Back to Search
Start Over
ACRIN 6684: Assessment of Tumor Hypoxia in Newly Diagnosed Glioblastoma Using 18F-FMISO PET and MRI.
- Source :
-
Clinical cancer research : an official journal of the American Association for Cancer Research [Clin Cancer Res] 2016 Oct 15; Vol. 22 (20), pp. 5079-5086. Date of Electronic Publication: 2016 May 16. - Publication Year :
- 2016
-
Abstract
- Purpose: Structural and functional alterations in tumor vasculature are thought to contribute to tumor hypoxia which is a primary driver of malignancy through its negative impact on the efficacy of radiation, immune surveillance, apoptosis, genomic stability, and accelerated angiogenesis. We performed a prospective, multicenter study to test the hypothesis that abnormal tumor vasculature and hypoxia, as measured with MRI and PET, will negatively impact survival in patients with newly diagnosed glioblastoma.<br />Experimental Design: Prior to the start of chemoradiation, patients with glioblastoma underwent MRI scans that included dynamic contrast enhanced and dynamic susceptibility contrast perfusion sequences to quantitate tumor cerebral blood volume/flow (CBV/CBF) and vascular permeability (k <superscript>trans</superscript> ) as well as <superscript>18</superscript> F-Fluoromisonidazole ( <superscript>18</superscript> F-FMISO) PET to quantitate tumor hypoxia. ROC analysis and Cox regression models were used to determine the association of imaging variables with progression-free and overall survival.<br />Results: Fifty patients were enrolled of which 42 had evaluable imaging data. Higher pretreatment <superscript>18</superscript> F-FMISO SUV <subscript>peak</subscript> (P = 0.048), mean k <superscript>trans</superscript> (P = 0.024), and median k <superscript>trans</superscript> (P = 0.045) were significantly associated with shorter overall survival. Higher pretreatment median k <superscript>trans</superscript> (P = 0.021), normalized RCBV (P = 0.0096), and nCBF (P = 0.038) were significantly associated with shorter progression-free survival. SUV <subscript>peak</subscript> [AUC = 0.75; 95% confidence interval (CI), 0.59-0.91], nRCBV (AUC = 0.72; 95% CI, 0.56-0.89), and nCBF (AUC = 0.72; 95% CI, 0.56-0.89) were predictive of survival at 1 year.<br />Conclusions: Increased tumor perfusion, vascular volume, vascular permeability, and hypoxia are negative prognostic markers in newly diagnosed patients with gioblastoma, and these important physiologic markers can be measured safely and reliably using MRI and <superscript>18</superscript> F-FMISO PET. Clin Cancer Res; 22(20); 5079-86. ©2016 AACR.<br />Competing Interests: Dr. Sorensen reports stock ownership and employment with Siemens and patents/royalties/intellectual property with General Electric. Dr Schmainda reports ownership interest in Imaging Biometrics LLC. All other authors report no conflict of interest.<br /> (©2016 American Association for Cancer Research.)
- Subjects :
- Adult
Aged
Biomarkers analysis
Brain Neoplasms pathology
Disease-Free Survival
Female
Glioblastoma pathology
Humans
Male
Middle Aged
Misonidazole analogs & derivatives
Misonidazole pharmacology
Prospective Studies
Radiopharmaceuticals pharmacology
Brain Neoplasms blood supply
Brain Neoplasms mortality
Glioblastoma blood supply
Glioblastoma mortality
Magnetic Resonance Imaging
Neovascularization, Pathologic pathology
Positron-Emission Tomography
Tumor Hypoxia physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1557-3265
- Volume :
- 22
- Issue :
- 20
- Database :
- MEDLINE
- Journal :
- Clinical cancer research : an official journal of the American Association for Cancer Research
- Publication Type :
- Academic Journal
- Accession number :
- 27185374
- Full Text :
- https://doi.org/10.1158/1078-0432.CCR-15-2529