Zarębska Izabela, Blok Maciej, Marjański Michał, Harat Maciej
Department of Neurooncology and Radiosurgery, Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Poland.
Department of Radiotherapy, Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Poland.
Front Oncol. 2025 Aug 7;15:1604448. doi: 10.3389/fonc.2025.1604448. eCollection 2025.
Radiation treatment with modern techniques is frequently used in the complex interdisciplinary management of glioblastoma, both in primary and recurrent setting. However, standard imaging limits the ability to precisely distinguish treatment-related changes from tumor progression and to accurately assess the outcomes of radiotherapy. Given the challenges, there is growing need for advanced imaging modalities that can enhance diagnostic precision and guide therapeutic decision. One such modality is FET-PET, whose role in glioblastoma radiotherapy is increasingly recognized - from target definition to response assessment and differentiation between progression and post-irradiation changes. Recently, PET RANO criteria have been published, providing an optimal strategy for evaluating treatment response using amino-acid PET. Earlier, contributions from the PET/RANO group also supported the integration of PET imaging in radiotherapy planning and monitoring of glioma patients. Increasing evidence highlights the advantages of amino-acid PET over standard RANO MRI in predicting overall survival. However, its value in case of patient selection and monitoring of reirradiation is less clear. In this narrative review, we aimed to summarize the published data on FET-PET in patients after initial treatment from the perspective of radiation oncologist. We focused on the role of FET-PET in accurate diagnosis of recurrence and in treatment response after reirradiation.
现代技术的放射治疗常用于胶质母细胞瘤的复杂多学科管理,无论是在初始治疗还是复发治疗中。然而,标准成像限制了精确区分治疗相关变化与肿瘤进展以及准确评估放疗结果的能力。鉴于这些挑战,对能够提高诊断精度并指导治疗决策的先进成像模态的需求日益增长。一种这样的模态是FET-PET,其在胶质母细胞瘤放疗中的作用越来越受到认可——从靶区定义到反应评估以及区分进展与放疗后变化。最近,PET RANO标准已经发布,为使用氨基酸PET评估治疗反应提供了最佳策略。早些时候,PET/RANO小组的贡献也支持将PET成像整合到胶质瘤患者的放疗计划和监测中。越来越多的证据凸显了氨基酸PET在预测总生存期方面优于标准RANO MRI的优势。然而,其在患者选择和再程放疗监测方面的价值尚不清楚。在这篇叙述性综述中,我们旨在从放射肿瘤学家的角度总结关于初始治疗后患者FET-PET的已发表数据。我们重点关注FET-PET在准确诊断复发以及再程放疗后治疗反应中的作用。
Cochrane Database Syst Rev. 2015-9-29
Cochrane Database Syst Rev. 2015-1-9
Cochrane Database Syst Rev. 2014-11-13
Cochrane Database Syst Rev. 2021-5-4
Eur J Nucl Med Mol Imaging. 2024-5
Strahlenther Onkol. 2022-11