrence volume than either of the modalities alone. Larger overlap of PET and RV was observed for patients with MGMT-methylation, less extensive surgery, and large PET on the RT-planning scans.

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http://dx.doi.org/10.1016/j.radonc.2017.01.002DOI Listing

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