Survival outcomes with a multi-modal imaging approach to tumor resection in WHO grade III or IV astrocytic glioma


  • Extent of resection per a combined [18F]-fluoro-ethyl-L-tyrosine positron emission tomography (FET-PET) and magnetic resonance imaging (MRI) approach correlated with improved overall survival in patients with WHO grade III or IV astrocytic glioma. Multi-modal pre-operative imaging could help to improve extent of gross total resection (GTR) during surgery and improve survival outcomes.

Why this matters

  • Surgical resection is the mainstay of treating WHO grade III or IV gliomas and able to extend both overall and progression-free survival. While complete GTR is impractical given the infiltrative nature of glioma, growing evidence suggests that resection of contrast-enhancing (CE) tumor in early post-operative MRI improves overall survival.

  • FET-PET can delineate the biological tumor volume and highlight active regions of the tumor, thereby providing additional information to CE MRI to improve assessment of GTR.

  • A multi-modal approach using CE MRI and FET-PET to examine GTR in grade III and IV glioma could help to improve survival outcomes.