Pre-irradiation tumour volumes defined by MRI and dual time-point FET-PET for the prediction of glioblastoma multiforme recurrence: A prospective study

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• 作者：Maciej Harat^a ; ^b ; ^{haratm@co.bydgoszcz.pl" class="auth_mail" title="E-mail the corresponding author} ; Bogdan Małkowski^c ; ^d ; Roman Makarewicz^b ; ^e
• 关键词：Glioblastoma multiforme ; FET-PET ; MRI ; Tumour volume ; Radiotherapy
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：120
• 期：2
• 页码：241-247
• 全文大小：1134 K

文摘

The diagnostic accuracy of magnetic resonance imaging (MRI) for glioblastoma multiforme (GBM) is suboptimal. We analysed pre-treatment MRI- and dual time-point 18F-fluoroethylthyrosine-PET (FET-PET)-based target volumes and GBM recurrence patterns following radiotherapy with temozolomide.

Materials and methods

Thirty-four patients with primary GBM were treated according to MRI-based treatment volumes (GTV_RM). Patients underwent dual time-point FET-PET scans prior to treatment, and biological tumour volumes (GTV_PET) were contoured but not used for target definition. Progressions were classified based on location of primary GTVs. Volume and uniformity of MRI- vs. FET-PET/CT-derived GTVs and progression patterns assessed by MRI were analysed.

Results

FET-based GTVs measured 10 min after radionuclide injection (a.r.i.; median 37.3 cm³) were larger than GTVs measured 60 min a.r.i. (median 27.7 cm³). GTV_PET volumes were significantly larger than corresponding MRI-based GTVs. MRI and PET concordance for the identification of glioblastoma GTVs was poor (mean uniformity index 0.4). 74% of failures were inside primary GTV_PET volumes, with no solitary progressions inside the MRI-defined margin +20 mm but outside the GTV_PET detected.

Conclusions

The size and geometry of GTVs differed in the majority of patients. The GTV_PET volume depends on time after radionuclide injection. FET-PET better defined failure site than MRI alone.