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Re-irradiation in recurrent malignant glioma: prognostic value of [18F]FET–PET

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Abstract

The aim of the present study is to determine new positron emission tomography (PET) imaging-related factors predictive of progression-free survival as well as survival in patients with recurrent malignant glioma (MG) prior to and after re-irradiation. Fifty-six patients with recurrent MG who underwent re-irradiation treatment and pretherapeutic dynamic [18F]-fluoroethyl-l-tyrosine (FET)–PET scan were retrospectively analyzed. The prognostic value of different parameters, such as biological tumor volume, maximal tumor uptake (SUVmax/BG), mean tumor uptake (SUVmean/BG), as well as uptake kinetics, was evaluated. [18F]FET uptake kinetics was classified according to a five-point rating as category G1–2 (strongly/mainly increasing kinetics), G3 (mixed 1:1), or G4–5 (mainly/strongly decreasing kinetics). Patients within the pretherapeutic kinetic group G4–5 had significantly worse survival than the other two groups (p = 0.01). Multivariate analysis revealed that histologic grade, Karnofsky Performance Score (KPS), and kinetic group were independent significant predictors for survival after re-irradiation. The uptake kinetics of [18F]FET–PET is an independent determinant of overall and to a lesser extent also progression-free survival. Thus, [18F]FET–PET kinetics may provide valuable additional prognostic information for treatment decisions.

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The authors declare that conflicts of interest do not exist.

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Authors and Affiliations

  1. Department of Radiation Oncology, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany

    Maximilian Niyazi, Ute Ganswindt, Silke Birgit Schwarz & Claus Belka

  2. Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany

    Nathalie Jansen, Julia Geisler & Christian la Fougère

  3. Department of Neurosurgery, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany

    Oliver Schnell

  4. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Karen Büsing

  5. Department of Neuropathology, Ludwig-Maximilians-University Munich, Feodor-Lynen-Str. 23, 81377, Munich, Germany

    Sabina Eigenbrod

Authors
  1. Maximilian Niyazi
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  2. Nathalie Jansen
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  3. Ute Ganswindt
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  4. Silke Birgit Schwarz
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  5. Julia Geisler
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  6. Oliver Schnell
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  7. Karen Büsing
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  8. Sabina Eigenbrod
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  9. Christian la Fougère
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  10. Claus Belka
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Correspondence to Maximilian Niyazi.

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Maximilian Niyazi and Nathalie Jansen contributed equally

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Niyazi, M., Jansen, N., Ganswindt, U. et al. Re-irradiation in recurrent malignant glioma: prognostic value of [18F]FET–PET. J Neurooncol 110, 389–395 (2012). https://doi.org/10.1007/s11060-012-0980-7

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  • DOI: https://doi.org/10.1007/s11060-012-0980-7

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