Exploratory Analysis of Serial 18F-fluciclovine PET-CT and Multiparametric MRI during Chemoradiation for Glioblastoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Selection and Assessment
2.2. Clinical Imaging
2.2.1. Imaging Timeline
2.2.2. MRI Acquisition
2.2.3. PET-CT Acquisition
2.2.4. Image Post-Processing and Analysis
2.2.5. Tumour Volume Analysis
2.3. Pre-Clinical Glioma Model
2.4. In Vivo Imaging Study Design
2.4.1. MRI Acquisition
2.4.2. Radiotracer Availability and PET-CT Acquisition
2.5. Immunohistochemistry
3. Results
3.1. Demographic and Oncological Outcomes
3.2. Clinical Imaging
3.2.1. Radiologist Assessment
3.2.2. Tumour Volume Analysis
Short Survival
Long Survival
Subtracted Volumes
3.3. Pre-Clinical Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Patient | ||||||
---|---|---|---|---|---|---|
GBM 1 | GBM 2 | GBM 3 | GBM 4 | GBM 5 | GBM 6 | |
Age at surgery (years) | 72 | 47 | 54 | 67 | 57 | 68 |
Gender | M | M | M | F | M | F |
PET-CT studies (number) | 2 | 2 | 3 | 3 | 3 | 3 |
Multiparametric MRI studies (number) | 3 | 3 | 3 | 3 | 3 | 3 |
Status | Deceased | Deceased | Deceased | Alive | Alive | Deceased |
Overall survival (days) | 249 | 193 | 292 | 910 * | 903 * | 554 |
Surgery | Stereotactic biopsy | Resection | Resection | Resection | Resection | Resection |
Radiotherapy | 60Gy/30 fractions | 60Gy/30 fractions | 60Gy/30 fractions | 60Gy/30 fractions | 60Gy/30 fractions | 60Gy/30 fractions |
Adjuvant temozolomide | None | None | 4 cycles | 6 cycles | 6 cycles | 6 cycles |
Histology | Glioblastoma | Glioblastoma | Glioblastoma | Glioblastoma | Glioblastoma | Glioblastoma |
Cytogenetic analysis | ||||||
IDH1/2 | Wild type | Wild type | Wild type | Wild type | Wild type | Failed |
MGMT | Unmethylated | Unmethylated | Unmethylated | Methylated | Methylated | Failed |
TERT promoter | Mutated | Mutated | Mutated | Mutated | Wild type | Failed |
1p/19q co-deletion | Wild-type | Wild-type | Wild-type | Wild-type | Wild-type | Failed |
GBM 1 | ||||||||
PET-CT | MRI | |||||||
Timepoint | 2 × SUVmax | 3 × SUVmax | 4 × SUVmax | Radiologist Assessment | Gd-T1 | Ktrans | ve | Radiologist Assessment |
Pre-RT | 16.0 | 11.1 | 8.9 | Avid tumour | 6.3 | 7.3 | 7.8 | Stable |
Mid-RT | 14.9 | 10.6 | 7.0 | Stable | 6.8 | 7.1 | 5.6 | Stable |
Post-RT | - | - | - | - | 13.5 | 14.1 | 15.5 | Progression |
GBM 2 | ||||||||
PET-CT | MRI | |||||||
Timepoint | 2 × SUVmax | 3 × SUVmax | 4 × SUVmax | Radiologist Assessment | Gd-T1 | Ktrans | ve | Radiologist Assessment |
Pre-RT | 47.7 | 36.2 | 29.0 | Avid tumour | 21.4 | 23.3 | 25.8 | Progression |
Mid-RT | 71.8 | 57.4 | 44.5 | Progression | 47.9 | 53.1 | 57.4 | Progression/Pseudoprogression |
Post-RT | - | - | - | - | 84.3 | 84.8 | 96.9 | Progression |
GBM 3 | ||||||||
PET-CT | MRI | |||||||
Timepoint | 2 × SUVmax | 3 × SUVmax | 4 × SUVmax | Radiologist Assessment | Gd-T1 | Ktrans | ve | Radiologist Assessment |
Pre-RT | 12.1 | 6.1 | 3.4 | Multifocal avid tumour | 3.4 | 2.8 | 3.9 | Mixed picture |
Mid-RT | 13.0 | 6.5 | 3.6 | Stable | 4.9 | 5.1 | 4.5 | Progression |
Post-RT | 31.0 | 18.4 | 12.8 | Progression | 13.4 | 23.3 | 12.5 | Progression |
GBM 4 | ||||||||
PET-CT | MRI | |||||||
Timepoint | 2 × SUVmax | 3 × SUVmax | 4 × SUVmax | Radiologist Assessment | Gd-T1 | Ktrans | ve | Radiologist Assessment |
Pre-RT | 0.6 | 0.1 | 0 | Likely remnant tumour | 0.4 | 0.6 | 0.8 | Small volume enhancement |
Mid-RT | 0.2 | 0 | 0 | Stable | 0.1 | 0.2 | 0.1 | Stable |
