Using FET-PET and MRI Fusion for Surgery and Radiotherapy in Adults with Glioblastoma Multiforme

What this Trial Is About

Glioblastoma multiforme GBM WHO IV is an aggressive primary brain tumor affecting mostly adults in their productive years, with a poor prognosis and median survival of 12-16 months. The standard treatment includes maximal safe surgical removal followed by radiotherapy and chemotherapy according to the Stupp protocol. However, conventional MRI lacks the sensitivity to define true tumor boundaries, leading to frequent local tumor recurrence driven by infiltrating glioblastoma stem cells. This trial investigates using fused 18F-fluoroethyl-L-tyrosine 18F-FET PET and contrast-enhanced MRI to better guide surgery and radiotherapy in glioblastoma treatment. Participants will be randomly assigned to one of three groups surgery and radiotherapy planned using fused FET-PET and MRI surgery planned using MRI only with radiotherapy planned using fused FET-PET and MRI or surgery and radiotherapy planned using MRI alone. The fused imaging aims to more precisely define tumor margins for removal and targeting, potentially reducing residual tumor cells. Surgery will be carefully stopped based on PET tumor margin or neurological monitoring. Radiotherapy planning also incorporates these imaging findings. Throughout the study, participants will undergo evaluations including MRI and PET imaging before radiotherapy, quality of life assessments at several time points, and monitoring of tumor volume and recurrence patterns. The main outcomes measured are progression-free and overall survival up to 36 months post-surgery. Additional assessments include tumor volume comparison between imaging methods, long-term survival, recurrence location, and quality of life related to tumor progression. This comprehensive monitoring aims to evaluate whether fused imaging improves treatment precision and patient outcomes.

Application of FET-PET in Fusion With MRI in the Treatment of Glioblastoma Multiforme [TYR-GLIO]