| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
|
|
|||||||||
|
|
Oncology-Clinical Diagnosis: Solid TumorsHead and Neck Cancer |
1 Radiology; 2 Rad.Onc., UM, Ann Arbor, Michigan
452
Objectives: We determined whether increased uptake on 11C-methionine (MET) PET imaging obtained prior to radiation therapy and temozolomide is associated with the site of subsequent failure in newly diagnosed glioblastoma multiforme (GBM).
Methods: Patients with primary GBM were treated with dose-escalated radiation and temozolomide. MET-PET was obtained prior to treatment but was not used for target volume definition. Using automated image registration, we assessed whether the area of increased MET-PET (uptake ratio >= 1.5 above cerebellar background) activity (PET-GTV) was fully encompassed within the high-dose region and compared the patterns of failure for those with and without adequate high-dose coverage of the PET-GTV.
Results: 26 patients were evaluated (median follow-up 15 months). 19/26 had tumor volumes of increased MET-PET activity >1cm3 prior to treatment. 5/19 patients had PET-GTVs not fully encompassed within the high-dose region, and all 5 patients had non-central treatment failures. Among the 14 patients with adequately covered PET-GTV, only 2 had non-central treatment failures. 3/14 patients had no evidence of recurrence with over 1 year after therapy. Inadequate PET-GTV coverage was associated with increased risk of non-central failures (p < 0.01). Patients with a MET-PET positive volume of less than 10 ml after tumor resection had a significantly better prognosis compared to tumors with a larger MET-positive tumor volume.
Conclusions: Pretreatment MET-PET identified areas at highest risk for GBM recurrence suggesting to incorporate MET-PET into radiation treatment planning, particularly for identifying areas for conformal radiation boost.
Research Support: NIH 3PO1 CA59827
| ||||||||||||||||||||||||||||||||||||||
