Prognostic value of 18FET positron emission tomography (18FET-PET) for the clinical course in newly diagnosed glioblastoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 2045-2045
Author(s):  
Joerg Christian Tonn ◽  
Bogdana Suchorska ◽  
Natalie Jansen ◽  
Jennifer Linn ◽  
Hans A Kretzschmar ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Response To Therapy ◽  
Therapeutic Effects ◽  
Newly Diagnosed ◽  
Prognostic Information ◽  
Prospective Longitudinal Study ◽  
Cox Regression Analysis ◽  
Fet Pet ◽  
Newly Diagnosed Glioblastoma ◽  
Prospective Longitudinal

2045 Background: Aim of this prospective longitudinal study was to evaluate whether 18FET-PET allow to monitor and quantify the therapeutic effects of surgery, radiotherapy and chemotherapy in newly diagnosed glioblastoma and whether 18FET-PET can provide additional prognostic information on response to therapy and outcome. Methods: 92 patients with newly diagnosed glioblastoma considered eligible for radiochemotherapy (RcX) were included; diagnosis was obtained by biopsy (n=46) or resection (n=46). Patients were to undergo 18FET-PET and cocomitant MRI scans prior to surgery, following RcX and as well as after three cycles of adjuvant temozolomide (TMZ). At each time point, biological tumor volume (BTV), maximal 18FET uptake as ratio to background (SUVmax/BG), and tumor uptake kinetics (TAC) were obtained. Overall survival (OS) was primary endpoint, progression-free survival (PFS) as defined by MRI using Macdonald criteria was a secondary endpoint. ROC analyses were done to determine optimal cut-off values of 18FET-PET parameters for survival outcome. To identify predictors for OS/PFS, Cox regression analysis was performed. Results: 79 patients were eligible for further evaluation. ROC analysis revealed cut-off values for pre-RCX BTV (9.5 ccm) and SUVmax/BG (2.95) with a sensitivity and specificity of both 70% for BTV and 68/73% for SUVmax/BG. Both pre-therapeutic BTV and SUVmax/BG were associated with PFS and OS (p<0.05). In contrast to MRI-based volume, the prognostic value of BTV remained highly significant in the multivariate Cox analysis independently of MGMT status.. Furthermore, 18FET TAC pattern and its changes were related to OS and PFS. Conclusions: Serial 18FET-PET imaging in glioblastoma before and after concomitant radio-/chemotherapy is a highly powerful tool to provide prognostic information for the outcome in newly diagnosed glioblastoma patients. These findings might help to personalize therapy and response evaluation in forthcoming clinical investigations. Clinical trial information: NCT01089868.

scholarly journals The prognostic value of FET PET at radiotherapy planning in newly diagnosed glioblastoma

2016 ◽  
Vol 44 (3) ◽  
pp. 373-381 ◽  
Author(s):  
Sidsel Højklint Poulsen ◽  
Thomas Urup ◽  
Kirsten Grunnet ◽  
Ib Jarle Christensen ◽  
Vibeke Andrée Larsen ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Radiotherapy Planning ◽  
Newly Diagnosed ◽  
Fet Pet ◽  
Newly Diagnosed Glioblastoma

Diagnosis of pseudoprogression following lomustine-temozolomide chemoradiation in newly diagnosed glioblastoma patients using FET PET

2021 ◽  
pp. clincanres.0471.2021
Author(s):  
Jan-Michael Werner ◽  
Johannes Weller ◽  
Garry Ceccon ◽  
Christina Schaub ◽  
Caroline Tscherpel ◽  
...  
Keyword(s):  
Newly Diagnosed ◽  
Fet Pet ◽  
Newly Diagnosed Glioblastoma

scholarly journals MON-307 Prospective, Longitudinal Study of Glucose-Suppressed GH Levels in 87 Acromegaly Patients with IGF-1 Normalization After Surgical Therapy: Prognostic Value of Nadir GH Levels for Long-Term Remission or Recurrence

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Pamela Freda ◽  
Jeffrey N Bruce ◽  
Carlos Reyes-Vidal ◽  
Yessica De Leon ◽  
Zhezhen Jin ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Prognostic Value ◽  
Relevant Information ◽  
Oral Glucose ◽  
Surgical Removal ◽  
Prospective Longitudinal Study ◽  
Normal Ranges ◽  
Prospective Longitudinal

