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18F-FDOPA and18F-FLT positron emission tomography parametric response maps predict response in recurrent malignant gliomas treated with bevacizumab

  • Author(s): Harris, RJ
  • Cloughesy, TF
  • Pope, WB
  • Nghiemphu, PL
  • Lai, A
  • Zaw, T
  • Czernin, J
  • Phelps, ME
  • Chen, W
  • Ellingson, BM
  • et al.
Abstract

The current study examined the use of voxel-wise changes in18F-FDOPA and18F-FLT PET uptake, referred to as parametric response maps (PRMs), to determine whether they were predictive of response to bevacizumab in patients with recurrent malignant gliomas. Twenty-four patients with recurrent malignant gliomas who underwent bevacizumab treatment were analyzed. Patients had MR and PET images acquired before and at 2 time points after bevacizumab treatment. PRMs were created by examining the percentage change in tracer uptake between time points in each image voxel. Voxel-wise increase in PET uptake in areas of pretreatment contrast enhancement defined by MRI stratified 3-month progression-free survival (PFS) and 6-month overall survival (OS) according to receiver-operating characteristic curve analysis. A decrease in PET tracer uptake was associated with longer PFS and OS, whereas an increase in PET uptake was associated with short PFS and OS. The volume fraction of increased18F-FDOPA PET uptake between the 2 posttreatment time points also stratified long- and short-term PFS and OS (log-rank, P <. 05); however,18F-FLT uptake did not stratify OS. This study suggests that an increase in FDOPA or FLT PET uptake on PRMs after bevacizumab treatment may be a useful biomarker for predicting PFS and that FDOPA PET PRMs are also predictive of OS in recurrent gliomas treated with bevacizumab. © The Author(s) 2012.

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