FDG PET/MRI Coregistration Helps Predict Response to Gamma Knife Radiosurgery in Patients With Brain Metastases.

Autor: Leiva-Salinas C; 1 Department of Radiology, University of Missouri, 1 Hospital Dr, Columbia, MO 65211.; 2 Department of Radiology, University of Virginia, Charlottesville, VA., Muttikkal TJE; 2 Department of Radiology, University of Virginia, Charlottesville, VA., Flors L; 1 Department of Radiology, University of Missouri, 1 Hospital Dr, Columbia, MO 65211.; 2 Department of Radiology, University of Virginia, Charlottesville, VA., Puig J; 3 Department of Radiology, University of Manitoba, Winnipeg, Canada.; 4 Department of Radiology, Girona Biomedical Research Institute, University Hospital Dr. Josep Trueta, Girona, Spain., Wintermark M; 5 Department of Radiology, Stanford University, Palo Alto, CA., Patrie JT; 6 Department of Public Health Sciences, University of Virginia, Charlottesville, VA., Rehm PK; 2 Department of Radiology, University of Virginia, Charlottesville, VA., Sheehan JP; 7 Department of Neurosurgery, University of Virginia, Charlottesville, VA., Schiff D; 8 Department of Neurology, Neuro-Oncology Center, University of Virginia, Charlottesville, VA.
Jazyk: angličtina
Zdroj: AJR. American journal of roentgenology [AJR Am J Roentgenol] 2019 Feb; Vol. 212 (2), pp. 425-430. Date of Electronic Publication: 2018 Nov 13.
DOI: 10.2214/AJR.18.20006
Abstrakt: Objective: The purpose of this study was to determine whether relative standardized uptake value (SUV) measurements at FDG PET/MRI coregistration are predictive of local tumor control in patients with brain metastases treated with stereotactic radiosurgery (SRS).
Materials and Methods: A retrospective review was conducted of the images and clinical characteristics of a cohort of patients with brain metastases from non-CNS neoplasms treated with gamma knife radiosurgery (GKRS) who underwent posttherapy FDG PET because of MRI findings concerning for progression. The PET and contrast-enhanced MR images were fused. Relative SUV measurements were calculated from ROIs placed in the area of highest FDG uptake within the enhancing lesion and in the contralateral normal-appearing white matter. Relative SUV was defined as the ratio of maximum SUV in the tumor to maximum SUV in healthy white matter. Two independent readers evaluated response to GKRS using serial posttherapy MRI performed at least 3 months after GKRS completion. The relation between relative SUV and local tumor progression was evaluated with respect to treatment effect.
Results: Eighty-five patients (48 [56.5%] women, 37 [43.5%] men; mean age at diagnosis, 60.5 ± 11.3 years) met the inclusion criteria. Thirty-three (38.8%) lesions progressed after SRS. There was a significant association between relative SUV and local tumor control (p = 0.035). Relative SUV provided a diagnostic ROC AUC of 0.67 (95% CI, 0.55-0.79).
Conclusion: Quantitative relative SUV at posttherapy FDG PET serves as a biomarker of response to SRS in patients with brain metastases in cases in which lesion growth is identified at follow-up MRI. This prognostic data may affect management, supporting the need for further therapeutic actions for selected patients.
Databáze: MEDLINE