Abstract Surgical removal of the GH-secreting tumor is the initial treatment of choice for acromegaly. Outcome of surgery is assessed by measuring IGF-1 and glucose-suppressed GH levels. IGF-1 normalization is an essential biochemical criterion for remission. The cut-off for nadir GH after oral glucose that signifies remission, however, is debated. It also remains unclear whether GH levels provide additional prognostic or clinically relevant information when IGF-1 results are definitive. To address this question, we examined how initial postoperative glucose-suppressed GH levels change over time on serial testing in patients who achieve initial remission as defined by IGF-1 normalization. We studied 87 acromegaly patients (48M, 39F) who achieved a normal IGF-1 level after surgery alone longitudinally from 1996 to 2019. All had GH measured before and 60, 90 and 120 minutes after 75 or 100 mg oral glucose (OGTT) at ≥ 3 months after surgery and GH and IGF-1 repeated ≥ 1 year later. GH was by measured by sensitive, 22KDa GH specific assays, either a IRMA (DSL, International Reference Standard (IRS) 88/624) or a chemiluminescence immunoassay (IDS-iSYS, IRS 98/574). OGTT Nadir GH levels were also measured in healthy subjects; n=46 (26 M, 20 F, ages 19-71 yr.) by DSL and n=46 (29 M, 17 F; ages 20-66 yr.) by IDS-iSYS. Nadir GH levels in acromegaly patients were compared to the 95%CI of healthy subjects’ mean and categorized relative to healthy subjects’ 97.5 percentile, which was 0.14 µg/L for both assays. IGF-1 levels were compared to age and gender adjusted normal ranges. Subjects were grouped based on initial nadir GH ≤ or &gt; 0.14 µg/L and the patterns of change in nadir GH and IGF-1 at last follow up or until IGF-1 became elevated (i.e. recurrence). Follow up durations are given as median(range). In follow up, 73 patients remained in remission (normal IGF-1) and 14 had a recurrence (elevated IGF-1). Of the 73 in remission, 55 had initial nadir GH ≤ 0.14 µg/L that persisted to 10 yr.(1-22yr.) of follow up, 5 had initial GH ≤ 0.14 µg/L that rose to &gt; 0.14 µg/L by 9(3-21)yr., 10 had GH &gt; 0.14 µg/L that persisted at 5.5(2-22)yr., and 3 had GH &gt; 0.14 µg/L that fell to ≤ 0.14 µg/L at 5(4-7)yr. of follow up. Of the 14 that recurred, 11 had an initial and persistent GH &gt; 0.14 µg/L and developed an elevated IGF-1 level after 6(1-23) yr.. The 3 other patients that recurred had an initial GH ≤ 0.14 µg/L that rose to &gt; 0.14 µg/L by 1-6 years later and subsequently developed an elevated IGF-1 level by 14-16 years of follow up. In summary, we found that the pattern of normal IGF-1 along with nadir GH &gt; 0.14 µg/L on initial testing or developing with time, was associated with recurrence in 14/32 patients. We also found that initial nadir GH ≤ 0.14 µg/L was highly predictive of long-term persistent remission: 60/63 such patients remained in remission. In conclusion, glucose-suppressed GH levels are of prognostic value in acromegaly patients with normal IGF-1 after surgery.

scholarly journals P14.32 Spatial discrepancies between FET PET and conventional MRI in patients with newly diagnosed glioblastoma

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii74-iii74
Author(s):  
P Lohmann ◽  
P Stavrinou ◽  
K Lipke ◽  
E K Bauer ◽  
G Ceccon ◽  
...  
Keyword(s):  
Amino Acid ◽  
Tumor Volume ◽  
Newly Diagnosed ◽  
Similarity Coefficients ◽  
Fet Pet ◽  
Spatial Similarity ◽  
Conventional Mri ◽  
Fluid Attenuated Inversion Recovery ◽  
Amino Acid Pet ◽  
Newly Diagnosed Glioblastoma

