Metabolic Response Of Glial Tumors After Gamma Knife Radiosurgery Assessed By Positron Emission Tomography.

Keywords: gamma knife, positron emission tomography, Imaging, glioblastoma multiforme, brain tumor

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     The role of Gamma Knife radiosurgery (GKR) in the therapeutic management of gliomas remains controversial. Tumor metabolism assessed by PET-scan has been correlated with prognosis for benign and malignant gliomas.
     We evaluate modification in PET-related metabolism of gliomas following GKR.
     A series of 80 patients treated by GKR in our center for cerebral glioma was analyzed. This group included 22 patients with a low-grade glioma (LGG) and 58 patients with a high-grade glioma (HGG). For all patients, a PET was performed the day of treatment and included in the dosimetric planning. For some patients, one or multiple PET examinations were performed during the follow-up.
     Changes in the tumor metabolism assessed by PET were analyzed and related to dosimetric parameters, WHO grade, and delay from irradiation.
     For patients with available data from one or several PET performed during the follow-up course, we evaluate changes in tumor metabolism by comparison of the different follow-up PET with the initial PET imaging for each patient, blinded of clinical evolution and MRI course. A significant decrease in tumor metabolism within the first year after GKR was found for some patients. PET performed more than 1 year after GKR showed persistence of reduction in tumor metabolism for some patients.
     This is a retrospective study.
     GKR can sometimes significantly reduce tumor metabolism of LGG and HGG.
     This metabolic decrease can be maintained in the long term for some patients.


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