Nathalie L Albert, Debie V Nelwan, Daniel F Fleischmann, Stefanie Quach, Katharina von Rohr, Lena Kaiser, Nico Teske, Lena M Unterrainer, Laura M Bartos, Viktoria C Ruf, Matthias Brendel, Markus J Riemenschneider, Christian Wetzel, Jochen Herms, Rainer Rupprecht, Niklas Thon, Joerg-Christian Tonn, Claus Belka, Peter Bartenstein, Louisa von Baumgarten, Maximilian Niyazi, Marcus Unterrainer, Adrien Holzgreve
{"title":"TSPO PET在新诊断的IDH野生型胶质母细胞瘤放疗前的预后价值。","authors":"Nathalie L Albert, Debie V Nelwan, Daniel F Fleischmann, Stefanie Quach, Katharina von Rohr, Lena Kaiser, Nico Teske, Lena M Unterrainer, Laura M Bartos, Viktoria C Ruf, Matthias Brendel, Markus J Riemenschneider, Christian Wetzel, Jochen Herms, Rainer Rupprecht, Niklas Thon, Joerg-Christian Tonn, Claus Belka, Peter Bartenstein, Louisa von Baumgarten, Maximilian Niyazi, Marcus Unterrainer, Adrien Holzgreve","doi":"10.2967/jnumed.122.265247","DOIUrl":null,"url":null,"abstract":"<p><p>The 18-kDa translocator protein (TSPO) is gaining recognition as a relevant target in glioblastoma imaging. However, data on the potential prognostic value of TSPO PET imaging in glioblastoma are lacking. Therefore, we investigated the association of TSPO PET imaging results with survival outcome in a homogeneous cohort of glioblastoma patients. <b>Methods:</b> Patients were included who had newly diagnosed, histologically confirmed isocitrate dehydrogenase (IDH)-wild-type glioblastoma with available TSPO PET before either normofractionated radiotherapy combined with temozolomide or hypofractionated radiotherapy. SUV<sub>max</sub> on TSPO PET, TSPO binding affinity status, tumor volumes on MRI, and further clinical data, such as <i>O</i> <sup>6</sup>-alkylguanine DNA methyltransferase (<i>MGMT</i>) and telomerase reverse transcriptase (<i>TERT</i>) gene promoter mutation status, were correlated with patient survival. <b>Results:</b> Forty-five patients (median age, 63.3 y) were included. Median SUV<sub>max</sub> was 2.2 (range, 1.0-4.7). A TSPO PET signal was associated with survival: High uptake intensity (SUV<sub>max</sub> > 2.2) was related to significantly shorter overall survival (OS; 8.3 vs. 17.8 mo, <i>P</i> = 0.037). Besides SUV<sub>max</sub>, prognostic factors for OS were age (<i>P</i> = 0.046), <i>MGMT</i> promoter methylation status (<i>P</i> = 0.032), and T2-weighted MRI volume (<i>P</i> = 0.031). In the multivariate survival analysis, SUV<sub>max</sub> in TSPO PET remained an independent prognostic factor for OS (<i>P</i> = 0.023), with a hazard ratio of 2.212 (95% CI, 1.115-4.386) for death in cases with a high TSPO PET signal (SUV<sub>max</sub> > 2.2). <b>Conclusion:</b> A high TSPO PET signal before radiotherapy is associated with significantly shorter survival in patients with newly diagnosed IDH-wild-type glioblastoma. TSPO PET seems to add prognostic insights beyond established clinical parameters and might serve as an informative tool as clinicians make survival predictions for patients with glioblastoma.</p>","PeriodicalId":16758,"journal":{"name":"Journal of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":9.1000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586482/pdf/","citationCount":"1","resultStr":"{\"title\":\"Prognostic Value of TSPO PET Before Radiotherapy in Newly Diagnosed IDH-Wild-Type Glioblastoma.\",\"authors\":\"Nathalie L Albert, Debie V Nelwan, Daniel F Fleischmann, Stefanie Quach, Katharina von Rohr, Lena Kaiser, Nico Teske, Lena M Unterrainer, Laura M Bartos, Viktoria C Ruf, Matthias Brendel, Markus J Riemenschneider, Christian Wetzel, Jochen Herms, Rainer Rupprecht, Niklas Thon, Joerg-Christian Tonn, Claus Belka, Peter Bartenstein, Louisa von Baumgarten, Maximilian Niyazi, Marcus Unterrainer, Adrien Holzgreve\",\"doi\":\"10.2967/jnumed.122.265247\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The 18-kDa translocator protein (TSPO) is gaining recognition as a relevant target in glioblastoma imaging. However, data on the potential prognostic value of TSPO PET imaging in glioblastoma are lacking. Therefore, we investigated the association of TSPO PET imaging results with survival outcome in a homogeneous cohort of glioblastoma patients. <b>Methods:</b> Patients were included who had newly diagnosed, histologically confirmed isocitrate dehydrogenase (IDH)-wild-type glioblastoma with available TSPO PET before either normofractionated radiotherapy combined