Delayed FDG PET Provides Superior Glioblastoma Conspicuity Compared to Conventional Image Timing

Background: Glioblastomas are malignant, often incurable brain tumors. Reliable discrimination between recurrent disease and treatment changes is a significant challenge. Prior work has suggested glioblastoma FDG PET conspicuity is improved at delayed time points vs. conventional imaging times. This...

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Main Authors: Jason Michael Johnson, Melissa M. Chen, Eric M. Rohren, Sujit Prabhu, Beth Chasen, Osama Mawlawi, Ho-Ling Liu, Maria Kristine Gule-Monroe
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-11-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2021.740280/full
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author Jason Michael Johnson
Melissa M. Chen
Eric M. Rohren
Sujit Prabhu
Beth Chasen
Osama Mawlawi
Ho-Ling Liu
Maria Kristine Gule-Monroe
author_facet Jason Michael Johnson
Melissa M. Chen
Eric M. Rohren
Sujit Prabhu
Beth Chasen
Osama Mawlawi
Ho-Ling Liu
Maria Kristine Gule-Monroe
author_sort Jason Michael Johnson
collection DOAJ
description Background: Glioblastomas are malignant, often incurable brain tumors. Reliable discrimination between recurrent disease and treatment changes is a significant challenge. Prior work has suggested glioblastoma FDG PET conspicuity is improved at delayed time points vs. conventional imaging times. This study aimed to determine the ideal FDG imaging time point in a population of untreated glioblastomas in preparation for future trials involving the non-invasive assessment of true progression vs. pseudoprogression in glioblastoma.Methods: Sixteen pre-treatment adults with suspected glioblastoma received FDG PET at 1, 5, and 8 h post-FDG injection within the 3 days prior to surgery. Maximum standard uptake values were measured at each timepoint for the central enhancing component of the lesion and the contralateral normal-appearing brain.Results: Sixteen patients (nine male) had pathology confirmed IDH-wildtype, glioblastoma. Our results revealed statistically significant improvements in the maximum standardized uptake values and subjective conspicuity of glioblastomas at later time points compared to the conventional (1 h time point). The tumor to background ratio at 1, 5, and 8 h was 1.4 ± 0.4, 1.8 ± 0.5, and 2.1 ± 0.6, respectively. This was statistically significant for the 5 h time point over the 1 h time point (p > 0.001), the 8 h time point over the 1 h time point (p = 0.026), and the 8 h time point over the 5 h time point (p = 0.036).Conclusions: Our findings demonstrate that delayed imaging time point provides superior conspicuity of glioblastoma compared to conventional imaging. Further research based on these results may translate into improvements in the determination of true progression from pseudoprogression.
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spelling doaj.art-1ff55c1dc5b34c658800dd316d1fe54e2022-12-21T19:52:44ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-11-011210.3389/fneur.2021.740280740280Delayed FDG PET Provides Superior Glioblastoma Conspicuity Compared to Conventional Image TimingJason Michael Johnson0Melissa M. Chen1Eric M. Rohren2Sujit Prabhu3Beth Chasen4Osama Mawlawi5Ho-Ling Liu6Maria Kristine Gule-Monroe7Department of Neuroradiology, University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Neuroradiology, University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Radiology, Baylor College of Medicine, Houston, TX, United StatesDepartment of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Nuclear Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Neuroradiology, University of Texas MD Anderson Cancer Center, Houston, TX, United StatesBackground: Glioblastomas are malignant, often incurable brain tumors. Reliable discrimination between recurrent disease and treatment changes is a significant challenge. Prior work has suggested glioblastoma FDG PET conspicuity is improved at delayed time points vs. conventional imaging times. This study aimed to determine the ideal FDG imaging time point in a population of untreated glioblastomas in preparation for future trials involving the non-invasive assessment of true progression vs. pseudoprogression in glioblastoma.Methods: Sixteen pre-treatment adults with suspected glioblastoma received FDG PET at 1, 5, and 8 h post-FDG injection within the 3 days prior to surgery. Maximum standard uptake values were measured at each timepoint for the central enhancing component of the lesion and the contralateral normal-appearing brain.Results: Sixteen patients (nine male) had pathology confirmed IDH-wildtype, glioblastoma. Our results revealed statistically significant improvements in the maximum standardized uptake values and subjective conspicuity of glioblastomas at later time points compared to the conventional (1 h time point). The tumor to background ratio at 1, 5, and 8 h was 1.4 ± 0.4, 1.8 ± 0.5, and 2.1 ± 0.6, respectively. This was statistically significant for the 5 h time point over the 1 h time point (p > 0.001), the 8 h time point over the 1 h time point (p = 0.026), and the 8 h time point over the 5 h time point (p = 0.036).Conclusions: Our findings demonstrate that delayed imaging time point provides superior conspicuity of glioblastoma compared to conventional imaging. Further research based on these results may translate into improvements in the determination of true progression from pseudoprogression.https://www.frontiersin.org/articles/10.3389/fneur.2021.740280/fullPET CT scandelayed imagingglioblastomaFDG (18F-fluorodeoxyglucose)-PET/CTbrain tumor
spellingShingle Jason Michael Johnson
Melissa M. Chen
Eric M. Rohren
Sujit Prabhu
Beth Chasen
Osama Mawlawi
Ho-Ling Liu
Maria Kristine Gule-Monroe
Delayed FDG PET Provides Superior Glioblastoma Conspicuity Compared to Conventional Image Timing
Frontiers in Neurology
PET CT scan
delayed imaging
glioblastoma
FDG (18F-fluorodeoxyglucose)-PET/CT
brain tumor
title Delayed FDG PET Provides Superior Glioblastoma Conspicuity Compared to Conventional Image Timing
title_full Delayed FDG PET Provides Superior Glioblastoma Conspicuity Compared to Conventional Image Timing
title_fullStr Delayed FDG PET Provides Superior Glioblastoma Conspicuity Compared to Conventional Image Timing
title_full_unstemmed Delayed FDG PET Provides Superior Glioblastoma Conspicuity Compared to Conventional Image Timing
title_short Delayed FDG PET Provides Superior Glioblastoma Conspicuity Compared to Conventional Image Timing
title_sort delayed fdg pet provides superior glioblastoma conspicuity compared to conventional image timing
topic PET CT scan
delayed imaging
glioblastoma
FDG (18F-fluorodeoxyglucose)-PET/CT
brain tumor
url https://www.frontiersin.org/articles/10.3389/fneur.2021.740280/full
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