CNSC-16. ASSOCIATION BETWEEN RESTING-STATE-NETWORK FUNCTIONAL CONNECTIVITY AND SURVIVAL IN RECURRENT GLIOMAS DIAGNOSED USING FET PET

Neuro-Oncology, vol. 26, pp. viii43–viii44

Abstract

Abstract BACKGROUND Functional connectivity between glioma-infiltrated brain tissue and remote cortical regions has been linked to overall survival (OS) in patients with newly diagnosed glioblastoma. We studied the association of functional connectivity between tumor and resting-state networks and OS in patients with recurrent gliomas. PATIENTS AND METHODS The study included 82 patients (26-81 years; median ECOG performance score, 0) with recurrent gliomas (grade 4 glioblastoma, n=57; grade 3 and 4 astrocytoma, n=12; grade 2 and 3 oligodendroglioma, n=13) who had undergone first-line therapy. Diagnosis of recurrence was confirmed by amino acid PET using the tracer O-(2-[18F]-fluoroethyl)-L-tyrosine (FET). FET PET and resting-state functional MRI were simultaneously acquired on a 3T hybrid PET/MR scanner. We performed a seed-based dual regression analysis to determine the functional connectivity between metabolically active tumors and seven canonical resting state networks. RESULTS Average functional connectivity was highest in oligodendrogliomas (z-score, 6.9±1.9) and was inversely related to the tumor grade (p=0.031). Univariate Cox regression analysis revealed a significant (p<0.05) positive association between OS and tumor connectivity with the visual, somatomotor, and dorsal attention networks. Subsequent stepwise multivariate Cox regression analysis refined this association to the dorsal attention network alone (HR, 0.88; 95% CI, 0.80-0.97; p=0.007). Patients with the highest functional connectivity (z-score>8.3, n=21) had a median OS of 31.4 months, while those with the lowest functional connectivity (z-score<4.3, n=21) had 10.6 months. Functional connectivity between tumors and the dorsal attention network showed an independent association with OS (HR, 0.90; 95% CI, 0.81-0.99; p=0.033) in a multivariate model, including various prognostic factors. CONCLUSION Recurrent gliomas exhibit significant functional connectivity to most of the major known resting-state networks, highest in oligodendrogliomas. The data suggest that high functional connectivity between the tumor and the dorsal attention network is an independent prognostic factor for improved OS.

Authors 17

1. Michel Friedrich

   Forschungszentrum Jülich

   Affiliation as printed

   Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Juelich , Juelich,

2. Jan‐Michael Werner

   University of Cologne · University Hospital Cologne

   Affiliation as printed

   Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne , and Duesseldorf,

   Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne , Cologne,

3. Jörg Steinbach

   Goethe University Frankfurt · University Hospital Frankfurt

   Affiliation as printed

   Department of Neuro-Oncology, University Hospital Frankfurt - Goethe-University , Frankfurt,

4. Michael Sabel

   Düsseldorf University Hospital · Heinrich Heine University Düsseldorf

   Affiliation as printed

   Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne , and Duesseldorf,

   Department of Neurosurgery, Heinrich Heine University Medical Faculty and University Hospital Düsseldorf , Düsseldorf,

5. Ulrich Herrlinger

   University Hospital Bonn

   Affiliation as printed

   Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne , and Duesseldorf,

   Department of Neurooncology, Center for Neurology, University Hospital Bonn , Bonn,

6. Marc Dieter Piroth

   Witten/Herdecke University · Helios Universitätsklinikum Wuppertal

   Affiliation as printed

   Department of Radiation Oncology, Helios University Hospital Wuppertal, Faculty of Health, Witten/Herdecke University , Wuppertal,

7. Gabriele Stoffels

   Forschungszentrum Jülich

   Affiliation as printed

   Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Juelich , Juelich,

8. Christian Filß Aachen Department of Nuclear Medicine

   Forschungszentrum Jülich · Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Nuclear Medicine, RWTH University Hospital Aachen, RWTH University Aachen , Aachen,

   Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Juelich , Juelich,

9. Philipp Lohmann Aachen Department of Nuclear Medicine

   Forschungszentrum Jülich · Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Nuclear Medicine, RWTH University Hospital Aachen, RWTH University Aachen , Aachen,

   Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Juelich , Juelich,

10. Nadim Jon Shah Aachen Department of Neurology

    Forschungszentrum Jülich · Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Department of Neurology, RWTH University Hospital Aachen, RWTH University Aachen , Aachen,

    Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Juelich , Juelich,

11. Maximilian Ingolf Ruge

    University of Cologne · University Hospital Cologne

    Affiliation as printed

    Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne , and Duesseldorf,

    Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital Cologne , Cologne,

12. Felix Manuel Mottaghy Aachen Department of Nuclear Medicine

    Maastricht University Medical Centre · Maastricht University · Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Department of Nuclear Medicine, RWTH University Hospital Aachen, RWTH University Aachen , Aachen,

    Department of Radiology and Nuclear Medicine, Maastricht University Medical Center , Maastricht, Netherlands

13. Roland Goldbrunner

    University of Cologne · University Hospital Cologne

    Affiliation as printed

    Center for Neurosurgery, Department of General Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne , Cologne,

    Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne , and Duesseldorf,

14. Karl‐Josef Langen Aachen Department of Nuclear Medicine

    Forschungszentrum Jülich · Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Department of Nuclear Medicine, RWTH University Hospital Aachen, RWTH University Aachen , Aachen,

    Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Juelich , Juelich,

15. Gereon R. Fink

    Forschungszentrum Jülich · University of Cologne · University Hospital Cologne

    Affiliation as printed

    Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne , Cologne,

    Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Juelich , Juelich,

16. Martin Köcher

    Forschungszentrum Jülich · University of Cologne · University Hospital Cologne

    Affiliation as printed

    Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital Cologne , Cologne,

    Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Juelich , Juelich,

17. Norbert Galldiks

    Forschungszentrum Jülich · University of Cologne · University Hospital Cologne

    Affiliation as printed

    Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne , Cologne,

    Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Juelich , Juelich,