Clinical Utility of [18F]-Fluciclovine PET/MRI for Differentiating True Progression from Treatment-Related Changes in Patients with Glioblastoma.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ivanidze Jana, Vu Kellen Vo, Fu Rongwei, Brandmaier Andrew, Szidonya Laszlo, Choudhary Gagandeep, Starkey Jay, Wang Tony J, Sisti Michael, McKhann L Guy, Puri Sushant, Konner Marcus, Roytman Michelle, Lin Eaton, Kuhn Andrew, Osborne Joseph R, Stieg Philip E, Beal Kathryn, Ramakrishna Rohan R, Singh Gagandeep, Lignelli-Dipple Angela, Doubrovin Mikhail, Vo Anh Huan, Welch Mary, Iwamoto Fabio, Haggiagi Aya, Donovan Laura, Ordonez Maria Diaz, Gill Brian, Liechty Benjamin, Pisapia David J, Walker Josh, Magge Rajiv S, Wood Matthew, Corzo Valentina Marulanda, Sanusi Olabisi R, Raslan Ahmed, Dogan Aclan, Bowden Stephen, Nehmeh Sadek A, Nickerson Joshua, Mallak Nadine, Ruiz Amber, Ambady Prakash, Nabavizadeh Ali, Barajas Ramon F
Аннотация
MATERIALS AND METHODS: In this retrospective, multi-institutional, institutional review board-approved study, we analyzed [18F]-fluciclovine PET/MRI scans performed in patients with presumed GBM progression. All PET/MRI examinations were clinically indicated and performed as part of routine standard-of-care imaging. Clinical classification was based on histopathology or imaging and clinical follow-up. Maximum standardized uptake value (SUVmax) was measured in enhancing lesions. Group comparisons were assessed with Mann-Whitney U tests. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis, including derivation of an optimal cutoff using Youden index and validation of the previously published diagnostic threshold of 4.66. Subgroup analyses compared diagnostic performance across institutions.
RESULTS: Thirty-six patients with presumed GBM progression (Institution 1, n=17; Institution 2, n=19) provided 22 examinations classified as true tumor progression and 14 as treatment-related change. There were no significant differences in clinical or demographic study population characteristics between the 2 institutions. SUVmax was significantly higher in true tumor progression than in treatment-related change (median [interquartile range], 8.73 [5.86-10.83] versus 3.71 [1.70-4.67]; P < .01). Combined ROC analysis demonstrated excellent diagnostic performance (area under the curve [AUC] = 0.90; 95% CI, 0.79-0.98). The optimal threshold of 5.7 yielded 86% sensitivity (0.70-0.99) and 86% specificity (0.64-0.99). Applying the published threshold of 4.66 produced similar results (AUC = 0.90), with 91% sensitivity (0.71-0.99) and 71% specificity (0.42-0.92). A stratified analysis demonstrated comparable diagnostic performance across both institutions.
CONCLUSIONS: [18F]-Fluciclovine PET/MRI demonstrated high diagnostic accuracy for differentiating true GBM progression from treatment-related changes, with consistent SUVmax thresholds across 2 institutions. These findings support the generalizability of [18F]-fluciclovine PET as a biologically specific adjunct to conventional MR imaging for patients with presumed GBM progression.