Prognostic Value of TSPO PET Before Radiotherapy in Newly Diagnosed IDH-Wild-Type Glioblastoma.

Autor:	Albert NL; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.; German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Munich, Germany.; Bavarian Cancer Research Center, Erlangen, Germany., Nelwan DV; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Fleischmann DF; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany., Quach S; Department of Neurosurgery, LMU University Hospital, LMU Munich, Munich, Germany., von Rohr K; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Kaiser L; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Teske N; German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Munich, Germany.; Department of Neurosurgery, LMU University Hospital, LMU Munich, Munich, Germany., Unterrainer LM; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Bartos LM; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Ruf VC; Institute of Neuropathology, Faculty of Medicine, LMU Munich, Munich, Germany., Brendel M; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.; SyNergy, University of Munich, Munich, Germany.; German Center for Neurodegenerative Diseases, Munich, Germany., Riemenschneider MJ; Department of Neuropathology, Regensburg University Hospital, Regensburg, Germany., Wetzel C; Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; and., Herms J; Institute of Neuropathology, Faculty of Medicine, LMU Munich, Munich, Germany.; SyNergy, University of Munich, Munich, Germany.; German Center for Neurodegenerative Diseases, Munich, Germany., Rupprecht R; Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; and., Thon N; German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Munich, Germany.; Department of Neurosurgery, LMU University Hospital, LMU Munich, Munich, Germany., Tonn JC; German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Munich, Germany.; Department of Neurosurgery, LMU University Hospital, LMU Munich, Munich, Germany., Belka C; German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Munich, Germany.; Bavarian Cancer Research Center, Erlangen, Germany.; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany., Bartenstein P; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.; German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Munich, Germany.; SyNergy, University of Munich, Munich, Germany., von Baumgarten L; German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Munich, Germany.; Bavarian Cancer Research Center, Erlangen, Germany.; Department of Neurosurgery, LMU University Hospital, LMU Munich, Munich, Germany., Niyazi M; German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Munich, Germany.; Bavarian Cancer Research Center, Erlangen, Germany.; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany., Unterrainer M; German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Munich, Germany.; Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany., Holzgreve A; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany; adrien.holzgreve@med.uni-muenchen.de.
Jazyk:	angličtina
Zdroj:	Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2023 Oct; Vol. 64 (10), pp. 1519-1525. Date of Electronic Publication: 2023 Aug 03.
DOI:	10.2967/jnumed.122.265247
Abstrakt:	The 18-kDa translocator protein (TSPO) is gaining recognition as a relevant target in glioblastoma imaging. However, data on the potential prognostic value of TSPO PET imaging in glioblastoma are lacking. Therefore, we investigated the association of TSPO PET imaging results with survival outcome in a homogeneous cohort of glioblastoma patients. Methods: Patients were included who had newly diagnosed, histologically confirmed isocitrate dehydrogenase (IDH)-wild-type glioblastoma with available TSPO PET before either normofractionated radiotherapy combined with temozolomide or hypofractionated radiotherapy. SUV max on TSPO PET, TSPO binding affinity status, tumor volumes on MRI, and further clinical data, such as O 6 -alkylguanine DNA methyltransferase ( MGMT ) and telomerase reverse transcriptase ( TERT ) gene promoter mutation status, were correlated with patient survival. Results: Forty-five patients (median age, 63.3 y) were included. Median SUV max was 2.2 (range, 1.0-4.7). A TSPO PET signal was associated with survival: High uptake intensity (SUV max > 2.2) was related to significantly shorter overall survival (OS; 8.3 vs. 17.8 mo, P = 0.037). Besides SUV max , prognostic factors for OS were age ( P = 0.046), MGMT promoter methylation status ( P = 0.032), and T2-weighted MRI volume ( P = 0.031). In the multivariate survival analysis, SUV max in TSPO PET remained an independent prognostic factor for OS ( P = 0.023), with a hazard ratio of 2.212 (95% CI, 1.115-4.386) for death in cases with a high TSPO PET signal (SUV max > 2.2). Conclusion: A high TSPO PET signal before radiotherapy is associated with significantly shorter survival in patients with newly diagnosed IDH-wild-type glioblastoma. TSPO PET seems to add prognostic insights beyond established clinical parameters and might serve as an informative tool as clinicians make survival predictions for patients with glioblastoma. (© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)
Databáze:	MEDLINE
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