Discriminating Inflammatory Radiation-Related Changes From Early Recurrence in Patients With Glioblastomas

Moreau, Aurélie; Khayi, Fouzi; Maureille, Aurélien; Bonneville-Levard, Alice; Larrouquère, Louis; Ducray, François; Kryza, David

doi:10.1097/rlu.0000000000004716

Cited by 6 publications

(5 citation statements)

References 54 publications

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“…The study reveals that 68 Ga-PSMA PET can assist in delineating non-enhancing tumor parts and recurrent tumor volumes, suggesting its potential in reirradiation scenarios. These findings contribute to the evolving understanding of the role of 68 Ga-PSMA PET in imaging glial tumors and its potential benefits in target volume delineation, especially in recurrent tumors [6,7].…”

Section: Introductionmentioning

confidence: 69%

“…The first study, by Moreau et al, explores the feasibility of using 68 Ga-prostate-specific membrane antigen (PSMA) 11 PET/CT in comparison with 18 F-FDOPA PET/CT to detect early recurrence in glioblastoma patients. Despite some discrepancies, the study underscores the potential role of 68 Ga-PSMA-11 PET/CT in discriminating between postradiation inflammation and recurrence, emphasizing the need for further prospective studies to validate these findings [6]. The second study, by Şahin et al, investigates the contribution of 68 Ga-PSMA PET to defining the radiotherapy target volumes for glioblastoma, comparing the results with magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 97%

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Preferred Imaging for Target Volume Delineation for Radiotherapy of Recurrent Glioblastoma: A Literature Review of the Available Evidence

Cuccia,

Jafari,

D’Alessandro

et al. 2024

JPM

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Background: Recurrence in glioblastoma lacks a standardized treatment, prompting an exploration of re-irradiation’s efficacy. Methods: A comprehensive systematic review from January 2005 to May 2023 assessed the role of MRI sequences in recurrent glioblastoma re-irradiation. The search criteria, employing MeSH terms, targeted English-language, peer-reviewed articles. The inclusion criteria comprised both retrospective and prospective studies, excluding certain types and populations for specificity. The PICO methodology guided data extraction, and the statistical analysis employed Chi-squared tests via MedCalc v22.009. Results: Out of the 355 identified studies, 81 met the criteria, involving 3280 patients across 65 retrospective and 16 prospective studies. The key findings indicate diverse treatment modalities, with linac-based photons predominating. The median age at re-irradiation was 54 years, and the median time interval between radiation courses was 15.5 months. Contrast-enhanced T1-weighted sequences were favored for target delineation, with PET-imaging used in fewer studies. Re-irradiation was generally well tolerated (median G3 adverse events: 3.5%). The clinical outcomes varied, with a median 1-year local control rate of 61% and a median overall survival of 11 months. No significant differences were noted in the G3 toxicity and clinical outcomes based on the MRI sequence preference or PET-based delineation. Conclusions: In the setting of recurrent glioblastoma, contrast-enhanced T1-weighted sequences were preferred for target delineation, allowing clinicians to deliver a safe and effective therapeutic option; amino acid PET imaging may represent a useful device to discriminate radionecrosis from recurrent disease. Future investigations, including the ongoing GLIAA, NOA-10, ARO 2013/1 trial, will aim to refine approaches and standardize methodologies for improved outcomes in recurrent glioblastoma re-irradiation.

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Section: Introductionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 97%

Preferred Imaging for Target Volume Delineation for Radiotherapy of Recurrent Glioblastoma: A Literature Review of the Available Evidence

Cuccia,

Jafari,

D’Alessandro

et al. 2024

JPM

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“…The previous few years have seen an immense uptick in PSMA in glioma investigation with 42 publications on the topic from 2020 to date (July 2023) 5,16–22,26–43,49,56,60–74 . These publications mainly focus on 3 fields of study: histopathology of PSMA in gliomas, use of PSMA imaging techniques in glioma diagnosis, and use of PSMA-targeted therapies in the treatment of gliomas.…”

Section: Methodsmentioning

confidence: 99%

“…Kumar et al 33 demonstrated no 68 Ga-PSMA-11 PET tracer accumulation in 3 lesions labeled radiation necrosis on MRI contributing to the promise of PSMA PET as a differentiating tool in glioma treatment. Moreau et al 39 also concluded that 68 Ga-PSMA-11 PET could have a role in differentiating postradiation inflammation from recurrence in GBM based on preliminary data from 9 GBM patients.…”

