Study of 18 F-fluciclovine PET for serial assessment of glioblastoma tumor volumes during surgery and radiotherapy.

IF 3.1 2区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuro-Oncology Pub Date : 2025-11-01 Epub Date: 2025-07-01 DOI:10.1007/s11060-025-05146-2

Samir A Dagher, Jason M Johnson, Rania M M Mohamed, Shehbaz Ansari, Osama Mawlawi, Ho-Ling Liu, Max Wintermark, Dawid Schellingerhout, Lesley Flynt, Debra N Yeboa, Jeffrey S Weinberg, Sherise D Ferguson, Maria K Gule-Monroe

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引用次数: 0

Abstract

Purpose: Recent evidence supports incorporating 18 F-Fluciclovine PET for glioblastoma treatment planning and monitoring, as it better captures tumor infiltration compared to conventional MRI. However, the relationship between PET- and MRI-defined tumor volumes remains unclear, particularly in the post-treatment setting. This study prospectively compares tumor volumes on MRI and PET at multiple timepoints throughout the treatment course and evaluates volumetric changes with therapy.

Methods: We prospectively enrolled 8 adults with IDH-wildtype glioblastoma treated with surgery and chemoradiation between September 2019 and 2021. Participants underwent paired 18 F-Fluciclovine PET/CT and conventional MRI at four timepoints: preoperatively, pre-radiation, and at one- and six-months post-radiation. Biological tumor volume (BTV) from PET, FLAIR, and post-contrast T1volumes (T1CV) were segmented. Volumetric changes were compared using the Friedman test.

Results: Participants (5 males, median age 63 years [IQR 54,66]) showed significantly larger BTVs compared to T1CV at diagnosis (median BTV = 27.2mL vs. T1CV = 13.3mL, adjusted P =.03), pre-radiation (BTV = 25.2mL vs. T1CV = 6.9mL, adjusted P =.03), and at one-month post-radiation (BTV = 27.3mL vs. T1CV = 12.1mL, P =.04). BTVs closely approximated yet were slightly smaller than their corresponding FLAIR volumes at all timepoints. After surgery, the median decrease in BTV (-4.4%) was significantly smaller than T1CV (-66.5%, P =.046), with a similar nonsignificant trend observed post-radiation (P =.50).

Conclusion: Glioblastoma BTVs consistently exceed post-contrast T1 volumes and closely approximate FLAIR abnormalities throughout treatment. BTVs decline more gradually post-treatment, indicating persistent hypermetabolic tumor burden. Thus, 18 F-Fluciclovine PET can serve as an adjunct to conventional MRI in glioblastoma treatment planning and monitoring.

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18f -氟氯洛夫PET在手术和放疗期间对胶质母细胞瘤肿瘤体积的系列评估研究。

目的：最近的证据支持在胶质母细胞瘤的治疗计划和监测中纳入18f -氟氯洛夫PET，因为与传统MRI相比，它能更好地捕捉肿瘤浸润。然而，PET和mri定义的肿瘤体积之间的关系尚不清楚，特别是在治疗后的情况下。本研究前瞻性地比较了整个治疗过程中多个时间点MRI和PET上的肿瘤体积，并评估了治疗过程中体积的变化。方法：我们前瞻性地招募了8名在2019年9月至2021年期间接受手术和放化疗治疗的idh野生型胶质母细胞瘤成人患者。参与者在术前、放疗前、放疗后1个月和6个月四个时间点接受了配对的18f -氟氯烃PET/CT和常规MRI检查。对PET、FLAIR的生物肿瘤体积（BTV）和对比后的t1体积（T1CV）进行分割。体积变化采用Friedman检验进行比较。结果：参与者（5名男性，中位年龄63岁[IQR 54,66]）在诊断时（中位BTV = 27.2mL vs. T1CV = 13.3mL，校正P = 0.03）、放射前（BTV = 25.2mL vs. T1CV = 6.9mL，校正P = 0.03）和放射后1个月（BTV = 27.3mL vs. T1CV = 12.1mL, P = 0.04）的BTV均显著高于T1CV。btv非常接近，但在所有时间点都略小于相应的FLAIR体积。术后BTV中位下降（-4.4%）明显小于T1CV (-66.5%, P = 0.046)，放疗后BTV中位下降趋势相似（P = 0.50）。结论：在整个治疗过程中，胶质母细胞瘤btv始终超过对比后T1体积，并与FLAIR异常非常接近。btv在治疗后逐渐下降，表明持续的高代谢肿瘤负担。因此，18f -氟氯薇PET可以作为常规MRI的辅助手段，用于胶质母细胞瘤的治疗计划和监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuro-Oncology 医学-临床神经学

CiteScore

6.60

自引率

7.70%

发文量

277

审稿时长

3.3 months

期刊介绍： The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.