Abstract

PURPOSE: With limited response rates and potential toxicity of chemotherapeutic treatment in patients with recurrent glioma, reliable response assessment is essential. Currently, the assessment of treatment response in glioma patients is based on the combination of radiologic and clinical findings. However, response monitoring with computed tomography (CT) or magnetic resonance imaging (MRI) is hampered by several pitfalls and is prone to interobserver variability. The aim of this study was to establish the value of thallium-201 single-photon emission computed tomography (201Tl-SPECT) as a predictor of overall survival and response to chemotherapy in recurrent glioma, and to compare the value of 201Tl-SPECT with that of CT and MRI.

PATIENTS AND METHODS: We studied patients who underwent CT or MRI and 201Tl-SPECT before chemotherapy (n = 57), and patients who also had undergone CT or MRI and 201Tl-SPECT after two courses of chemotherapy (n = 44). The value of the radiologic variables (CT-MRI tumor size, 201Tl-SPECT tumor size, and maximal tumor intensity) at baseline and at follow-up in predicting overall survival, and the percentage of patients alive and progression-free at 6 months (APF6) were examined using Cox regression and logistic regression analysis.

RESULTS: Both at baseline and at follow-up, 201Tl-SPECT maximal tumor intensity was the strongest predictive variable and was inversely related to overall survival and APF6. In particular, progression of maximal tumor intensity after two courses of chemotherapy was a powerful predictor of poor outcome.

CONCLUSION: 201Tl-SPECT is superior to conventional CT-MRI in the early prediction of overall survival and response to chemotherapy in patients with recurrent glioma.

Original languageEnglish
Pages (from-to)3559-65
Number of pages7
JournalJournal of Clinical Oncology
Volume21
Issue number19
DOIs
Publication statusPublished - 1 Oct 2003

Cite this

@article{1c127eeb18ac421790a43382e8851840,
title = "Thallium-201 single-photon emission computed tomography as an early predictor of outcome in recurrent glioma",
abstract = "PURPOSE: With limited response rates and potential toxicity of chemotherapeutic treatment in patients with recurrent glioma, reliable response assessment is essential. Currently, the assessment of treatment response in glioma patients is based on the combination of radiologic and clinical findings. However, response monitoring with computed tomography (CT) or magnetic resonance imaging (MRI) is hampered by several pitfalls and is prone to interobserver variability. The aim of this study was to establish the value of thallium-201 single-photon emission computed tomography (201Tl-SPECT) as a predictor of overall survival and response to chemotherapy in recurrent glioma, and to compare the value of 201Tl-SPECT with that of CT and MRI.PATIENTS AND METHODS: We studied patients who underwent CT or MRI and 201Tl-SPECT before chemotherapy (n = 57), and patients who also had undergone CT or MRI and 201Tl-SPECT after two courses of chemotherapy (n = 44). The value of the radiologic variables (CT-MRI tumor size, 201Tl-SPECT tumor size, and maximal tumor intensity) at baseline and at follow-up in predicting overall survival, and the percentage of patients alive and progression-free at 6 months (APF6) were examined using Cox regression and logistic regression analysis.RESULTS: Both at baseline and at follow-up, 201Tl-SPECT maximal tumor intensity was the strongest predictive variable and was inversely related to overall survival and APF6. In particular, progression of maximal tumor intensity after two courses of chemotherapy was a powerful predictor of poor outcome.CONCLUSION: 201Tl-SPECT is superior to conventional CT-MRI in the early prediction of overall survival and response to chemotherapy in patients with recurrent glioma.",
keywords = "Adult, Aged, Brain Neoplasms/diagnostic imaging, Female, Glioma/diagnostic imaging, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Recurrence, Local/diagnostic imaging, Predictive Value of Tests, Sensitivity and Specificity, Survival Analysis, Thallium Radioisotopes, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed, Treatment Outcome",
author = "Vos, {Maaike J} and Hoekstra, {Otto S} and Frederik Barkhof and Johannes Berkhof and Heimans, {Jan J} and {van Groeningen}, {Cees J} and Vandertop, {W Peter} and Slotman, {Ben J} and Postma, {Tjeerd J}",
year = "2003",
month = "10",
day = "1",
doi = "10.1200/JCO.2003.01.001",
language = "English",
volume = "21",
pages = "3559--65",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "19",

}

Thallium-201 single-photon emission computed tomography as an early predictor of outcome in recurrent glioma. / Vos, Maaike J; Hoekstra, Otto S; Barkhof, Frederik; Berkhof, Johannes; Heimans, Jan J; van Groeningen, Cees J; Vandertop, W Peter; Slotman, Ben J; Postma, Tjeerd J.

