Explore The Predictive Value Of ¹⁸F-RGD PET/CT Parametes To Treatment Sensitivity Of Concurrent Chemoradiotherapy In Postoperative Patients With Newly Diagnosed Glioblastoma

ObjectiveGlioblastoma multiform?GBM? is a malignant cerebral tumor that rich of neovascularization. Integrin ?v?3 plays an important role in the process of angiogenesis. ¹⁸F-AlF-NOTA-PRGD2(denoted as ¹⁸F-RGD) is a novel radiotracer for positron emission tomography?PET? which can specifically combined to ?v?3.Although the development in surgery, radiotherapy and temozolomide chemotherapy have been made, the prognosis of GBM is still poor. Therefore, it is essential for further evaluation of the current treatment prescription. This study examined the value of a novel one-step labeled integrin ?v?3-targeting¹⁸F-RGD PET/CT in assessing the sensitivity of concurrent chemoradiotherapy?CCRT? in patients with newly diagnostic GBM. MethodsThis study has been approved by the ethics committee of Shandong Tumor Hospital. All participates have given written consent. 25 patients with newly diagnosed GBM were enrolled in this study 3-5 weeks after surgical resection. All participants were investigated with ¹⁸F-RGD PET/CT on baseline?T1? and the third week?T2? after the start of CCRT. Tumor volume?TV?, maximal and mean standard uptake of the tumor?SUVmax, SUVmean? and tumor to not-tumor ratios?T/NT? of the TV were obtained. The MRI treatment response was assessed at the 11 th week?T3?. The change in the lesion volume from T1 to T3??VOLT1-3? on MRI was used as an endpoint to evaluate the predictive ability of ¹⁸F-RGD PET/CT. And ?VOLT1-3 was calculated by the equation ?VOLT1-3=?VOLT3-VOLT3?/VOLT1. ResultsWith ¹⁸F-RGD PET/CT imaging, we successfully visualized the residual lesions of GBM. A total of 25 and 23 ¹⁸F-RGD PET/CT scans at baseline and the third week were available for analysis. We found that ¹⁸F-RGD PET/CT parameters, both pre-treatment SUVmaxT1?P<0.05? and intra-treatment SUVmaxT2?P<0.05? and T/NTT2?P<0.05? were predictive of the treatment sensitivity of CCRT. Additionally, the change of volume from T1 to T2??VOLT1-2? on MRI was also predictive?P<0.05?. According to ROC curve analysis, the most significant parameter was SUVmaxT2?AUC=0.846?.The threshold of SUVmaxT2 was 1.35, and its sensitivity, specificity and accuracy were 84.6%, 90.0% and 87.0%, respectively. Conclusions ¹⁸F-RGD PET/CT allows for the noninvasive visualization of GBM lesions and the prediction of the sensitivity of CCRT as early as three weeks after treatment initiation.