Serial FLT PET imaging to discriminate between true progression and pseudoprogression in patients with newly diagnosed glioblastoma: a long-term follow-up study.
Serial FLT PET imaging to discriminate between true progression and pseudoprogression in patients with newly diagnosed glioblastoma: a long-term follow-up study.
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DOI：
10.1007/s00259-018-4090-4
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发表时间：
2018-12
影响因子：
9.1
通讯作者：
Walenkamp AME
中科院分区：
文献类型：
--
作者：
Brahm CG;den Hollander MW;Enting RH;de Groot JC;Solouki AM;den Dunnen WFA;Heesters MAAM;Wagemakers M;Verheul HMW;de Vries EGE;Pruim J;Walenkamp AME
由于MRI上的进行性对比增强病变不能反映真实的肿瘤进展，因此对放化疗后胶质母细胞瘤患者的缓解评估具有挑战性。在这项研究中，我们前瞻性地评估了PET示踪剂18F-氟胸苷（FLT）（一种反映增殖活性的示踪剂）在新诊断的胶质母细胞瘤患者中区分真正进展和假进展的能力。在放化疗前和放化疗后4周进行FLT PET和MRI扫描。在三个周期的辅助替莫唑胺后也进行了MRI扫描。假进展定义为放化疗后MRI上的疾病进展，并在三个周期的替莫唑胺治疗后稳定或减少对比增强病变，并与长期随访期间的病程进行比较。计算FLT的最大标准化摄取值（SUVmax）和肿瘤与正常摄取比值的变化，并表示为多个病变的平均SUVmax。在2009年至2012年期间，纳入了30名患者。在24名可评估患者中，根据MRI反应的定义，7名患者出现假进展，7名患者出现真正进展。FLT PET参数在MRI定义的真实进展和假进展患者之间无显著差异。SUVmax变化与生存率的相关性（p = 0.059）几乎达到统计学显著性的标准水平。基线FLT PET摄取较低与生存率改善显著相关（p = 0.022）。基线FLT摄取似乎可预测总生存期。此外，SUVmax随时间的变化显示出与生存率改善相关的趋势。然而，有必要进一步研究FLT PET成像区分胶质母细胞瘤患者的真实进展和假进展的能力。
Response evaluation in patients with glioblastoma after chemoradiotherapy is challenging due to progressive, contrast-enhancing lesions on MRI that do not reflect true tumour progression. In this study, we prospectively evaluated the ability of the PET tracer 18F-fluorothymidine (FLT), a tracer reflecting proliferative activity, to discriminate between true progression and pseudoprogression in newly diagnosed glioblastoma patients treated with chemoradiotherapy. FLT PET and MRI scans were performed before and 4 weeks after chemoradiotherapy. MRI scans were also performed after three cycles of adjuvant temozolomide. Pseudoprogression was defined as progressive disease on MRI after chemoradiotherapy with stabilisation or reduction of contrast-enhanced lesions after three cycles of temozolomide, and was compared with the disease course during long-term follow-up. Changes in maximum standardized uptake value (SUVmax) and tumour-to-normal uptake ratios were calculated for FLT and are presented as the mean SUVmax for multiple lesions. Between 2009 and 2012, 30 patients were included. Of 24 evaluable patients, 7 showed pseudoprogression and 7 had true progression as defined by MRI response. FLT PET parameters did not significantly differ between patients with true progression and pseudoprogression defined by MRI. The correlation between change in SUVmax and survival (p = 0.059) almost reached the standard level of statistical significance. Lower baseline FLT PET uptake was significantly correlated with improved survival (p = 0.022). Baseline FLT uptake appears to be predictive of overall survival. Furthermore, changes in SUVmax over time showed a tendency to be associated with improved survival. However, further studies are necessary to investigate the ability of FLT PET imaging to discriminate between true progression and pseudoprogression in patients with glioblastoma.
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影响因子：
15.9
作者：
Dolecek, Therese A.;Propp, Jennifer M.;Kruchko, Carol
通讯作者：
Kruchko, Carol
影响因子：
9.3
作者：
Idema, Albert J. S.;Hoffmann, Aswin L.;Oyen, Wim J. G.
通讯作者：
Oyen, Wim J. G.
DOI：
10.1007/s00259-004-1742-3
发表时间：
2005-06-01
影响因子：
9.1
作者：
Choi, SJ;Kim, JS;Moon, DH
通讯作者：
Moon, DH
DOI：
10.1007/s00259-012-2251-4
发表时间：
2013-01-01
影响因子：
9.1
作者：
Galldiks, Norbert;Rapp, Marion;Langen, Karl-Josef
通讯作者：
Langen, Karl-Josef
影响因子：
45.3
作者：
Chen, Wei;Delaloye, Sibylle;Cloughesy, Timothy
通讯作者：
Cloughesy, Timothy