Patterns of failure for patients with glioblastoma following O-(2-[18F]fluoroethyl)-L-tyrosine PET- and MRI-guided radiotherapy

Michael Lundemann; Junia Cardoso Costa; Ian Law; Svend Aage Engelholm; Aida Muhic; Hans Skovgaard Poulsen; Per Munck af Rosenschöld

doi:10.1016/j.radonc.2017.01.002

Patterns of failure for patients with glioblastoma following O-(2-[¹⁸F]fluoroethyl)-L-tyrosine PET- and MRI-guided radiotherapy

Michael Lundemann, Junia Cardoso Costa, Ian Law, Svend Aage Engelholm, Aida Muhic, Hans Skovgaard Poulsen, Per Munck af Rosenschöld

14 Citations (Scopus)

Abstract

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 (PET_vol). 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, PET_vol and the composite MRPET_vol, respectively. MGMT-methylation (p = 0.03), larger PET_vol (p < 0.001), and less extensive surgery (p < 0.001), were associated with larger PET_vol overlap. Conclusion The combined MRPET_vol had a stronger association with the recurrence volume than either of the modalities alone. Larger overlap of PET_vol and RV was observed for patients with MGMT-methylation, less extensive surgery, and large PET_vol on the RT-planning scans.

Original language	English
Journal	Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Volume	122
Issue number	3
Pages (from-to)	380-386
Number of pages	7
ISSN	0167-8140
DOIs	https://doi.org/10.1016/j.radonc.2017.01.002
Publication status	Published - 1 Mar 2017

Keywords

Adult
Aged
Aged, 80 and over
Brain Neoplasms
Disease Progression
Female
Glioblastoma
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Recurrence, Local
Positron Emission Tomography Computed Tomography
Positron-Emission Tomography
Radiology, Interventional
Radiopharmaceuticals
Radiotherapy, Image-Guided
Retrospective Studies
Treatment Failure
Tyrosine
Journal Article

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10.1016/j.radonc.2017.01.002

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Lundemann, M., Costa, J. C., Law, I., Engelholm, S. A., Muhic, A., Poulsen, H. S., & Munck af Rosenschöld, P. (2017). Patterns of failure for patients with glioblastoma following O-(2-[¹⁸F]fluoroethyl)-L-tyrosine PET- and MRI-guided radiotherapy. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 122(3), 380-386. https://doi.org/10.1016/j.radonc.2017.01.002

Patterns of failure for patients with glioblastoma following O-(2-[¹⁸F]fluoroethyl)-L-tyrosine PET- and MRI-guided radiotherapy. / Lundemann, Michael; Costa, Junia Cardoso; Law, Ian et al.

In: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, Vol. 122, No. 3, 01.03.2017, p. 380-386.

Research output: Contribution to journal › Journal article › Research › peer-review

Lundemann, M, Costa, JC, Law, I, Engelholm, SA, Muhic, A, Poulsen, HS & Munck af Rosenschöld, P 2017, 'Patterns of failure for patients with glioblastoma following O-(2-[¹⁸F]fluoroethyl)-L-tyrosine PET- and MRI-guided radiotherapy', Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, vol. 122, no. 3, pp. 380-386. https://doi.org/10.1016/j.radonc.2017.01.002

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title = "Patterns of failure for patients with glioblastoma following O-(2-[18F]fluoroethyl)-L-tyrosine PET- and MRI-guided radiotherapy",

abstract = "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.",

keywords = "Adult, Aged, Aged, 80 and over, Brain Neoplasms, Disease Progression, Female, Glioblastoma, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Recurrence, Local, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Radiology, Interventional, Radiopharmaceuticals, Radiotherapy, Image-Guided, Retrospective Studies, Treatment Failure, Tyrosine, Journal Article",

author = "Michael Lundemann and Costa, {Junia Cardoso} and Ian Law and Engelholm, {Svend Aage} and Aida Muhic and Poulsen, {Hans Skovgaard} and {Munck af Rosensch{\"o}ld}, Per",

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day = "1",

doi = "10.1016/j.radonc.2017.01.002",

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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

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 -