Comparison of 18F-Fluorodeoxyglucose and 18F-Fluorothymidine PET in Differentiating Radiation Necrosis From Recurrent Glioma

Enslow, Michael S.; Zollinger, Lauren; Morton, Kathryn A.; Butterfield, Regan; Kadrmas, Dan; Christian, Paul E.; Boucher, Kenneth M.; Heilbrun, Marta E.; Jensen, Randy L.; Hoffman, John M.

doi:10.1097/rlu.0b013e318262c76a

Cited by 65 publications

(81 citation statements)

References 25 publications

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“…This was confirmed in recurrent glioma patients treated with bevacizumab and irinotecan showing that 18 F-FLT is able to predict overall survival and would allow differentiation between recurrent glioma and RN (56,116,117). A high LNR of a GB tumor on 18 F-FLT PET is visible in Figure 2F (9).…”

Section: F-fluorothymidinesupporting

confidence: 53%

PET for Therapy Response Assessment in Glioblastoma

et al. 2017

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Glioblastoma (GB) is the most malignant and the most common type of glioma in adults, accounting for 60-70% of all malignant gliomas. Despite the current therapy, the clinical course of GB is usually rapid, with a mean survival time of approximately 1 year. For therapy response assessment in GB, magnetic resonance imaging (MRI) is the method of choice. In 2010, the Response Assessment in Neuro-Oncology (RANO) was introduced, including the tumor size (in 2D) as measured on T2-weighted and Fluid Attenuated Inversion Recovery (FLAIR)-weighted images, in addition to the contrast-enhancing tumor part. Although the RANO criteria addressed some of the limitations of the previous MacDonald criteria for therapy evaluation in high-grade glioma, treatment-related side effects hamper correct response assessment. To address the above-mentioned drawbacks in the follow-up of GB, incorporating changes in tumor biology measured by advanced MRI and positron emission tomography (PET) imaging, which may precede anatomical changes of the tumor volume, is promising. Imaging biomarkers capable of predicting response at an early time point after treatment initiation are the premise of personalized treatment enabling change or GB Treatment Response Using PET 176 discontinuation of therapy to prevent ineffective treatment or adverse events of treatment. In this chapter, an overview of applicable PET tracers for the therapy response assessment in GB and the determination of tumor recurrence versus treatment-related effects is given.

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Section: F-fluorothymidinesupporting

confidence: 53%

PET for Therapy Response Assessment in Glioblastoma

et al. 2017

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“…A recent study compared 18 F-FDG, 18 F-FLT, and 11 C-methionine PET tracers in patients with grade II-IV gliomas (32). Although 18 F-FDG could not be used to differentiate between the different tumor grades, both 18 Uptake of 18 F-FLT has been used to evaluate radiation necrosis compared with tumor recurrence, and both 18 F-FDG and 18 F-FLT provided accurate assessments (33).…”

Section: Central Nervous System Cancersmentioning

confidence: 99%

PET Imaging of Proliferation with Pyrimidines

Tehrani

Shields

2013

J Nucl Med

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“…In brain tumors, distinguishing tumor growth from radiation-induced injury is often challenging, as both are often visible on posttherapy molecular images. 18 F-FDG and 18 F-FLT PET imaging have shown promise in the differentiation of recurrent glioma from radiation necrosis through both quantitative and visual image assessment (146). Similarly, 18 F-FDG PET/CT and dynamic susceptibility-weighted contrast-enhanced perfusion MRI have demonstrated the ability to differentiate tumor growth from radiation injury (147).…”

Section: Normal-tissue Response Evaluationmentioning

confidence: 99%

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

2015

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) how to acquire high-quality molecular images for use in radiation therapy; (2) how molecular imaging can be used to plan radiotherapy and evaluate treatment efficacy; and (3) the limitations and challenges to widespread use of molecular imaging in radiation oncology.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through November 2018.Molecular imaging plays a central role in the management of radiation oncology patients. Specific uses of imaging, particularly to plan radiotherapy and assess its efficacy, require an additional level of reproducibility and image quality beyond what is required for diagnostic imaging. Specific requirements include proper patient preparation, adequate technologist training, careful imaging protocol design, reliable scanner technology, reproducible software algorithms, and reliable data analysis methods. As uncertainty in target definition is arguably the greatest challenge facing radiation oncology, the greatest impact that molecular imaging can have may be in the reduction of interobserver variability in target volume delineation and in providing greater conformity between target volume boundaries and true tumor boundaries. Several automatic and semiautomatic contouring methods based on molecular imaging are available but still need sufficient validation to be widely adopted. Biologically conformal radiotherapy (dose painting) based on molecular imaging-assessed tumor heterogeneity is being investigated, but many challenges remain to fully exploring its potential. Molecular imaging also plays increasingly important roles in both early (during treatment) and late (after treatment) response assessment as both a predictive and a prognostic tool. Because of potentially confounding effects of radiation-induced inflammation, treatment response assessment requires careful interpretation. Although molecular imaging is already strongly embedded in radiotherapy, the path to widespread and all-inclusive use is still long. The lack of solid clinical evidence is the main impediment to broader use. Recommendations for practicing physicians are still rather scarce. 18 F-FDG PET/CT remains the main molecular imaging modality in radiation oncology applications. Although other molecular imaging options (e.g., proliferation imaging) are becoming more common, their widespread use is limited ...

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Comparison of 18F-Fluorodeoxyglucose and 18F-Fluorothymidine PET in Differentiating Radiation Necrosis From Recurrent Glioma

Cited by 65 publications

References 25 publications

PET for Therapy Response Assessment in Glioblastoma

PET for Therapy Response Assessment in Glioblastoma

PET Imaging of Proliferation with Pyrimidines

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

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