Impact of [18F]-fluoro-ethyl-tyrosine PET Imaging on Target Definition for Radiation Therapy of High-grade Glioma

Overview

Journal Neuro Oncol

Publisher Oxford University Press

Specialties Neurology
Oncology

Date 2014 Dec 25

PMID 25537018

Citations 31

Authors

Per Munck Af Rosenschold

Junia Costa

Svend Aage Engelholm

Michael J Lundemann

Ian Law

Lars Ohlhues

Silke Engelholm

Affiliations

Soon will be listed here.

Abstract

Background: We sought to assess the impact of amino-acid (18)F-fluoro-ethyl-tyrosine (FET) positron emission tomography (PET) on the volumetric target definition for radiation therapy of high-grade glioma versus the current standard using MRI alone. Specifically, we investigated the influence of tumor grade, MR-defined tumor volume, and the extent of surgical resection on PET positivity.

Methods: Fifty-four consecutive high-grade glioma patients (World Health Organization grades III-IV) with confirmed histology were scanned using FET-PET/CT and T1 and T2/fluid attenuated inversion recovery MRI. Gross tumor volume and clinical target volumes (CTVs) were defined in a blinded fashion based on MRI and subsequently PET, and volumetric analysis was performed. The extent of the surgical resection was reviewed using postoperative MRI.

Results: Overall, for ∼ 90% of the patients, the PET-positive volumes were encompassed by T1 MRI with contrast-defined tumor plus a 20-mm margin. The tumor volume defined by PET was larger for glioma grade IV (P < .001) and smaller for patients with more extensive surgical resection (P = .004). The margin required to be added to the MRI-defined tumor in order to fully encompass the FET-PET positive volume tended to be larger for grade IV tumors (P = .018).

Conclusion: With an unchanged CTV margin and by including FET-PET for gross tumor volume definition, the CTV will increase moderately for most patients, and quite substantially for a minority of patients. Patients with grade IV glioma were found to be the primary candidates for PET-guided radiation therapy planning.

Citing Articles

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Ryan J, Hardcastle N, Francis R, Ferjancic P, Ng S, Koh E Phys Imaging Radiat Oncol. 2024; 29:100536.

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Harat M, Rakowska J, Harat M, Szylberg T, Furtak J, Miechowicz I Nat Commun. 2023; 14(1):4572.

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