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68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
7. Joint Meeting mit der Britischen Gesellschaft für Neurochirurgie (SBNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

14. - 17. Mai 2017, Magdeburg

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Identification of 18FET-PET time-to-peak as a prognostic marker specifically in IDH1/2 mutant diffuse astrocytoma

Meeting Abstract

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  • Bogdana Suchorska - Neurochirurgische Klinik der LMU München, München, Deutschland
  • Armin Giese - Zentrum für Neuropathologie und Prionenforschung, München, Deutschland
  • Annamaria Biczok - Neurochirurgische Klinik der LMU München, München, Deutschland
  • Marcus Unterrainer - Klinik für Nuklearmedizin der LMU München, München, Deutschland
  • Michael Weller - Klinik für Neurologie Universitätsspital Zürich, Zürich, Switzerland
  • Peter Bartenstein - Klinik für Nuklearmedizin der LMU München, München, Deutschland
  • Ulrich Schüller - Zentrum für Neuropathologie und Prionenforschung, München, Deutschland
  • Nathalie Albert - Klinik für Nuklearmedizin der LMU München, München, Deutschland
  • Jörg-Christian Tonn - Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, Neurochirurgische Klinik und Poliklinik, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.14.05

doi: 10.3205/17dgnc458, urn:nbn:de:0183-17dgnc4587

Veröffentlicht: 9. Juni 2017

© 2017 Suchorska et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Stratification of glial tumors according to IDH1/2 mutation and 1p/19q co-deletion status has gained major importance in the new WHO classification and guides current clinical decision making. Parameters derived from 18FET-PET uptake dynamics such as minimal time-to-peak (TTPmin) analysis allow discrimination between different prognostic glioma subgroups, too. The present study aimed at exploring whether TTPmin analysis provides prognostic information beyond the new WHO classification.

Methods: Three-hundred patients with newly diagnosed WHO 2007 grade II-IV gliomas with 18FET-PET imaging at diagnosis were grouped according to IDH1/2 mutation and 1p/19q co-deletion status into 3 subgroups (IDH1/2 mut/1p/19q co-del; IDH1/2 mut/1p/19q non co-del and IDH1/2 wildtype). Clinical and imaging factors such as age, Karnofsky performance score, treatment, TTP analysis, biological tumor volume (BTV) and tumor-to-brain ratio (TBR) were analyzed with regard to progression-free and overall survival (PFS and OS) via univariate and multivariate regression analysis.

Results: PFS and OS were longest in the IDH1/2 mut/1p/19q co-del subgroup followed by IDH1/2 mut/1p/19q non co-del and IDH1/2 wt patients (p<0.0001). Further, outcome stratified by TTPmin with a cut-off of 17.5 minutes revealed significantly longer PFS and OS in patients with TTPmin >17.5 minutes (p<0.0001 for PFS and OS). Lower TBRmax values or the absence of 18FET-uptake were also associated with favorable outcome in the entire group. Longer median TTPmin times were associated with improved outcome specifically in the IDH1/2 mut/1p/19q non co-del group, but neither in the IDH1/2 mut/1p/19q co-del nor in the IDH1/2 wt group.

Conclusion: 18FET-PET-derived dynamic analysis defines prognostically distinct sub-groups of IDH1/2 mutant/ 1p/19q-non-co-deleted gliomas which cannot be distinguished as yet by molecular marker analysis.