Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy

Abstract High-precision radiotherapy (HPR) of recurrent high grade glioma (HGG) requires accurate spatial allocation of these infiltrative tumors. We investigated the impact of 18F-FET PET on tumor delineation and progression of recurrent HGG after HPR with carbon ions. T1 contrast enhanced MRI and...

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Autores principales:	Charlotte Debus, Maria Waltenberger, Ralf Floca, Ali Afshar-Oromieh, Nina Bougatf, Sebastian Adeberg, Sabine Heiland, Martin Bendszus, Wolfgang Wick, Stefan Rieken, Uwe Haberkorn, Jürgen Debus, Maximilian Knoll, Amir Abdollahi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d9353d8d07da4471969a1b48ef0e5b2b
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spelling	oai:doaj.org-article:d9353d8d07da4471969a1b48ef0e5b2b2021-12-02T15:08:34ZImpact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy10.1038/s41598-018-25350-72045-2322https://doaj.org/article/d9353d8d07da4471969a1b48ef0e5b2b2018-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-25350-7https://doaj.org/toc/2045-2322Abstract High-precision radiotherapy (HPR) of recurrent high grade glioma (HGG) requires accurate spatial allocation of these infiltrative tumors. We investigated the impact of 18F-FET PET on tumor delineation and progression of recurrent HGG after HPR with carbon ions. T1 contrast enhanced MRI and 18F-FET-PET scans of 26 HGG patients were fused with radiotherapy planning volumes. PET-positive (PET+) tumor volumes using different isocontours (I%) were systematically investigated and compared with MRI-derived gross tumor volumes (GTV). Standardized uptake ratios (SUR) were further correlated with GTV and tumor progression patterns. In grade IV glioma, SUR > 2.92 significantly correlated with poor median overall survival (6.5 vs 13.1 months, p = 0.00016). We found no reliable SUR cut-off criteria for definition of PET+ volumes. Overall conformity between PET and MRI-based contours was low, with maximum conformities between 0.42–0.51 at I40%. The maximum sensitivity and specificity for PET+ volumes outside of GTV predicting tumor progression were 0.16 (I40%) and 0.52 (I50%), respectively. In 75% of cases, FLAIR hyperintense area covered over 80% of PET+ volumes. 18F-FET-PET derived SUR has a prognostic impact in grade IV glioma. The value of substantial mismatches between MRI-based GTV and PET+ volumes to improve tumor delineation in radiotherapy awaits further validation in randomized prospective trials.Charlotte DebusMaria WaltenbergerRalf FlocaAli Afshar-OromiehNina BougatfSebastian AdebergSabine HeilandMartin BendszusWolfgang WickStefan RiekenUwe HaberkornJürgen DebusMaximilian KnollAmir AbdollahiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-13 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Charlotte Debus Maria Waltenberger Ralf Floca Ali Afshar-Oromieh Nina Bougatf Sebastian Adeberg Sabine Heiland Martin Bendszus Wolfgang Wick Stefan Rieken Uwe Haberkorn Jürgen Debus Maximilian Knoll Amir Abdollahi Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy
description	Abstract High-precision radiotherapy (HPR) of recurrent high grade glioma (HGG) requires accurate spatial allocation of these infiltrative tumors. We investigated the impact of 18F-FET PET on tumor delineation and progression of recurrent HGG after HPR with carbon ions. T1 contrast enhanced MRI and 18F-FET-PET scans of 26 HGG patients were fused with radiotherapy planning volumes. PET-positive (PET+) tumor volumes using different isocontours (I%) were systematically investigated and compared with MRI-derived gross tumor volumes (GTV). Standardized uptake ratios (SUR) were further correlated with GTV and tumor progression patterns. In grade IV glioma, SUR > 2.92 significantly correlated with poor median overall survival (6.5 vs 13.1 months, p = 0.00016). We found no reliable SUR cut-off criteria for definition of PET+ volumes. Overall conformity between PET and MRI-based contours was low, with maximum conformities between 0.42–0.51 at I40%. The maximum sensitivity and specificity for PET+ volumes outside of GTV predicting tumor progression were 0.16 (I40%) and 0.52 (I50%), respectively. In 75% of cases, FLAIR hyperintense area covered over 80% of PET+ volumes. 18F-FET-PET derived SUR has a prognostic impact in grade IV glioma. The value of substantial mismatches between MRI-based GTV and PET+ volumes to improve tumor delineation in radiotherapy awaits further validation in randomized prospective trials.
format	article
author	Charlotte Debus Maria Waltenberger Ralf Floca Ali Afshar-Oromieh Nina Bougatf Sebastian Adeberg Sabine Heiland Martin Bendszus Wolfgang Wick Stefan Rieken Uwe Haberkorn Jürgen Debus Maximilian Knoll Amir Abdollahi
author_facet	Charlotte Debus Maria Waltenberger Ralf Floca Ali Afshar-Oromieh Nina Bougatf Sebastian Adeberg Sabine Heiland Martin Bendszus Wolfgang Wick Stefan Rieken Uwe Haberkorn Jürgen Debus Maximilian Knoll Amir Abdollahi
author_sort	Charlotte Debus
title	Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy
title_short	Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy
title_full	Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy
title_fullStr	Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy
title_full_unstemmed	Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy
title_sort	impact of 18f-fet pet on target volume definition and tumor progression of recurrent high grade glioma treated with carbon-ion radiotherapy
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/d9353d8d07da4471969a1b48ef0e5b2b
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Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy

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