¹⁸F-FET PET for planning of thermotherapy using magnetic nanoparticles in recurrent glioblastoma

Figures & data

Table I.  Demographic data and history of 11 patients with recurrent glioblastoma.

Pat. No.	Age (years)	Sex	Location	Pre-treatment
1	34	F	R FL	Surg, Rad, Chemo
2	57	M	L TL	Surg, Rad
3	25	M	L Thalamus	Surg, Rad, Chemo
4	55	M	L FL	Surg
5	69	M	L TL	Surg, Rad, Chemo
6	44	F	L OL	Surg, Chemo
7	41	M	L TL	Surg, Rad
8	38	F	L FL	Surg, Rad, Chemo
9	40	M	R FL	Surg, Rad, Chemo
10	75	F	L TL	Surg, Rad, Chemo
11	58	M	L TL	Surg, Rad, Chemo

M = male; F = female; L = left side; R = right side; FL = frontal lobe; TL = temporal lobe; OL = occipital lobe; Surg = Surgery; Rad = Radiation therapy; Chemo = Chemotherapy.

Table II.  Results of volumetric measurements using Gd-enhanced MRI and FET-PET in 11 patients with recurrent glioblastomas.

	GTV MRI (cm^3)	GTV FET (cm^3)	Common GTV (cm^3)	GTV MRI less common GTV (cm^3)	GTV FET less common GTV (cm^3)	Final GTV (cm^3)	Change in GTV by FET-PET (cm^3/%)
1	59.7	76.8	39.7	20.0	37.1	59.7	0*
2	11.3	43.6	6.2	5.1	37.4	43.6	+32.3/+286
3	2.5	5.2	1.9	0.6	3.3	5.2	+2.7/+108
4	15.1	18.3	9.3	5.8	9.0	24.1	+9.0/+60
5	39.9	40.2	31.3	8.6	8.9	48.5	+8.7/+22
6	44.0	26.2	19.6	14.4	6.6	26.2	−7.8/−23
7	13.6	14.8	6.6	7.0	8.2	22.0	+8.4/+62
8	31.7	23.3	17.5	14.2	5.8	23.3	−8.4/−26
9	19.9	18.4	6.4	13.5	12.0	30.7#	+10.8/−54#
10	5.3	6.6	1.2	4.1	5.4	10.7	+5.4/+102
11	34.8	77.9	30.1	4.7	47.8	77.9#	+43.1/+128#
Mean	24.3	31.9	15.4	8.9	16.5	33.8	+9.4
SD	13.3	21.7	11.0	4.7	15.2	20.9	16.8(±79%)

GTV = gross tumour volume; SD = standard deviation.

*The additional volume, defined using FET-PET, was not accessible for nano cancer therapy and thus did not contribute to the PV; # no therapy was performed; ± mean percentage change (absolute value).

Figure 1. A 41-year-old male patient (No. 7) suffering from recurrent glioblastoma in the left temporal lobe. The FET-PET scan (A) shows a larger tumour extension than the corresponding Gd-enhanced MR scan (C); see also the fused image (B). The discrepancies between tumour borders, defined on the PET and MR scans, are shown in the transversal MR image (D) and in the 3D surface-based reconstruction (E). The blue-coloured line/surface marks the MRI-based tumour borders and the rose-coloured line/surface marks the PET-based tumour borders. The green-coloured surface in the image E marks the ventricular system.

Figure 2. A 44-year-old female patient (No. 6) with recurrent glioblastoma in the left occipital lobe, showing an increased amino acid accumulation (A). CT examination (C), performed 1 day after PET-guided injection of nanoparticles and the fused PET/CT scan (B) allow assessment of their distribution. The control examinations 13 weeks after nano cancer therapy (D–F) show a significant reduction in the amino acid accumulation (PET) and building of necrotic/oedematous zones around the nanoparticles deposits (CT).