Abstract BACKGROUND In patients with glioblastoma, the tissue showing contrast enhancement (CE) in MRI is usually the target for resection or radiotherapy. However, the solid tumor mass typically extends beyond the area of CE. Amino acid PET can detect tumor parts that show no CE. We systematically investigated tumor volumes delineated by amino acid PET and MRI in newly diagnosed, untreated glioblastoma patients. MATERIAL AND METHODS Preoperatively, 50 patients with subsequently neuropathologically confirmed glioblastoma underwent O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) PET, fluid-attenuated inversion recovery (FLAIR), and CE MRI. Areas of CE were manually delineated. FET PET tumor volumes were segmented using a tumor-to-brain ratio ≥ 1.6. The percentage of overlapping volumes (OV), as well as Dice and Jaccard spatial similarity coefficients (DSC; JSC), were calculated. FLAIR images were evaluated visually. RESULTS In 86% of patients (n = 43), the FET PET tumor volume was significantly larger than the volume of CE (21.5 ± 14.3 mL vs. 9.4 ± 11.3 mL; P < 0.001). Forty patients (80%) showed both an increased uptake of FET and CE. In these 40 patients, the spatial similarity between FET and CE was low (mean DSC, 0.39 ± 0.21; mean JSC, 0.26 ± 0.16). Ten patients (20%) showed no CE, and one of these patients showed no FET uptake. In 10% of patients (n = 5), increased FET uptake was present outside of areas of FLAIR hyperintensity. CONCLUSION Our results show that the metabolically active tumor volume delineated by FET PET is significantly larger than tumor volume delineated by CE. The data strongly suggest that the information derived from FET PET should be integrated into the management of newly diagnosed glioblastoma patients. FUNDING This work was supported by the Wilhelm-Sander Stiftung, Germany

scholarly journals Autologous Heat Shock Protein Peptide Vaccination for Newly Diagnosed Glioblastoma: Impact of Peripheral PD-L1 Expression on Response to Therapy

2017 ◽  
Vol 23 (14) ◽  
pp. 3575-3584 ◽  
Author(s):  
Orin Bloch ◽  
Michael Lim ◽  
Michael E. Sughrue ◽  
Ricardo J. Komotar ◽  
John M. Abrahams ◽  
...  
Keyword(s):  
Heat Shock ◽  
Heat Shock Protein ◽  
Response To Therapy ◽  
Newly Diagnosed ◽  
Peptide Vaccination ◽  
Newly Diagnosed Glioblastoma

Biological Parameters Predictive Of Percent Dense Red Blood Cell Decrease Under Hydroxyurea Therapy

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 990-990
Author(s):  
Marie Georgine Rakotoson ◽  
Gaetana Di Liberto ◽  
Anoosha Habibi ◽  
Christine Fauroux ◽  
Sanam Khorgami ◽  
...  
Keyword(s):  
Blood Cell ◽  
Univariate Analysis ◽  
Acute Chest Syndrome ◽  
Mean Corpuscular Hemoglobin ◽  
Therapeutic Effects ◽  
Biological Parameters ◽  
Inclusion Criteria ◽  
Corpuscular Hemoglobin ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal

Abstract Introduction Dehydrated, dense red blood cells (DRBC), a subpopulation of sickle cells, are characterized by density >1.112; their increased mean corpuscular hemoglobin concentration (MCHC) leads to hemoglobin S (HbS) polymerization. The %DRBC is the biological parameter most strongly associated with some sickle-cell–disease (SCD) chronic organ damage, e.g., renal dysfunction, leg ulcers and priapism, also called hemolytic subphenotypes (Bartolucci et al. Blood 2012; Kato et al. Blood Rev 2007). Proven hydroxyurea (HU) efficacy against SCD lowers vaso-occlusive crisis, acute chest syndrome frequencies, and mortality (Charache et al. N Engl J Med 1995). The classical biological parameters indicating HU response are fetal hemoglobin (HbF) and mean corpuscular cell volume (MCV) increases (Steinberg et al. Blood 1997). However, we previously found decreased %DRBC in 33 patients after 6 months of HU (Bartolucci et al. Blood 2012) .We analyzed baseline biological parameters to identify those predictive of %DRBC decline under HU. Patients and methods We conducted a monocenter, prospective, longitudinal study on SCD patients undergoing HU therapy. Data were collected at baseline (day 0) and after 6 months of HU. Inclusion criteria were: SS and S-β0 thalassemia patients, age >18 years. Non-inclusion criteria were pregnancy, chronic blood transfusion and refused consent. Biological parameters determined were: %DRBC assessed with the phthalate density-distribution technique, D50 (defined as the density at which [(height of cells below phthalate index/sum of those above and below that index) = 0.5]), white blood-cell count (WBC count), MCV, MCHC, mean corpuscular hemoglobin content (MCH), total Hb, reticulocytes (RET), %HbF, platelet count, total bilirubin, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase. Results are expressed as means ± SD, numbers or %, as appropriate. Quantitative parameters were compared between groups with Student’s paired t-test. Correlations were established with Pearson’s correlation coefficient. Multiple linear regressions were used to explore models that better predicted DRBC variation under HU. The final models included the variables that remained significantly associated with %DRBC decline after adjustment for the other variables in the models. R-squared (r2) were used as measures of variance explained by the models. P < 0.05 defined significance. This study was approved by the local Institutional Review Board. Results and Discussion Fifty-nine patients, mean age 35 ± 9 years, were included. Their %DRBC fell significantly by 40.7% after 6 months of HU therapy (P = 0.0003) from 10.1 ± 8% to 6 ± 4%. The %HbF rose from 7.2 ± 4% to 17.3 ± 8%. Our univariate analysis identified variables significantly correlated with %DRBC (Table). Multivariate analysis retained a significantly positive correlation between %DRBC decreases under HU and the pretreatment %DRBC on day 0. This statistical model accounted for 71.9% of the variability of %DRBC decline under HU. Pertinently, no correlation was found between %HbF and %DRBC changes, suggesting different mechanisms of action. Conclusion Our results confirmed the HU impact on %DRBC decrease, suggesting new indications to prevent or treat SCD complications associated with high %DRBC. They also showed that the major parameter predictive of DRBC decline under HU was the baseline %DRBC. %HbF and %DRBC changes under HU were not correlated. Prospective studies are needed to analyze the therapeutic effects of HU on chronic complications. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The Diagnostic and Prognostic Value of Neurofilament Heavy Chain Levels in Immune-Mediated Optic Neuropathies

