F-18-FET PET Uptake Characteristics of Long-Term IDH-Wildtype Diffuse Glioma Survivors

Mittlmeier, Lena M.; Suchorska, Bogdana; Ruf, Viktoria; Holzgreve, Adrien; Brendel, Matthias; Herms, Jochen; Bartenstein, Peter; Tonn, Jörg C.; Unterrainer, Marcus und Albert, Nathalie L. (2021): F-18-FET PET Uptake Characteristics of Long-Term IDH-Wildtype Diffuse Glioma Survivors. In: Cancers, Bd. 13, Nr. 13, 3163

Abstract

IDH-wildtype (IDHwt) gliomas represent a tumor entity with poor overall survival. Only rare cases have an overall survival over several years. Dynamic and static F-18-FET PET is recommended as valuable complementary tool for glioma imaging in gliomas. This study shows that, besides molecular genetic prognosticators, long survival (>= 36 months survival) in IDHwt gliomas is associated with a longer time-to-peak and smaller volume on F-18-FET PET at initial diagnosis compared to glioma patients with a short-term survival (<= 15 months survival). F-18-FET uptake intensity and MRI-derived tumor size do not differ in patients with long-term survival compared to patient with a short-term survival. Background: IDHwt diffuse gliomas represent the tumor entity with one of the worst clinical outcomes. Only rare cases present with a long-term survival of several years. Here we aimed at comparing the uptake characteristics on dynamic F-18-FET PET, clinical and molecular genetic parameters of long-term survivors (LTS) versus short-term survivors (STS): Methods: Patients with de-novo IDHwt glioma (WHO grade III/IV) and F-18-FET PET prior to any therapy were stratified into LTS (>= 36 months survival) and STS (<= 15 months survival). Static and dynamic F-18-FET PET parameters (mean/maximal tumor-to-background ratio (TBRmean/max), biological tumor volume (BTV), minimal time-to-peak (TTPmin)), diameter and volume of contrast-enhancement on MRI, clinical parameters (age, sex, Karnofksy-performance-score), mode of surgery;initial treatment and molecular genetics were assessed and compared between LTS and STS. Results: Overall, 75 IDHwt glioma patients were included (26 LTS, 49 STS). LTS were significantly younger (p < 0.001), had a higher rate of WHO grade III glioma (p = 0.032), of O(6)-Methylguanine-DNA methyltransferase (MGMT) promoter methylation (p < 0.001) and missing Telomerase reverse transcriptase promoter (TERTp) mutations (p = 0.004) compared to STS. On imaging, LTS showed a smaller median BTV (p = 0.017) and a significantly longer TTPmin (p = 0.008) on F-18-FET PET than STS, while uptake intensity (TBRmean/max) did not differ. In contrast to the tumor-volume on PET, MRI-derived parameters such as tumor size as well as all other above-mentioned parameters did not differ between LTS and STS (p > 0.05 each). Conclusion: Besides molecular genetic prognosticators, a long survival time in IDHwt glioma patients is associated with a longer TTPmin as well as a smaller BTV on F-18-FET PET at initial diagnosis. F-18-FET uptake intensity as well as the MRI-derived tumor size (volume and maximal diameter) do not differ in patients with long-term survival.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Sprache: Englisch