Use of C-11-methionine PET parametric response map for monitoring WT1 immunotherapy response in recurrent malignant glioma Clinical article

作者：Chiba Yasuyoshi; Kinoshita Manabu^*; Okita Yoshiko; Tsuboi Akihito; Isohashi Kayako; Kagawa Naoki; Fujimoto Yasunori; Oji Yusuke; Oka Yoshihiro; Shimosegawa Eku; Morita Satoshi; Hatazawa Jun; Sugiyama Haruo; Hashimoto Naoya; Yoshimine Toshiki

来源：Journal of Neurosurgery, 2012, 116(4): 835-842.

DOI：10.3171/2011.12.JNS111255

• glioma
• C-11-methionine PET
• WT1 immunotherapy
• parametric response map
• oncology

Object. Immunotherapy targeting the Wilms tumor 1 (WT1) gene product is a promising treatment modality for patients with malignant gliomas, and there have been reports of encouraging results. It has become clear, however, that Gd-enhanced MR imaging does not reflect prognosis, thereby necessitating a more robust imaging evaluation system for monitoring response to WT1 immunotherapy. To meet this demand, the authors performed a voxel-wise parametric response map (PRM) analysis of C-11-methionine PET (MET-PET) in WT1 immunotherapy and compared the data with the overall survival after initiation of WT1 immunotherapy (OSWT1). %26lt;br%26gt;Methods. Fourteen patients with recurrent malignant glioma were included in the study, and OSWT1 was compared with: 1) volume and length change in the contrast area of the tumor on Gd-enhanced MR images; 2) change in maximum uptake of C-11-methionine; and 3) a more detailed voxel-wise PRM analysis of MET-PET pre- and post-WT1 immunotherapy. %26lt;br%26gt;Results. The PRM analysis was able to identify the following 3 areas within the tumor core: I) area with no change in C-11-methionine uptake pre- and posttreatment; 2) area with increased C-11-methionine uptake posttreatment (PRM+MET); and 3) area with decreased C-11-methionine uptake posttreatment. While the results of Gd-enhanced MR imaging volumetric and conventional MET-PET analysis did not correlate with OSWT1 (p = 0.270 for Gd-enhanced MR imaging length, p = 0.960 for Gd-enhanced MR imaging volume, and p = 0.110 for MET-PET), the percentage of PRM+MET area showed excellent correlation (p = 0.008) with OSWT1. %26lt;br%26gt;Conclusions. This study describes the limited value of Gd-enhanced MR imaging and highlights the potential of voxel-wise PRM analysis of MET-PET for monitoring treatment response in immunotherapy for malignant gliomas. Clinical trial registration no.: UMIN000002001. (http://thejns.org/doi/abs/10.3171/2011.12.JNS111255)

• 出版日期2012-4