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。

IF 9.1 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Nuclear Medicine Pub Date : 2023-10-01 Epub Date: 2023-08-03 DOI:10.2967/jnumed.122.265247
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
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引用次数: 1

摘要

18kDa转运蛋白(TSPO)作为胶质母细胞瘤成像的相关靶点正在获得认可。然而,关于TSPO PET成像在胶质母细胞瘤中的潜在预后价值的数据尚缺乏。因此,我们在一个同质的胶质母细胞瘤患者队列中研究了TSPO PET成像结果与生存结果的关系。方法:纳入新诊断的、经组织学证实的异柠檬酸脱氢酶(IDH)-野生型胶质母细胞瘤患者,在正常分割放疗联合替莫唑胺或低分割放疗之前,使用TSPO PET。TSPO PET上的SUVmax、TSPO结合亲和力状态、MRI上的肿瘤体积以及其他临床数据,如O 6-烷基鸟嘌呤DNA甲基转移酶(MGMT)和端粒酶逆转录酶(TERT)基因启动子突变状态,与患者生存率相关。结果:45名患者(中位年龄63.3 y) 包括在内。中位SUVmax为2.2(范围1.0-4.7)。TSPO PET信号与生存率相关:高摄取强度(SUVmax>2.2)与显著缩短的总生存率相关(OS;8.3 vs.17.8 mo,P=0.037)。除SUVmax外,OS的预后因素还有年龄(P=0.046)、MGMT启动子甲基化状态(P=0.032)和T2加权MRI体积(P=0.031)。在多变量生存分析中,TSPO PET中的SUVmax仍然是OS的独立预后因素(P=0.023),TSPO PET高信号(SUVmax>2.2)患者死亡的危险比为2.212(95%CI,1.115-4.386)。结论:放疗前TSPO PET信号高与新诊断的IDH野生型胶质母细胞瘤患者的生存期显著缩短有关。TSPO PET似乎在既定的临床参数之外增加了预后见解,并可能成为临床医生预测胶质母细胞瘤患者生存率的一种信息工具。
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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 O 6-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.

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来源期刊
Journal of Nuclear Medicine
Journal of Nuclear Medicine 医学-核医学
CiteScore
13.00
自引率
8.60%
发文量
340
审稿时长
1 months
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.
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