Post-RT | 0.1 | 0 | 0 | Stable | 0.1 | 0.1 | 0.03 | Stable |
GBM 5 | ||||||||
PET-CT | MRI | |||||||
Timepoint | 2 × SUVmax | 3 × SUVmax | 4 × SUVmax | Radiologist Assessment | Gd-T1 | Ktrans | ve | Radiologist Assessment |
Pre-RT | 12.4 | 3.2 | 0.5 | Uptake at margins | 6.3 | 11.6 | 9.9 | Stable |
Mid-RT | 12.8 | 5.1 | 1.4 | Stable | 5.1 | 4.0 | 5.3 | Stable |
Post-RT | 7.2 | 1.8 | 0.2 | Stable | 5.1 | 4.6 | 5.5 | Progression/pseudoprogression |
GBM 6 | ||||||||
PET-CT | MRI | |||||||
Timepoint | 2 × SUVmax | 3 × SUVmax | 4 × SUVmax | Radiologist Assessment | Gd-T1 | Ktrans | ve | Radiologist Assessment |
Pre-RT | 44.4 | 35.0 | 27.5 | Large avid tumour | 46.6 | 51.0 | 48.3 | Stable/Large residuum |
Mid-RT | 43.9 | 33.7 | 26.3 | Partial response | 32.9 | 36.6 | 34.6 | Stable |
Post-RT | 46.8 | 36.8 | 28.6 | Stable tumour | 35.4 | 40.0 | 39.3 | Likely progression |
GBM 1 | |||||
Volume (cm3) | Dice Similarity Coefficient (DSC) | ||||
Timepoint | PET (3 × SUVmax) | Ktrans | ve | PET vs. Ktrans | PET vs. ve |
Pre-RT | 5.1 | 1.4 | 1.6 | 0.4 | 0.3 |
Mid-RT | 4.1 | 2.1 | 1.1 | 0.2 | 0.2 |
Post-RT | - | 1.9 | 2.6 | - | - |
GBM 2 | |||||
Volume (cm3) | Dice Similarity Coefficient (DSC) | ||||
Timepoint | PET (3 × SUVmax) | Ktrans | ve | PET vs. Ktrans | PET vs. ve |
Pre-RT | 15.7 | 5.4 | 6.6 | 0.5 | 0.5 |
Mid-RT | 12.0 | 9.5 | 12.6 | 0.5 | 0.5 |
Post-RT | - | 7.3 | 16.1 | - | - |
GBM 3 | |||||
Volume (cm3) | Dice Similarity Coefficient (DSC) | ||||
Timepoint | PET (3 × SUVmax) | Ktrans | ve | PET vs. Ktrans | PET vs. ve |
Pre-RT | 3.8 | 1.0 | 2.3 | 0.2 | 0.3 |
Mid-RT | 2.9 | 2.3 | 1.3 | 0.3 | 0.3 |
Post-RT | 1.0 | 10.4 | 3.9 | 0.1 | 0.1 |
GBM 4 | |||||
Volume (cm3) | Dice Similarity Coefficient (DSC) | ||||
Timepoint | PET (3 × SUVmax) | Ktrans | ve | PET vs. Ktrans | PET vs. ve |
Pre-RT | 0.1 | 0.4 | 0.5 | 0 | 0 |
Mid-RT | - | 0.1 | 0.04 | - | - |
Post-RT | - | 0.04 | 0.03 | - | - |
GBM 5 | |||||
Volume (cm3) | Dice Similarity Coefficient (DSC) | ||||
Timepoint | PET (3 × SUVmax) | Ktrans | ve | PET vs. Ktrans | PET vs. ve |
Pre-RT | 1.9 | 6.0 | 5.0 | 0.2 | 0.2 |
Mid-RT | 2.3 | 0.7 | 1.4 | 0.2 | 0.3 |
Post-RT | 2.3 | 1.2 | 1.8 | 0.1 | 0.1 |
GBM 6 | |||||
Volume (cm3) | Dice Similarity Coefficient (DSC) | ||||
Timepoint | PET (3 × SUVmax) | Ktrans | ve | PET vs. Ktrans | PET vs. ve |
Pre-RT | 0.7 | 7.6 | 7.1 | 0.1 | 0.1 |
Mid-RT | 4.4 | 7.3 | 6.3 | 0.5 | 0.5 |
Post-RT | 4.9 | 7.1 | 6.1 | 0.3 | 0.4 |
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Fatania, K.; Frood, R.; Tyyger, M.; McDermott, G.; Fernandez, S.; Shaw, G.C.; Boissinot, M.; Salvatore, D.; Ottobrini, L.; Teh, I.; et al. Exploratory Analysis of Serial 18F-fluciclovine PET-CT and Multiparametric MRI during Chemoradiation for Glioblastoma. Cancers 2022, 14, 3485. https://doi.org/10.3390/cancers14143485
Fatania K, Frood R, Tyyger M, McDermott G, Fernandez S, Shaw GC, Boissinot M, Salvatore D, Ottobrini L, Teh I, et al. Exploratory Analysis of Serial 18F-fluciclovine PET-CT and Multiparametric MRI during Chemoradiation for Glioblastoma. Cancers. 2022; 14(14):3485. https://doi.org/10.3390/cancers14143485
Chicago/Turabian StyleFatania, Kavi, Russell Frood, Marcus Tyyger, Garry McDermott, Sharon Fernandez, Gary C. Shaw, Marjorie Boissinot, Daniela Salvatore, Luisa Ottobrini, Irvin Teh, and et al. 2022. "Exploratory Analysis of Serial 18F-fluciclovine PET-CT and Multiparametric MRI during Chemoradiation for Glioblastoma" Cancers 14, no. 14: 3485. https://doi.org/10.3390/cancers14143485