Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy

被引：29

作者：

Debus, Charlotte ^{[1
,2
,3
,4
]}

Waltenberger, Maria ^{[1
,2
,3
,4
]}

Floca, Ralf ^{[3
,5
]}

Afshar-Oromieh, Ali ^{[6
]}

Bougatf, Nina ^{[3
,4
]}

Adeberg, Sebastian ^{[3
,4
]}

Heiland, Sabine ^{[7
]}

Bendszus, Martin ^{[7
]}

Wick, Wolfgang ^{[1
,8
,9
]}

Rieken, Stefan ^{[3
,4
]}

Haberkorn, Uwe ^{[6
,10
]}

Debus, Juergen ^{[1
,2
,3
,4
]}

Knoll, Maximilian ^{[1
,3
,4
]}

Abdollahi, Amir ^{[1
,2
,3
,4
]}

机构：

[1] German Canc Consortium DKTK, Heidelberg, Germany

[2] German Canc Res Ctr, Translat Radiat Oncol, Natl Ctr Tumor Dis NCT, Heidelberg, Germany

[3] Natl Ctr Radiat Res Oncol NCRO, Div Mol & Translat Radiat Oncol, HIRO, Heidelberg, Germany

[4] Heidelberg Univ Hosp, Heidelberg Ion Beam Therapy Ctr HIT, Dept Radiat Oncol, Heidelberg, Germany

[5] German Canc Res Ctr, Div Med Image Comp, Heidelberg, Germany

[6] Heidelberg Univ Hosp, Dept Nucl Med, Heidelberg, Germany

[7] Heidelberg Univ Hosp, Dept Neuroradiol, Heidelberg, Germany

[8] Heidelberg Univ Hosp, Dept Neurol, Heidelberg, Germany

[9] German Canc Res Ctr, Clin Cooperat Unit Neurooncol, Natl Ctr Tumor Dis NCT, Heidelberg, Germany

[10] German Canc Res Ctr, Clin Cooperat Unit Nucl Med, Heidelberg, Germany

来源：

SCIENTIFIC REPORTS | 2018年 / 8卷

关键词：

AMINO-ACID PET; MALIGNANT GLIOMA; PLUS CONCOMITANT; PROGNOSTIC VALUE; UPTAKE KINETICS; FET-PET; REIRRADIATION; PATTERNS; SURVIVAL; RADIOCHEMOTHERAPY;

D O I：

10.1038/s41598-018-25350-7

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

High-precision radiotherapy (HPR) of recurrent high grade glioma (HGG) requires accurate spatial allocation of these infiltrative tumors. We investigated the impact of F-18-FET PET on tumor delineation and progression of recurrent HGG after HPR with carbon ions. T-1 contrast enhanced MRI and F-18-FET-PET scans of 26 HGG patients were fused with radiotherapy planning volumes. PET-positive (PET+) tumor volumes using different isocontours (I%) were systematically investigated and compared with MRI-derived gross tumor volumes (GTV). Standardized uptake ratios (SUR) were further correlated with GTV and tumor progression patterns. In grade IV glioma, SUR > 2.92 significantly correlated with poor median overall survival (6.5 vs 13.1 months, p = 0.00016). We found no reliable SUR cut-off criteria for definition of PET+ volumes. Overall conformity between PET and MRI-based contours was low, with maximum conformities between 0.42-0.51 at I40%. The maximum sensitivity and specificity for PET+ volumes outside of GTV predicting tumor progression were 0.16 (I40%) and 0.52 (I50%), respectively. In 75% of cases, FLAIR hyperintense area covered over 80% of PET+ volumes. F-18-FET-PET derived SUR has a prognostic impact in grade IV glioma. The value of substantial mismatches between MRI-based GTV and PET+ volumes to improve tumor delineation in radiotherapy awaits further validation in randomized prospective trials.

引用

页数：13

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