Glioblastoma is the most common primary malignant neoplasm of the adult brain. Even after multimodal therapy, outcomes remain poor, with a median survival of one year. Although advanced imaging methods have been suggested as molecular markers of prognosis and therapeutic response, these methods have not been validated for clinical use. In this exploratory, imaging-based, trial, thirty patients with a pathological diagnosis of glioblastoma will be followed prospectively for two years. The study examines how PET and MR imaging signals change following administration of a standard radio-chemotherapy treatment regimen to determine whether these imaging modalities can provide early indicators of response to therapeutic intervention. The investigators hypothesize that decreases in uptake of an investigational 18F-FLT PET tracer following treatment with radiation and chemotherapy will be a reliable predictor of glioblastoma response. In a more exploratory fashion, the investigators also will identify changes in diffusion and hypoxia MR imaging that may also correlate well with treatment response.
Patients with glioblastoma will be imaged with FLT PET/CT followed by MRI. The FLT uptake will be correlated with advanced MRI markers of tumor progression to determine the ability of using FLT PET and MRI for predicting response to treatment.
Study Type
OBSERVATIONAL
Enrollment
5
Washington University School of Medicine/Barnes-Jewish Hospital
St Louis, Missouri, United States
Change in FLT uptake, measured by SUV tumor/SUV normal contralateral white matter
Determines the change in FLT uptake as a result of chemotherapy/radiation therapy
Time frame: Before and after chemotherapy/radiation therapy
Survival
Number of months from date of diagnosis to date of death.
Time frame: 2 years
Ki-67
Ki-67 proliferation index on tumor specimens obtained at biopsy or from surgical resection specimen
Time frame: At diagnosis
Radiographic progression defined by MacDonald criteria
MacDonald criteria to be used to determine whether tumor progress or not during the course of this study
Time frame: 2 years
O(6)-methylguanine DNA-methyltransferase (MGMT) activity
MGMT activity from tumor specimens
Time frame: prior to treatment
Time to progression
Months after completing radiation treatment to first instance of radiographic progression
Time frame: 2 years
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