PT - JOURNAL ARTICLE AU - Hutterer, Markus AU - Nowosielski, Martha AU - Putzer, Daniel AU - Waitz, Dietmar AU - Tinkhauser, Gerd AU - Kostron, Herwig AU - Muigg, Armin AU - Virgolini, Irene J. AU - Staffen, Wolfgang AU - Trinka, Eugen AU - Gotwald, Thaddäus AU - Jacobs, Andreas H. AU - Stockhammer, Guenther TI - <em>O</em>-(2-<sup>18</sup>F-Fluoroethyl)-<span class="sc">L</span>-Tyrosine PET Predicts Failure of Antiangiogenic Treatment in Patients with Recurrent High-Grade Glioma AID - 10.2967/jnumed.110.086645 DP - 2011 Jun 01 TA - Journal of Nuclear Medicine PG - 856--864 VI - 52 IP - 6 4099 - http://jnm.snmjournals.org/content/52/6/856.short 4100 - http://jnm.snmjournals.org/content/52/6/856.full SO - J Nucl Med2011 Jun 01; 52 AB - The objective of this study was to compare MRI response assessment with metabolic O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) PET response evaluation during antiangiogenic treatment in patients with recurrent high-grade glioma (rHGG). Methods: Eleven patients with rHGG were treated biweekly with bevacizumab–irinotecan. MR images and 18F-FET PET scans were obtained at baseline and at follow-up 8–12 wk after treatment onset. MRI treatment response was evaluated by T1/T2 volumetry according to response assessment in neurooncology (RANO) criteria. For 18F-FET PET evaluation, an uptake reduction of more than 45% calculated with a standardized uptake value of more than 1.6 was defined as a metabolic response (receiver-operating-characteristic curve analysis). MRI and 18F-FET PET volumetry results and response assessment were compared with each other and in relation to progression-free survival (PFS) and overall survival (OS). Results: At follow-up, MR images showed partial response in 7 of 11 patients (64%), stable disease in 2 of 11 patients (18%), and tumor progression in 2 of 11 patients (18%). In contrast, 18F-FET PET revealed 5 of 11 metabolic responders (46%) and 6 of 11 nonresponders (54%). MRI and 18F-FET PET showed that responders survived significantly longer than did nonresponders (10.24 vs. 4.1 mo, P = 0.025, and 7.9 vs. 2.3 mo, P = 0.015, respectively). In 4 patients (36.4%), diagnosis according to RANO criteria and 18F-FET PET was discordant. In these cases, PET was able to detect tumor progression earlier than was MRI. Conclusion: In rHGG patients undergoing antiangiogenic treatment, 18F-FET PET seems to be predictive for treatment failure in that it contributes important information to response assessment based solely on MRI and RANO criteria.