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- Title
[<sup>18</sup>F]Fluoroethyltyrosine--Positron Emission Tomography--Based Therapy Monitoring after Stereotactic Iodine-125 Brachytherapy in Patients with Recurrent High-Grade Glioma.
- Authors
Jansen, Nathalie L.; Suchorska, Bogdana; Schwarz, Silke B.; Eigenbrod, Sabina; Lutz, Juergen; Graute, Vera; Bartenstein, Peter; Belka, Claus; Kreth, Friedrich W.; la Fougère, Christian
- Abstract
Therapy monitoring of glioma after stereotactic iodine-125 brachytherapy (SBT) remains challenging because posttherapeutic changes in magnetic resonance imaging can mimic tumor progression. We evaluated the prognostic value of serial [18F]fluoroethyltyrosine (FET)--positron emission tomographic (PET) scans for therapy monitoring of high-grade glioma (HGG) after SBT. Thirty-three patients with recurrent HGG were included. Serial FET-PET scans were performed prior to therapeutic intervention and at 3-month intervals during the first year after SBT. FET-PET evaluation was performed by both conventional data analysis and kinetic analysis. Prognostic factors were obtained from proportional hazard models. Median local progression--free survival (LPFS) was 11.1 months. Maximal standardized background uptake value (SUVmax/BG) and biologic tumor volume (BTV) differentiated accurately between therapeutic effects and local tumor progression at the 6-month and subsequent examinations. Increasing uptake kinetics at baseline (p, .05) and during follow-up (p, .01) were stringently associated with a longer LPFS. Early increase in FET uptake after SBT is not unequivocally associated with tumor progression; it might be induced by reactive changes and could easily lead to a misclassification of the tumor status (pseudoprogression). Six months after SBT (or later), however, increased SUVmax/BG and BTV values are associated with a worse prognosis. Multivariate analysis stresses the prognostic importance of dynamic studies.
- Publication
Molecular Imaging, 2013, Vol 12, Issue 3, p137
- ISSN
1535-3508
- Publication type
Academic Journal
- DOI
10.2310/7290.2012.00027