Section: Methodsmentioning

confidence: 99%

Prostate-Specific Membrane Antigen Use in Glioma Management

McBriar,

Shafiian,

Scharf

et al. 2024

Clin Nucl Med

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Background Prostate-specific membrane antigen (PSMA) is a membrane-bound metallopeptidase highly expressed in the neovasculature of many solid tumors including gliomas. It is a particularly enticing therapeutic target due to its ability to internalize, thereby delivering radioligands or pharmaceuticals to the intracellular compartment. Targeting the neovasculature of gliomas using PSMA for diagnosis and management has been a recent area of increased study and promise. The purpose of this review is to synthesize the current state and future directions of PSMA use in the histopathologic study, imaging, and treatment of gliomas. Methods PubMed and Scopus databases were used to conduct a literature review on PSMA use in gliomas in June 2023. Terms searched included “PSMA,” “Prostate-Specific Membrane Antigen” OR “PSMA” OR “PSMA PET” AND “glioma” OR “high grade glioma” OR “glioblastoma” OR “GBM.” Results Ninety-four publications were screened for relevance with 61 studies, case reports, and reviews being read to provide comprehensive context for the historical, contemporary, and prospective use of PSMA in glioma management. Conclusions PSMA PET imaging is currently a promising and accurate radiographic tool for the diagnosis and management of gliomas. PSMA histopathology likely represents a viable tool for helping predict glioma behavior. More studies are needed to investigate the role of PSMA-targeted therapeutics in glioma management, but preliminary reports have indicated its potential usefulness in treatment.

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“…Finally, although the trial is still recruiting, [ 68 Ga]Ga-PSMA-11 has also been compared with [ 18 F]F-DOPA in the PAraDiGM trial to differentiate GBM recurrence from TRC, showing a good performance of [ 68 Ga]Ga-PSMA-11 in the preliminary results in nine patients [49].…”

Section: Brain Tumorsmentioning

confidence: 99%

Prostate-Specific Membrane Antigen Positron Emission Tomography Oncological Applications beyond Prostate Cancer in Comparison to Other Radiopharmaceuticals

Miceli,

Liberini,

Pepe

et al. 2024

Diagnostics

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Background: Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein overexpressed on the surface of tumor cells in most of the patients affected by prostate adenocarcinoma (PCa). However, PSMA expression has also been demonstrated in the endothelial cells of newly formed vessels of various solid tumors, suggesting a role for PSMA in neoangiogenesis. In this scenario, gallium-68 (68Ga) or fluoro-18 (18F)-labeled PSMA positron emission tomography (PET) may play a role in tumors other than PCa, generally evaluated employing other radiopharmaceuticals targeting different pathways. This review aims to investigate the detection rate of PSMA-PET compared to other radiopharmaceuticals (especially [18F]FDG) in non-prostate tumors to identify patients who may benefit from the use of such a theragnostic agent. Methods: We performed a bibliographic search on three different databases until February 2024 using the following terms: “positron emission tomography”, “PET”, “PET/CT”, “Prostate-specific membrane antigen”, “PSMA”, “non-prostate”, “not prostate cancer”, “solid tumor”, “FDG”, “Fluorodeoxyglucose”, “FAPi”, “FET”, “MET”, “DOPA”, “choline”, “FCH”, “FES”, “DOTATOC”, “DOTANOC”, and “DOTATATE”. Only original articles edited in English with at least 10 patients were included. Results: Out of a total of 120 articles, only 25 original articles comparing PSMA with other radiotracers were included in this study. The main evidence was demonstrated in renal cell carcinoma, where PSMA showed a higher detection rate compared to [18F]FDG PET/CT, with implications for patient management. PSMA PET may also improve the assessment of other entities, such as gliomas, in defining regions of early neoangiogenesis. Further data are needed to evaluate the potential role of PSMA-PET in triple-negative breast cancer as a novel therapeutic vascular target. Finally, unclear applications of PSMA-PET include thyroid and gastrointestinal tumors. Conclusions: The present review shows the potential use of PSMA-labeled PET/CT in solid tumors beyond PCa, underlining its value over other radiopharmaceuticals (mainly [18F]FDG). Prospective clinical trials with larger sample sizes are crucial to further investigate these possible clinical applications.

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Discriminating Inflammatory Radiation-Related Changes From Early Recurrence in Patients With Glioblastomas

Cited by 6 publications

References 54 publications

Preferred Imaging for Target Volume Delineation for Radiotherapy of Recurrent Glioblastoma: A Literature Review of the Available Evidence

Preferred Imaging for Target Volume Delineation for Radiotherapy of Recurrent Glioblastoma: A Literature Review of the Available Evidence

Prostate-Specific Membrane Antigen Use in Glioma Management

Prostate-Specific Membrane Antigen Positron Emission Tomography Oncological Applications beyond Prostate Cancer in Comparison to Other Radiopharmaceuticals

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