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Prognostic
and therapeutic indicator of fluoroboronophenylalanine positron emission
tomography in patients with gliomas
Takahashi Y, Imahori Y,
Mineura K
Department
of Neurosurgery, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji,
Kyoto, Japan.
Purpose.
Boron neutron capture therapy (BNCT) for the treatment of brain tumors has
attracted attention recently, and its clinical application has been
progressing.
We have focused on the use of BNCT with (10)B-boronophenylalanine, which
preferentially delivers boron-10 atoms to malignant cells through the amino acid
transport system.
In the present study, we evaluated the long-term outcomes of treatments using
(18)F-(10)B-fluoroboronophenylalanine (FBPA), which is an analogue of
(10)B-boronophenylalanine, by investigating the prognostic significance of the
metabolic values and ratios of FBPA as determined by positron emission
tomography (PET) in patients with gliomas.
Experimental
Design. Our subjects were 22 patients who underwent an FBPA-PET study and were followed
for at least 4 months thereafter.
PET parameters, such as the rate constants K1, k2, k3, and k4, were measured
before treatment.
Data regarding the tumors, the contralateral normal region, and the uptake ratio
of FBPA between the tumor and normal tissue 40 min after injection of the tracer
were compared with survival rates after the PET treatment.
The survival time and the prognostic factors were tested using a Kaplan-Meier
survival curve and Cox regression analysis, respectively.
Results.
Among the clinical parameters, the histological grade of a tumor influences
survival significantly.
When the survival of patients with PET parameters or ratios above the median was
compared with that of patients with parameters or ratios below the median, the
most significant PET parameter was the K1 value of the tumor.
Median survival in patients with a tumor K1 value of 0.033 ml/min (median value)
or higher was 11 months, which was significantly shorter than the 77 months in
patients with a K1 value below the median (P = 0.0006 by generalized Wilcoxon
test).
Conclusions.
The kinetic constants of FBPA metabolism as determined by PET can be of
ancillary significance in predicting the prognosis and indicating the
feasibility of BNCT in patients with gliomas.
The mean survival time was significantly shorter in patients with high uptakes
of FBPA.
A contributing factor is the K1 value, which reflects amino acid transport
activity.
FBPA-PET images can allow clinicians to develop treatment plans that are better
tailored to the clinical features of their patients.
PMID: 14676111 [PubMed - in process]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14676111&dopt=Abstract
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