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Axel Petzold ◽  
Gordon T. Plant
Keyword(s):  
Optic Neuritis ◽  
Heavy Chain ◽  
Prognostic Value ◽  
Visual Outcome ◽  
High Serum ◽  
Healthy Controls ◽  
Prospective Longitudinal Study ◽  
Immune Mediated ◽  
Prospective Longitudinal ◽  
Diagnostic And Prognostic Value

Background. Loss of visual function differs between immune-mediated optic neuropathies and is related to axonal loss in the optic nerve. This study investigated the diagnostic and prognostic value of a biomarker for neurodegeneration, the neurofilament heavy chain (NfH) in three immune-mediated optic neuropathies.Methods. A prospective, longitudinal study including patients with optic neuritis due to multiple sclerosis (MSON,n=20), chronic relapsing inflammatory optic neuritis (CRION,n=19), neuromyelitis optica (NMO,n=9), and healthy controls (n=28). Serum NfH-SMI35 levels were quantified by ELISA.Findings. Serum NfH-SMI35 levels were highest in patients with NMO (mean0.79±1.51 ng/mL) compared to patients with CRION (0.13±0.16 ng/mL,P=0.007), MSON (0.09±0.09,P=0.008), and healthy controls (0.01±0.02 ng/mL,P=0.001). High serum NfH-SMI35 levels were related to poor visual outcome.Conclusions. Blood NfH-SMI35 levels are of moderate diagnostic and more important prognostic value in immune-mediated optic neuropathies. We speculate that longitudinal blood NfH levels may help to identify particular disabling events in relapsing conditions.

Cognitive decline in Parkinson’s disease: A prospective longitudinal study

2009 ◽  
Vol 15 (3) ◽  
pp. 426-437 ◽  
Author(s):  
DINO MUSLIMOVIĆ ◽  
BART POST ◽  
JOHANNES D. SPEELMAN ◽  
ROB J. DE HAAN ◽  
BEN SCHMAND
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Decline ◽  
Disease Onset ◽  
Cognitive Change ◽  
Newly Diagnosed ◽  
Psychomotor Speed ◽  
Prospective Longitudinal Study ◽  
Normative Comparisons ◽  
Prospective Longitudinal

AbstractThis controlled prospective study examined the evolution and predictors of cognitive decline in Parkinson’s disease (PD). Consecutive patients diagnosed at baseline with PD (n = 89), established PD (EPD) patients (n = 52) with a mean disease duration of 6.5 years, and healthy control subjects (n = 64) underwent extensive neuropsychological assessment twice, approximately 3 years apart. A standardized regression-based method, normative data, and multivariate normative comparisons were used to assess the cognitive course of PD. Cognitive performance of newly diagnosed patients decreased significantly over time, particularly on measures of psychomotor speed and attention and to a lesser extent on tests of memory, visuospatial skills, and executive functions. About 50% of the patients showed cognitive decline and 9% developed dementia. Similar results were observed in EPD patients. None of the baseline features predicted cognitive change in newly diagnosed patients, whereas age at disease onset and axial impairment (postural and gait disorders) contributed to decline in established patients. We conclude that within few years after diagnosis, PD patients show faster rate of cognitive decline than matched healthy subjects, particularly in domains of attention and psychomotor speed. Selection bias probably led to underestimation of the true extent of cognitive decline in established patients. (JINS, 2009, 15, 426–437.)

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