Change in F18-Fluoromisonidazole PET Is an Early Predictor of the Prognosis in the Patients with Recurrent High-Grade Glioma Receiving Bevacizumab Treatment

Yamaguchi Shigeru; Hirata Kenji; Toyonaga Takuya; Kobayashi Kentaro; Ishi Yukitomo; Motegi Hiroaki; Kobayashi Hiroyuki; Shiga Tohru; Tamaki Nagara; Terasaka Shunsuke; Houkin Kiyohiro

Title	en Change in F18-Fluoromisonidazole PET Is an Early Predictor of the Prognosis in the Patients with Recurrent High-Grade Glioma Receiving Bevacizumab Treatment
Creator	en Yamaguchi, Shigeru en Hirata, Kenji NRID 1000030431365 en Toyonaga, Takuya en Kobayashi, Kentaro en Ishi, Yukitomo en Motegi, Hiroaki en Kobayashi, Hiroyuki en Shiga, Tohru NRID 1000080374495 en Tamaki, Nagara NRID 1000030171888 en Terasaka, Shunsuke NRID 1000010447055 en Houkin, Kiyohiro NRID 1000090229146
Accessrights	open access
Rights	https://creativecommons.org/licenses/by/4.0/ en Creative Commons Attribution 4.0 International
Subject	NDC 490
Description	Abstract en Background: Bevacizumab (BEV), a humanized monoclonal antibody, become a currently important chemotherapeutic option for the patients with recurrent glioma. The aim of this retrospective study is to investigate whether 18F-Fluoromisonidazole (FMISO) PET have the potential to detect BEV-resistant gliomas in the early-stage. Methods: We reviewed the FMISO PET and MRI appearances before and 3 to 4 courses after BEV treatment on 18 recurrent glioma patients. FMISO accumulation was assessed by visual inspection and semi-quantitative values which were tumor-to-normal (T/N) ratio and hypoxic volume. MRI responses were evaluated based on RANO (Response Assessment in Neuro-Oncology) criteria. The prognostic analysis was performed in relation to the response assessment by FMISO PET and MRI using overall survival (OS) after BEV application. Results: After BEV application, MRI revealed partial response in 14 of 18 patients (78%), of which 9 patients also demonstrated decreased FMISO accumulation. These 9 patients (50%) were classified as "MRI-FMISO double responder". As for the other 5 patients (28%), FMISO accumulation volumes increased or remained stable after BEV treatment although partial responses were achieved on MRI. Therefore, these cases were classified as "MRI-only responder". The remaining 4 patients (22%) did not show treatment response on FMISO PET or MRI ("non-responder"). MRI-FMISO double responders showed significantly longer OS than that in other groups (median 12.4 vs 5.7 months; P < 0.001), whereas there were no overall survival difference between MRI-only responders and non-responders (median OS, 5.7 and 4.8 months; P = 0.58). Among the pre-treatment clinical factors, high FMISO T/N ratio was a significant prognostic factor of overall survival in these patients under the assessment of Cox proportional hazard model. Conclusions: Recurrent gliomas with decreasing FMISO accumulation after short-term BEV application could derive a survival benefit from BEV treatment. Change in FMISO PET appearance can identify BEV-resistant gliomas in early-stage regardless of MRI findings in a comprehensible way.
Publisher	en Public Library of Science
Date	Issued2016-12-09
Language	eng
Resource Type	journal article
Version Type	VoR
Identifier	HDL http://hdl.handle.net/2115/64472
Relation	isIdenticalTo DOI https://doi.org/10.1371/journal.pone.0167917
Journal	PISSN 1932-6203 en PLoS ONE Volume Number11 Issue Number12 Page Starte0167917
File	fulltext journal.pone.0167917.pdf 1.25 MB (application/pdf) Issued2016-12-09
Oaidate	2023-07-26