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
{"title":"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。","authors":"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","doi":"10.1007/s11060-025-05146-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"549-560"},"PeriodicalIF":3.1000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420720/pdf/","citationCount":"0","resultStr":"{\"title\":\"Study of 18 F-fluciclovine PET for serial assessment of glioblastoma tumor volumes during surgery and radiotherapy.\",\"authors\":\"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\",\"doi\":\"10.1007/s11060-025-05146-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":16425,\"journal\":{\"name\":\"Journal of Neuro-Oncology\",\"volume\":\" \",\"pages\":\"549-560\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420720/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Neuro-Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11060-025-05146-2\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuro-Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11060-025-05146-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
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。
Study of 18 F-fluciclovine PET for serial assessment of glioblastoma tumor volumes during surgery and radiotherapy.
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.
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.
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