MRI and 11C-methyl-L-methionine PET Differentiate Bevacizumab True Responders After Initiating Therapy for Recurrent Glioblastoma
MRI and 11C-methyl-L-methionine PET Differentiate Bevacizumab True Responders After Initiating Therapy for Recurrent Glioblastoma
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DOI：
10.1097/rlu.0000000000001377
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发表时间：
2016-11-01
影响因子：
10.6
通讯作者：
Ogasawara, Kuniaki
中科院分区：
文献类型：
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作者：
Beppu, Takaaki;Terasaki, Kazunori;Ogasawara, Kuniaki
目的：贝伐单抗（BEV）给药后肿瘤血管的正常化使得使用MRI评估治疗反应变得困难。本研究的目的是澄清是否PET与C-11-甲基-L-蛋氨酸（MET-PET）将补充MRI评估后，启动BEV在glioblastoma.Methods的反应：20例复发性胶质母细胞瘤进行治疗，每两周一次BEV加替莫唑胺。在治疗前（基线）和开始治疗后4周和8周进行MRI和MET-PET。将MRI结果（反应或无反应）与MET-PET结果进行比较，反应定义为肿瘤与正常脑的SUV比值（SUVT/N）小于1.6。在单独MRI和单独MET-PET的应答者和非应答者之间比较无进展生存期（PFS）。无进展生存期也比较了患者的MRI和MET-PET和MRI上显示的反应，但在MET-PET无反应的患者在每个时间点。结果：PFS显着长于MRI在4周和8周和MET-PET在8周，而MET-PET在4周没有提供有关结果的信息。4周时MRI和MET-PET的联合评估无法预测PFS，而患者在两种模式下均表现出反应在第8周，与MRI显示缓解但MET-PET显示无缓解的患者相比，（真正缓解者）的PFS显著更长结论：在8周时使用MRI和MET-PET进行联合评估可以区分预测显示更有利预后的真正应答者与假应答者。
Purpose: Normalization of tumor vasculature after administering bevacizumab (BEV) makes assessment of therapeutic response using MRI difficult. The aim of this study was to clarify whether PET with C-11-methyl-L-methionine (MET-PET) would supplement MRI assessing of response after initiating BEV in glioblastoma.Methods: Twenty patients with recurrent glioblastoma were treated with biweekly BEV plus temozolomide. Both MRI and MET-PET were performed before treatment (baseline) and at 4 and 8 weeks after starting treatment. Results on MRI (response or nonresponse) were compared with those on MET-PET, with response defined as a tumor-to-normal brain ratio of SUV (SUVT/N) of less than 1.6. Progression-free survival (PFS) was compared between responders and nonresponders on MRI alone and MET-PET alone. Progression-free survival was also compared between patients showing response on both MRI and MET-PET and patients showing response on MRI but nonresponse on MET-PET at each time point.Results: PFS was significantly longer in responders than nonresponders on both MRI at 4 and 8 weeks and MET-PET at 8 weeks, whereas MET-PET at 4 weeks provided no information regarding outcomes. Combined assessment with MRI and MET-PET at 4 weeks was not provide predictive of PFS, whereas patients showing response on both modalities (true responders) at 8 weeks exhibited significantly longer PFS than did patients showing response on MRI but nonresponse on MET-PET (pseudoresponders).Conclusions: Combined assessment with MRI and MET-PET at 8 weeks can differentiate true responders who are predicted to show more favorable prognosis from pseudoresponders.