Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy
Abstract High-precision radiotherapy (HPR) of recurrent high grade glioma (HGG) requires accurate spatial allocation of these infiltrative tumors. We investigated the impact of 18F-FET PET on tumor delineation and progression of recurrent HGG after HPR with carbon ions. T1 contrast enhanced MRI and...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2018-05-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-018-25350-7 |
| _version_ | 1819200128181862400 |
|---|---|
| author | Charlotte Debus Maria Waltenberger Ralf Floca Ali Afshar-Oromieh Nina Bougatf Sebastian Adeberg Sabine Heiland Martin Bendszus Wolfgang Wick Stefan Rieken Uwe Haberkorn Jürgen Debus Maximilian Knoll Amir Abdollahi |
| author_facet | Charlotte Debus Maria Waltenberger Ralf Floca Ali Afshar-Oromieh Nina Bougatf Sebastian Adeberg Sabine Heiland Martin Bendszus Wolfgang Wick Stefan Rieken Uwe Haberkorn Jürgen Debus Maximilian Knoll Amir Abdollahi |
| author_sort | Charlotte Debus |
| collection | DOAJ |
| description | Abstract High-precision radiotherapy (HPR) of recurrent high grade glioma (HGG) requires accurate spatial allocation of these infiltrative tumors. We investigated the impact of 18F-FET PET on tumor delineation and progression of recurrent HGG after HPR with carbon ions. T1 contrast enhanced MRI and 18F-FET-PET scans of 26 HGG patients were fused with radiotherapy planning volumes. PET-positive (PET+) tumor volumes using different isocontours (I%) were systematically investigated and compared with MRI-derived gross tumor volumes (GTV). Standardized uptake ratios (SUR) were further correlated with GTV and tumor progression patterns. In grade IV glioma, SUR > 2.92 significantly correlated with poor median overall survival (6.5 vs 13.1 months, p = 0.00016). We found no reliable SUR cut-off criteria for definition of PET+ volumes. Overall conformity between PET and MRI-based contours was low, with maximum conformities between 0.42–0.51 at I40%. The maximum sensitivity and specificity for PET+ volumes outside of GTV predicting tumor progression were 0.16 (I40%) and 0.52 (I50%), respectively. In 75% of cases, FLAIR hyperintense area covered over 80% of PET+ volumes. 18F-FET-PET derived SUR has a prognostic impact in grade IV glioma. The value of substantial mismatches between MRI-based GTV and PET+ volumes to improve tumor delineation in radiotherapy awaits further validation in randomized prospective trials. |
| first_indexed | 2024-12-23T03:27:18Z |
| format | Article |
| id | doaj.art-d9353d8d07da4471969a1b48ef0e5b2b |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-23T03:27:18Z |
| publishDate | 2018-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-d9353d8d07da4471969a1b48ef0e5b2b2022-12-21T18:01:49ZengNature PortfolioScientific Reports2045-23222018-05-018111310.1038/s41598-018-25350-7Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion RadiotherapyCharlotte Debus0Maria Waltenberger1Ralf Floca2Ali Afshar-Oromieh3Nina Bougatf4Sebastian Adeberg5Sabine Heiland6Martin Bendszus7Wolfgang Wick8Stefan Rieken9Uwe Haberkorn10Jürgen Debus11Maximilian Knoll12Amir Abdollahi13German Cancer Consortium (DKTK)German Cancer Consortium (DKTK)Division of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO)Department of Nuclear Medicine, Heidelberg University HospitalDivision of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO)Division of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO)Department of Neuroradiology, Heidelberg University HospitalDepartment of Neuroradiology, Heidelberg University HospitalGerman Cancer Consortium (DKTK)Division of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO)Department of Nuclear Medicine, Heidelberg University HospitalGerman Cancer Consortium (DKTK)German Cancer Consortium (DKTK)German Cancer Consortium (DKTK)Abstract High-precision radiotherapy (HPR) of recurrent high grade glioma (HGG) requires accurate spatial allocation of these infiltrative tumors. We investigated the impact of 18F-FET PET on tumor delineation and progression of recurrent HGG after HPR with carbon ions. T1 contrast enhanced MRI and 18F-FET-PET scans of 26 HGG patients were fused with radiotherapy planning volumes. PET-positive (PET+) tumor volumes using different isocontours (I%) were systematically investigated and compared with MRI-derived gross tumor volumes (GTV). Standardized uptake ratios (SUR) were further correlated with GTV and tumor progression patterns. In grade IV glioma, SUR > 2.92 significantly correlated with poor median overall survival (6.5 vs 13.1 months, p = 0.00016). We found no reliable SUR cut-off criteria for definition of PET+ volumes. Overall conformity between PET and MRI-based contours was low, with maximum conformities between 0.42–0.51 at I40%. The maximum sensitivity and specificity for PET+ volumes outside of GTV predicting tumor progression were 0.16 (I40%) and 0.52 (I50%), respectively. In 75% of cases, FLAIR hyperintense area covered over 80% of PET+ volumes. 18F-FET-PET derived SUR has a prognostic impact in grade IV glioma. The value of substantial mismatches between MRI-based GTV and PET+ volumes to improve tumor delineation in radiotherapy awaits further validation in randomized prospective trials.https://doi.org/10.1038/s41598-018-25350-7 |
| spellingShingle | Charlotte Debus Maria Waltenberger Ralf Floca Ali Afshar-Oromieh Nina Bougatf Sebastian Adeberg Sabine Heiland Martin Bendszus Wolfgang Wick Stefan Rieken Uwe Haberkorn Jürgen Debus Maximilian Knoll Amir Abdollahi Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy Scientific Reports |
| title | Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy |
| title_full | Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy |
| title_fullStr | Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy |
| title_full_unstemmed | Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy |
| title_short | Impact of 18F-FET PET on Target Volume Definition and Tumor Progression of Recurrent High Grade Glioma Treated with Carbon-Ion Radiotherapy |
| title_sort | impact of 18f fet pet on target volume definition and tumor progression of recurrent high grade glioma treated with carbon ion radiotherapy |
| url | https://doi.org/10.1038/s41598-018-25350-7 |
| work_keys_str_mv | AT charlottedebus impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT mariawaltenberger impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT ralffloca impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT aliafsharoromieh impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT ninabougatf impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT sebastianadeberg impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT sabineheiland impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT martinbendszus impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT wolfgangwick impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT stefanrieken impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT uwehaberkorn impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT jurgendebus impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT maximilianknoll impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy AT amirabdollahi impactof18ffetpetontargetvolumedefinitionandtumorprogressionofrecurrenthighgradegliomatreatedwithcarbonionradiotherapy |