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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Complete resection of biological tumor volume in 18F-FET-PET correlates with better overall survival in WHO grade III and grade IV glioma

Vollständige Resektion des biologischen Tumorvolumens in 18F-FET-PET korreliert mit besserem Überleben in WHO Grad III und Grad IV Tumoren

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  • Hussam Hamou - Klinik für Neurochirurgie, RWTH Universität, Aachen, Deutschland
  • Sony Tan - Klinik für Neurochirurgie, RWTH Universität, Aachen, Aachen, Deutschland
  • Karl-Josef Langen - Institute für Neurowissenschaften und Medizin (INM-4) Forschungszentrum Jülich, Jülich, Deutschland; Klinik für Nuklearmedizin, RWTH Aachen Universität, Aachen, Deutschland
  • Georg Neuloh - Klinik für Neurochirurgie, RWTH Universität, Aachen, Aachen, Deutschland
  • Hans Clusmann - Klinik für Neurochirurgie, RWTH Universität, Aachen, Deutschland
  • presenting/speaker Daniel Delev - Klinik für Neurochirurgie, RWTH Universität, Aachen, Aachen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV123

doi: 10.3205/19dgnc138, urn:nbn:de:0183-19dgnc1389

Published: May 8, 2019

© 2019 Hamou 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

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Objective: PET using 18F-Fluoroethyltyrosine (FET) represents an important imaging modality to assess tumor extent, treatment response and tumor progression during the therapy of high-grade glioma. The aim of the study was to investigate, whether the complete resection of the FET-PET “hot spots” influences overall survival (OS) in patients with WHO grade III and grade IV glioma.

Methods: This is a retrospective analysis of 24 patients with WHO III and WHO IV glioma, who underwent surgical resection. Preoperative MRI and FET-PET imaging as well as postoperative MRI were performed. Complete resection of the biological tumor volume delineated by preoperative FET-PET was evaluated after co-registration of the FET-PET images with postoperative MRI images using a commercial imaging fusion algorithm.

Results: All 24 patients underwent FET-PET examination before surgical treatment. There were 9 WHO grade III and 15 WHO grade IV tumors. The biological tumor volume (BTV) in FET-PET corresponded to the MRI contrast enhancing (CE) tumor parts in 13 (54%) patients, whereas the remaining 11 patients showed a discrepancy between the localization BTV and CE.

Gross total resection (GTR) resection regarding the complete removal of MRI contrast enhancing parts was achieved in 19 (79%) patients, while complete removal of the BTV as delineated by FET-PET could be achieved in 15 (62%) patients. All patients underwent a combined radio-chemotherapy during their postoperative treatment course.

There were no significant differences in age and MGMT-methylation status between patients with complete BTV removal and those with tumor residual. However, the survival analysis showed a significant survival benefit for those patients, in whom a complete removal the BTV could be achieved (median OS (days) 511 VS. 341=0.032)

Conclusion: Complete removal of the FET-PET derived BTV is associated with significant longer OS in patients with WHO III and IV glioma. Our data suggest that FET-PET-guided resection may increase the impact of the surgical therapy in this subgroup of patients.