Treatment Response Evaluation Using 18F-FDOPA PET in Patients with Recurrent Malignant Glioma on Bevacizumab Therapy

Overview

Journal Clin Cancer Res

Specialty Oncology

Date 2014 Apr 2

PMID 24687922

Citations 56

Authors

Johannes Schwarzenberg

Johannes Czernin

Timothy F Cloughesy

Benjamin M Ellingson

Whitney B Pope

Tristan Grogan

David Elashoff

Cheri Geist

Daniel H S Silverman

Michael E Phelps

Wei Chen

Affiliations

Soon will be listed here.

Abstract

Purpose: This study compares the value of 3,4-dihydroxy-6-[(18)F]-fluoro-l-phenylalanine ((18)F-FDOPA) positron emission tomography (PET) and MRI in assessing outcome during antiangiogenic treatment in patients with recurrent high-grade gliomas.

Experimental Design: Thirty patients were prospectively studied with (18)F-FDOPA PET scans immediately before, and two and six weeks after start of bevacizumab therapy. (18)F-FDOPA metabolic tumor volumes (MTV) as well as max and mean standardized uptake values (SUV) within this MTV were obtained. MRI treatment response was assessed at six weeks. The predictive ability of (18)F-FDOPA PET and MRI response assessment were evaluated with regard to progression-free survival (PFS) and overall survival (OS).

Results: A total of 30, 28, and 24 (18)F-FDOPA PET scans at baseline, two weeks, and six weeks, were available for analysis, respectively. (18)F-FDOPA PET SUVs as well as their changes through therapy were not predictive of outcome. However, MTV parameters such as MTV changes were highly prognostic. Interestingly, absolute MTV at the first follow up scan provides the most significant prediction for increased OS (P < 0.0001) as well as PFS (P = 0.001). This surprising result was scrutinized with cross-validation and simulation analysis. Responders based on (18)F-FDOPA PET data survived 3.5 times longer (12.1 months vs. 3.5 months, median OS, P < 0.001) than nonresponders (17 patients vs. 11 patients, respectively). In comparison, responders based on MRI data lived 1.5 times longer (11.4 months vs 7.7 months, P = 0.03) than nonresponders (22 patients vs. 7 patients, respectively).

Conclusions: (18)F-FDOPA PET identifies treatment responders to antiangiogenic therapy as early as two weeks after treatment initiation.

Citing Articles

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Complex Diagnostic Challenges in Glioblastoma: The Role of F-FDOPA PET Imaging.

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PET-based response assessment criteria for diffuse gliomas (PET RANO 1.0): a report of the RANO group.

Albert N, Galldiks N, Ellingson B, van den Bent M, Chang S, Cicone F Lancet Oncol. 2024; 25(1):e29-e41.

PMID: 38181810 PMC: 11787868. DOI: 10.1016/S1470-2045(23)00525-9.

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