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18‐fluorodeoxyglucose uptake and survival of patients with suspected recurrent malignant glioma
Author(s) -
Barker Fred G.,
Chang Susan M.,
Valk Peter E.,
Pounds Thomas R.,
Prados Michael D.
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970101)79:1<115::aid-cncr17>3.0.co;2-7
Subject(s) - medicine , glioma , nuclear medicine , fluorodeoxyglucose , positron emission tomography , radiation therapy , magnetic resonance imaging , univariate analysis , hazard ratio , radiology , proportional hazards model , multivariate analysis , confidence interval , cancer research
BACKGROUND After intensive initial radiation therapy for malignant glioma, magnetic resonance imaging (MRI) and computerized tomography (CT) cannot distinguish tumor progression from radiation injury. METHODS The authors studied the prognostic value of 18‐fluorodeoxyglucose positron emission tomography (FDG‐PET) in 55 patients with malignant glioma for whom MRI obtained after initial surgery and radiation therapy demonstrated enlarging, enhancing lesions consistent with either tumor progression or radiation necrosis. Forty patients (73%) had an initial diagnosis of Grade 4 malignant glioma and 15 (27%) had Grade 3 malignant glioma. The FDG‐PET scans were graded visually on a four‐level scale at the time of acquisition. RESULTS In univariate analysis, the FDG‐PET score was a significant predictor of survival time after FDG‐PET scanning ( P = 0.005). Median survival was 10 months for patients with FDG‐PET scores of 2 or 3 (glucose uptake ≥ adjacent cortex) and 20 months for those with scores of 0 or 1 (glucose uptake < adjacent cortex). In multivariate proportional hazards analysis, the FDG‐PET score was a significant predictor of survival ( P = 0.019) in a model that included patient age, recurrence number, and FDG‐PET score. There was no significant difference in the FDG‐PET score hazard ratio for patients with Grade 3 or 4 tumors at initial diagnosis, first or later suspected recurrence, initial photon irradiation given with standard fractions or hyperfractionation, or stereotactic irradiation prior to FDG‐PET scanning. CONCLUSIONS This analysis demonstrates that FDG‐PET scanning has prognostic value in a cohort limited to patients with suspected recurrent high grade glioma. Cancer 1997; 79:115‐26. © 1997 American Cancer Society.