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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Usefulness of [18F]FET-PET for chemotherapy monitoring in non-contrast enhancing glioma

Meeting Abstract

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  • Bogdana Suchorska - Department of Neurosurgery, Ludwig-Maximilians University, Munich, Germany
  • Marcus Unterrainer - Department of Nuclear Medicine, Ludwig-Maximilians University, Munich, Germany
  • Annamaria Biczok - Department of Neurosurgery, Ludwig-Maximilians University, Munich, Germany
  • Jörg-Christian Tonn - Department of Neurosurgery, Ludwig-Maximilians University, Munich, Germany
  • Nathalie Lisa Albert - Department of Nuclear Medicine, Ludwig-Maximilians University, Munich, Germany
  • Friedrich-Wilhelm Kreth - Department of Neurosurgery, Ludwig-Maximilians University, Munich, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.08.02

doi: 10.3205/16dgnc137, urn:nbn:de:0183-16dgnc1371

Published: June 8, 2016

© 2016 Suchorska et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Monitoring treatment response in non-contrast enhancing gliomas by means of conventional MRI can be difficult, as many patients show no radiological changes during therapy. Molecular imaging using [18F]FET-PET might detect metabolic changes within the tumour prior to structural volume reduction on MRI.

Method: 62 patients with a histologically proven grade II (n= 45) or grade III (n=17) glioma receiving alkylating chemotherapy with temozolomide or PCV were included. MRI and 18FET-PET investigations were scheduled prior to the beginning of chemotherapy and after 6 months. We analysed T2-volume as well as 18FET-PET based biological tumour volume (BTV) and maximal tumour-to-brain ratio (TBRmax). T2-volume, BTV and TBRmax changes of >-20% were classified as therapy response, while change of >+20% was regarded as therapy failure; all other patients were categorized as stable. Overall survival (OS) and progression free survival (PFS) times were calculated from beginning of therapy. Cox regression analysis was performed for outcome analysis, [18F]FET-PET and MRI parameter changes were assessed via t-test.

Results: During the follow-up time of 59.6 months, 10 patients out of 20 patients experiencing tumour progression had died. Mean OS time was 98.8 months, mean PFS time 77.4 months; median values were not reached yet. Response or failure assessed by BTV and TBRmax was highly associated with both PFS and OS (p<0.0001), while T2-volume based assessment was not associated with outcome (p=0.09 for PFS and p=0.21 for OS). PFS time in patients classified as responders according to a BTV reduction of >-20% was 91.0 months, compared to 43.0 months in patients rated as stable and 19.3 months in patients with a BTV increase of >+20%.

Conclusions: [18F]FET-PET-based monitoring provides an additional possibility to assess metabolic changes in glioma patients undergoing chemotherapy and might help to identify non-responders.