Nuklearmedizin 2020; 59(02): 108
DOI: 10.1055/s-0040-1708176
Wissenschaftliche Vorträge
Onkologie: Therapiekontrolle & Risikostratifizierung
© Georg Thieme Verlag KG Stuttgart · New York

Prognostic value of 18F-GE-180 PET in newly diagnosed IDH-wildtype glioma prior to radiotherapy

Authors

  • D Nelwan

    1   Ludwig-Maximilians-Universität München, Klinik für Nuklearmedizin, München

  • M Unterrainer

    1   Ludwig-Maximilians-Universität München, Klinik für Nuklearmedizin, München

  • DF Fleischmann

    2   Ludwig-Maximilians-Universität München, Klinik für Strahlentherapie und Radioonkologie, München

  • K von Rohr

    1   Ludwig-Maximilians-Universität München, Klinik für Nuklearmedizin, München

  • R Rupprecht

    3   Universität Regensburg, Klinik für Psychiatrie und Psychotherapie, Regensburg

  • JC Tonn

    4   Ludwig-Maximilians-Universität München, Klinik für Neurochirurgie, München

  • C Belka

    2   Ludwig-Maximilians-Universität München, Klinik für Strahlentherapie und Radioonkologie, München

  • P Bartenstein

    1   Ludwig-Maximilians-Universität München, Klinik für Nuklearmedizin, München

  • M Niyazi

    2   Ludwig-Maximilians-Universität München, Klinik für Strahlentherapie und Radioonkologie, München

  • NL Albert

    1   Ludwig-Maximilians-Universität München, Klinik für Nuklearmedizin, München
Further Information

Publication History

Publication Date:
08 April 2020 (online)

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    Ziel/Aim The 18 kDa translocator-protein (TSPO) is overexpressed in high-grade glioma cells and therefore represents a promising target for glioma imaging. 18F-GE-180 is a novel TSPO-ligand with improved imaging properties compared to last generation TSPO-ligands with a high uptake in gliomas. However, the prognostic value of TSPO PET with 18F-GE-180 in patients withIDH-wildtype (IDHwt)glioma is unknown and therefore evaluated in this study.

    Methodik/Methods Patients with newly diagnosed IDHwt glioma (WHO grade III/IV) and 18F-GE-180 PET prior to initial radiotherapy (RT) were included. Molecular genetic and clinical factors (i.e. MGMT methylation, TERT mutation, age, sex, Karnofsky performace score (KPS), and RT fractionation scheme), as well as PET parameters (i.e. maximal/mean tumour-to-background ratios (TBRmax/mean) and biological-tumor-volume (BTV)) were assessed and correlated with progression-free and overall survival (PFS and OS) as defined by RANO criteria using Kaplan-Meier and multivariate Cox regression analysis.

    Ergebnisse/Results 42 patients with a median PFS of 9 months and median OS of 16 months were evaluated. None of the PET derived parameters were associated with PFS (p>0.05 each). In contrast, a high TBRmax (cut-off 5.4; 11.0 months vs. median not reached, p = 0.015), unmethylated MGMT-promoter (11.0 months vs. median not reached, p = 0.039) and hypofractionated RT (9.0 vs. 20.0 months, p = 0.007) were associated with inferior OS. These parameters remained significant on multivariate analysis (TBRmax>5.4: Hazard-Ratio (HR) 5.78[1.62-20.61], p = 0.007; unmethylated MGMT: HR 8.5[2.24-32.28], p = 0.002; hypofractionated RT: HR 6.11[2.17-17.18], p = 0.001). Other PET parameters associated with OS were intercorrelated with TBRmax (Spearman’s correlation, p < 0.05).

    Schlussfolgerungen/Conclusions Uptake intensity of 18F-GE-180provides additional prognostic information beyond molecular genetic and clinical factors with regard to OS in IDHwt glioma prior to radiotherapy. TSPO PET might therefore be helpful to optimize patient management.