with temozolomide or hypofractionated radiotherapy. SUV<sub>max</sub> on TSPO PET, TSPO binding affinity status, tumor volumes on MRI, and further clinical data, such as <i>O</i> <sup>6</sup>-alkylguanine DNA methyltransferase (<i>MGMT</i>) and telomerase reverse transcriptase (<i>TERT</i>) gene promoter mutation status, were correlated with patient survival. <b>Results:</b> Forty-five patients (median age, 63.3 y) were included. Median SUV<sub>max</sub> was 2.2 (range, 1.0-4.7). A TSPO PET signal was associated with survival: High uptake intensity (SUV<sub>max</sub> > 2.2) was related to significantly shorter overall survival (OS; 8.3 vs. 17.8 mo, <i>P</i> = 0.037). Besides SUV<sub>max</sub>, prognostic factors for OS were age (<i>P</i> = 0.046), <i>MGMT</i> promoter methylation status (<i>P</i> = 0.032), and T2-weighted MRI volume (<i>P</i> = 0.031). In the multivariate survival analysis, SUV<sub>max</sub> in TSPO PET remained an independent prognostic factor for OS (<i>P</i> = 0.023), with a hazard ratio of 2.212 (95% CI, 1.115-4.386) for death in cases with a high TSPO PET signal (SUV<sub>max</sub> > 2.2). <b>Conclusion:</b> A high TSPO PET signal before radiotherapy is associated with significantly shorter survival in patients with newly diagnosed IDH-wild-type glioblastoma. TSPO PET seems to add prognostic insights beyond established clinical parameters and might serve as an informative tool as clinicians make survival predictions for patients with glioblastoma.</p>\",\"PeriodicalId\":16758,\"journal\":{\"name\":\"Journal of Nuclear Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":9.1000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586482/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2967/jnumed.122.265247\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2967/jnumed.122.265247","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/3 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Prognostic Value of TSPO PET Before Radiotherapy in Newly Diagnosed IDH-Wild-Type Glioblastoma.
The 18-kDa translocator protein (TSPO) is gaining recognition as a relevant target in glioblastoma imaging. However, data on the potential prognostic value of TSPO PET imaging in glioblastoma are lacking. Therefore, we investigated the association of TSPO PET imaging results with survival outcome in a homogeneous cohort of glioblastoma patients. Methods: Patients were included who had newly diagnosed, histologically confirmed isocitrate dehydrogenase (IDH)-wild-type glioblastoma with available TSPO PET before either normofractionated radiotherapy combined with temozolomide or hypofractionated radiotherapy. SUVmax on TSPO PET, TSPO binding affinity status, tumor volumes on MRI, and further clinical data, such as O6-alkylguanine DNA methyltransferase (MGMT) and telomerase reverse transcriptase (TERT) gene promoter mutation status, were correlated with patient survival. Results: Forty-five patients (median age, 63.3 y) were included. Median SUVmax was 2.2 (range, 1.0-4.7). A TSPO PET signal was associated with survival: High uptake intensity (SUVmax > 2.2) was related to significantly shorter overall survival (OS; 8.3 vs. 17.8 mo, P = 0.037). Besides SUVmax, prognostic factors for OS were age (P = 0.046), MGMT promoter methylation status (P = 0.032), and T2-weighted MRI volume (P = 0.031). In the multivariate survival analysis, SUVmax in TSPO PET remained an independent prognostic factor for OS (P = 0.023), with a hazard ratio of 2.212 (95% CI, 1.115-4.386) for death in cases with a high TSPO PET signal (SUVmax > 2.2). Conclusion: A high TSPO PET signal before radiotherapy is associated with significantly shorter survival in patients with newly diagnosed IDH-wild-type glioblastoma. TSPO PET seems to add prognostic insights beyond established clinical parameters and might serve as an informative tool as clinicians make survival predictions for patients with glioblastoma.
期刊介绍:
The Journal of Nuclear Medicine (JNM), self-published by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), provides readers worldwide with clinical and basic science investigations, continuing education articles, reviews, employment opportunities, and updates on practice and research. In the 2022 Journal Citation Reports (released in June 2023), JNM ranked sixth in impact among 203 medical journals worldwide in the radiology, nuclear medicine, and medical imaging category.