TY - JOUR
T1 - Patterns of failure for patients with glioblastoma following O-(2-[18F]fluoroethyl)-L-tyrosine PET- and MRI-guided radiotherapy
AU - Lundemann, Michael
AU - Costa, Junia Cardoso
AU - Law, Ian
AU - Engelholm, Svend Aage
AU - Muhic, Aida
AU - Poulsen, Hans Skovgaard
AU - Munck af Rosenschöld, Per
N1 - Copyright © 2017 Elsevier B.V. All rights reserved.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background and purpose To evaluate the patterns of failure following clinical introduction of amino-acid O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-PET-guided target definition for radiotherapy (RT) of glioblastoma patients. Materials and methods The first 66 consecutive patients with confirmed histology, scanned using FET-PET/CT and MRI were selected for evaluation. Chemo-radiotherapy was delivered to a volume based on both MRI and FET-PET (PETvol). The volume of recurrence (RV) was defined on MRI data collected at the time of progression according to RANO criteria. Results Fifty patients were evaluable, with median follow-up of 45 months. Central, in-field, marginal and distant recurrences were observed for 82%, 10%, 2%, and 6% of the patients, respectively. We found a volumetric overlap of 26%, 31% and 39% of the RV with the contrast-enhancing MR volume, PETvol and the composite MRPETvol, respectively. MGMT-methylation (p = 0.03), larger PETvol (p < 0.001), and less extensive surgery (p < 0.001), were associated with larger PETvol overlap. Conclusion The combined MRPETvol had a stronger association with the recurrence volume than either of the modalities alone. Larger overlap of PETvol and RV was observed for patients with MGMT-methylation, less extensive surgery, and large PETvol on the RT-planning scans.
AB - Background and purpose To evaluate the patterns of failure following clinical introduction of amino-acid O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-PET-guided target definition for radiotherapy (RT) of glioblastoma patients. Materials and methods The first 66 consecutive patients with confirmed histology, scanned using FET-PET/CT and MRI were selected for evaluation. Chemo-radiotherapy was delivered to a volume based on both MRI and FET-PET (PETvol). The volume of recurrence (RV) was defined on MRI data collected at the time of progression according to RANO criteria. Results Fifty patients were evaluable, with median follow-up of 45 months. Central, in-field, marginal and distant recurrences were observed for 82%, 10%, 2%, and 6% of the patients, respectively. We found a volumetric overlap of 26%, 31% and 39% of the RV with the contrast-enhancing MR volume, PETvol and the composite MRPETvol, respectively. MGMT-methylation (p = 0.03), larger PETvol (p < 0.001), and less extensive surgery (p < 0.001), were associated with larger PETvol overlap. Conclusion The combined MRPETvol had a stronger association with the recurrence volume than either of the modalities alone. Larger overlap of PETvol and RV was observed for patients with MGMT-methylation, less extensive surgery, and large PETvol on the RT-planning scans.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Brain Neoplasms
KW - Disease Progression
KW - Female
KW - Glioblastoma
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Neoplasm Recurrence, Local
KW - Positron Emission Tomography Computed Tomography
KW - Positron-Emission Tomography
KW - Radiology, Interventional
KW - Radiopharmaceuticals
KW - Radiotherapy, Image-Guided
KW - Retrospective Studies
KW - Treatment Failure
KW - Tyrosine
KW - Journal Article
U2 - 10.1016/j.radonc.2017.01.002
DO - 10.1016/j.radonc.2017.01.002
M3 - Journal article
C2 - 28110959
SN - 0167-8140
VL - 122
SP - 380
EP - 386
JO - Radiotherapy & Oncology
JF - Radiotherapy & Oncology
IS - 3
ER -