RT Journal Article
SR Electronic
T1 Prognostic Value of TSPO PET Before Radiotherapy in Newly Diagnosed IDH–Wild-Type Glioblastoma
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1519
OP 1525
DO 10.2967/jnumed.122.265247
VO 64
IS 10
A1 Albert, Nathalie L.
A1 Nelwan, Debie V.
A1 Fleischmann, Daniel F.
A1 Quach, Stefanie
A1 von Rohr, Katharina
A1 Kaiser, Lena
A1 Teske, Nico
A1 Unterrainer, Lena M.
A1 Bartos, Laura M.
A1 Ruf, Viktoria C.
A1 Brendel, Matthias
A1 Riemenschneider, Markus J.
A1 Wetzel, Christian
A1 Herms, Jochen
A1 Rupprecht, Rainer
A1 Thon, Niklas
A1 Tonn, Joerg-Christian
A1 Belka, Claus
A1 Bartenstein, Peter
A1 von Baumgarten, Louisa
A1 Niyazi, Maximilian
A1 Unterrainer, Marcus
A1 Holzgreve, Adrien
YR 2023
UL http://jnm.snmjournals.org/content/64/10/1519.abstract
AB The 18-kDa translocator protein (TSPO) is gaining recognition as a relevant target in glioblastoma imaging. However, data on the potential prognostic value of TSPO PET imaging in glioblastoma are lacking. Therefore, we investigated the association of TSPO PET imaging results with survival outcome in a homogeneous cohort of glioblastoma patients. Methods: Patients were included who had newly diagnosed, histologically confirmed isocitrate dehydrogenase (IDH)–wild-type glioblastoma with available TSPO PET before either normofractionated radiotherapy combined with temozolomide or hypofractionated radiotherapy. SUVmax on TSPO PET, TSPO binding affinity status, tumor volumes on MRI, and further clinical data, such as O6-alkylguanine DNA methyltransferase (MGMT) and telomerase reverse transcriptase (TERT) gene promoter mutation status, were correlated with patient survival. Results: Forty-five patients (median age, 63.3 y) were included. Median SUVmax was 2.2 (range, 1.0–4.7). A TSPO PET signal was associated with survival: High uptake intensity (SUVmax > 2.2) was related to significantly shorter overall survival (OS; 8.3 vs. 17.8 mo, P = 0.037). Besides SUVmax, prognostic factors for OS were age (P = 0.046), MGMT promoter methylation status (P = 0.032), and T2-weighted MRI volume (P = 0.031). In the multivariate survival analysis, SUVmax in TSPO PET remained an independent prognostic factor for OS (P = 0.023), with a hazard ratio of 2.212 (95% CI, 1.115–4.386) for death in cases with a high TSPO PET signal (SUVmax > 2.2). Conclusion: A high TSPO PET signal before radiotherapy is associated with significantly shorter survival in patients with newly diagnosed IDH–wild-type glioblastoma. TSPO PET seems to add prognostic insights beyond established clinical parameters and might serve as an informative tool as clinicians make survival predictions for patients with glioblastoma.