Sponsored by
In a recent prospective pilot study, published in the Journal of Neuro-Oncology, researchers compared MRI-based and FET-PET/MRI-based radiation target volumes in 30 patients with newly diagnosed high-grade gliomas. Contrast-enhanced MRI highlights areas where the blood-brain barrier is disrupted, while FET-PET uses a radioactive amino acid tracer to identify areas of increased amino acid transport associated with glioma, potentially revealing tumor beyond the areas of contrast enhancement. FET-PET/MRI identified significantly larger target volumes, with discrepancies between the radiation approaches in more than half of patients. The findings suggest that FET-PET may help refine radiation target planning, but whether this improves outcomes remains uncertain. In another randomized trial in Europe (the GLIAA trial), published earlier this year in The Lancet Oncology, FET-PET-guided re-irradiation did not significantly improve progression-free or overall survival compared with contrast-enhanced MRI-guided re-irradiation in patients with recurrent glioblastoma. These findings highlight the urgent need for more research to determine which patients and treatment settings may benefit from FET-PET-guided planning.