3′-Deoxy-3′-18F-Fluorothymidine PET and MRI for Early Survival Predictions in Patients with Recurrent Malignant Glioma Treated with Bevacizumab

摘要

With the dismal prognosis for malignant glioma patients, survival predictions become key elements in patient management. This study compares the value of 3′-deoxy-3′-¹⁸F-fluorothymidine (¹⁸F-FLT) PET and MRI for early outcome predictions in patients with recurrent malignant glioma on bevacizumab therapy.MethodsThirty patients treated with bevacizumab combination therapy underwent ¹⁸F-FLT PET immediately before and at 2 and 6 wk after the start of treatment. A metabolic treatment response was defined as a decrease of equal to or greater than 25% in tumor ¹⁸F-FLT uptake (standardized uptake values) from baseline using receiver-operating-characteristic analysis. MRI treatment response was assessed at 6 wk according to the Response Assessment in Neurooncology criteria. ¹⁸F-FLT responses at different times were compared with MRI response and correlated with progression-free survival and overall survival using Kaplan–Meier analysis. Metabolic response based on ¹⁸F-FLT was further compared with other outcome predictors using Cox regression analysis.