In: Journal of Clinical Oncology, Vol. 21, No. 19, 01.10.2003, p. 3559-65.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Thallium-201 single-photon emission computed tomography as an early predictor of outcome in recurrent glioma

AU - Vos, Maaike J

AU - Hoekstra, Otto S

AU - Barkhof, Frederik

AU - Berkhof, Johannes

AU - Heimans, Jan J

AU - van Groeningen, Cees J

AU - Vandertop, W Peter

AU - Slotman, Ben J

AU - Postma, Tjeerd J

PY - 2003/10/1

Y1 - 2003/10/1

N2 - PURPOSE: With limited response rates and potential toxicity of chemotherapeutic treatment in patients with recurrent glioma, reliable response assessment is essential. Currently, the assessment of treatment response in glioma patients is based on the combination of radiologic and clinical findings. However, response monitoring with computed tomography (CT) or magnetic resonance imaging (MRI) is hampered by several pitfalls and is prone to interobserver variability. The aim of this study was to establish the value of thallium-201 single-photon emission computed tomography (201Tl-SPECT) as a predictor of overall survival and response to chemotherapy in recurrent glioma, and to compare the value of 201Tl-SPECT with that of CT and MRI.PATIENTS AND METHODS: We studied patients who underwent CT or MRI and 201Tl-SPECT before chemotherapy (n = 57), and patients who also had undergone CT or MRI and 201Tl-SPECT after two courses of chemotherapy (n = 44). The value of the radiologic variables (CT-MRI tumor size, 201Tl-SPECT tumor size, and maximal tumor intensity) at baseline and at follow-up in predicting overall survival, and the percentage of patients alive and progression-free at 6 months (APF6) were examined using Cox regression and logistic regression analysis.RESULTS: Both at baseline and at follow-up, 201Tl-SPECT maximal tumor intensity was the strongest predictive variable and was inversely related to overall survival and APF6. In particular, progression of maximal tumor intensity after two courses of chemotherapy was a powerful predictor of poor outcome.CONCLUSION: 201Tl-SPECT is superior to conventional CT-MRI in the early prediction of overall survival and response to chemotherapy in patients with recurrent glioma.

AB - PURPOSE: With limited response rates and potential toxicity of chemotherapeutic treatment in patients with recurrent glioma, reliable response assessment is essential. Currently, the assessment of treatment response in glioma patients is based on the combination of radiologic and clinical findings. However, response monitoring with computed tomography (CT) or magnetic resonance imaging (MRI) is hampered by several pitfalls and is prone to interobserver variability. The aim of this study was to establish the value of thallium-201 single-photon emission computed tomography (201Tl-SPECT) as a predictor of overall survival and response to chemotherapy in recurrent glioma, and to compare the value of 201Tl-SPECT with that of CT and MRI.PATIENTS AND METHODS: We studied patients who underwent CT or MRI and 201Tl-SPECT before chemotherapy (n = 57), and patients who also had undergone CT or MRI and 201Tl-SPECT after two courses of chemotherapy (n = 44). The value of the radiologic variables (CT-MRI tumor size, 201Tl-SPECT tumor size, and maximal tumor intensity) at baseline and at follow-up in predicting overall survival, and the percentage of patients alive and progression-free at 6 months (APF6) were examined using Cox regression and logistic regression analysis.RESULTS: Both at baseline and at follow-up, 201Tl-SPECT maximal tumor intensity was the strongest predictive variable and was inversely related to overall survival and APF6. In particular, progression of maximal tumor intensity after two courses of chemotherapy was a powerful predictor of poor outcome.CONCLUSION: 201Tl-SPECT is superior to conventional CT-MRI in the early prediction of overall survival and response to chemotherapy in patients with recurrent glioma.

KW - Adult

KW - Aged

KW - Brain Neoplasms/diagnostic imaging

KW - Female

KW - Glioma/diagnostic imaging

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Neoplasm Recurrence, Local/diagnostic imaging

KW - Predictive Value of Tests

KW - Sensitivity and Specificity

KW - Survival Analysis

KW - Thallium Radioisotopes

KW - Tomography, Emission-Computed, Single-Photon

KW - Tomography, X-Ray Computed

KW - Treatment Outcome

U2 - 10.1200/JCO.2003.01.001

DO - 10.1200/JCO.2003.01.001

M3 - Article

VL - 21

SP - 3559

EP - 3565

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 19

ER -