Association Of Neuro-Oncology Research Articles

P13.04 Practice patterns of diagnosis and management of leptomeningeal metastasis in Europe: results from a web-based survey

AbstractLeptomeningeal metastases are typically a late manifestation of systemic cancer affecting up to 10% of patients with solid tumors. Depending on the pattern of spread within the central nervous system, a broad variety of clinical symptoms and signs may occur, but cranial nerve palsies and multifocal deficits are particularly common. The incidence is highest in lung cancer, malignant melanoma and breast cancer. Survival is a only a few weeks without treatment, but is approximately 10% across the spectrum of patients. The diagnosis is typically triggered by clinical suspicion followed by neuroimaging and cerebrospinal fluid analysis. Management is often individualized and depends on primary tumor and pattern of metastasis, in particular concurrent systemic or solid brain metastases.Here we set out to characterize current practice patterns of diagnosing and treating leptomeningeal metastasis in Europe. To this end, we prepared a web-based survey including multiple choice questions on best practice supplemented by some case vignettes. This survey was sent to members of the European Association of Neuro-Oncology (EANO) and the Brain Tumor Group of the European Organisation for Research and Treatment of Cancer (EORTC) in April 2016.We will present the results of this survey and illustrate patterns of care by profession and country or region. Results from this survey shall inform on the design of future EANO recommendations for the diagnosis and management of leptomeningeal metastasis from solid tumors.

Does the duration of adjuvant temozolomide impact survival in glioblastoma patients? A retrospective analysis from an Italian registry (GLIOSTRY).

2047Background: The Stupp regimen for newly diagnosed glioblastoma (GBM) consists of radiotherapy with concomitant and adjuvant temozolomide (TMZ) up to 6 cycles. A number of Institutions prolong the duration of the adjuvant chemotherapy up to 12 or more cycles, but it is unknown whether the prolongation of the adjuvant phase favorably impacts the length of survival. The aim of this retrospective study was to investigate this issue in an homogeneous population of GBM patients (age 18-70 years), receiving the Stupp regimen and the nitrosourea fotemustine at first relapse. Methods: Patients were collected through a national registry (Gliostry), that was established by the Italian Association for Neuro-Oncology (AINO). The survival of 556 patients receiving up to 6 cycles of TMZ was compared with that of 365 patients receiving more than 6 cycles of TMZ. Results: Median PFS following the Stupp regimen was 8.4 months for the group TMZ ≤ 6 cycles and 14.3 months for the group TMZ ˃ 6 cycles (p < 0.001). The adv...

R03 - Prognostic factors in glioblastoma patients treated with the nitrosourea fotemustine at first relapse after the Stupp regimen: results from the GLIOSTRY (GLIOblastoma regiSTRY) of the AINO (Italian Association of Neuro-Oncology)

R03 - Prognostic factors in glioblastoma patients treated with the nitrosourea fotemustine at first relapse after the Stupp regimen: results from the GLIOSTRY (GLIOblastoma regiSTRY) of the AINO (Italian Association of Neuro-Oncology)

Predictors of survival and effect of short (40 Gy) or standard-course (60 Gy) irradiation plus concomitant temozolomide in elderly patients with glioblastoma: a multicenter retrospective study of AINO (Italian Association of Neuro-Oncology).

The efficacy of temozolomide (TMZ) plus radiation therapy (RT) in elderly patients with glioblastoma is unclear. We performed a large multicenter retrospective study to analyze prognostic factors and clinical outcome in these patients. Inclusion criteria were age ≥65 years, newly histologically confirmed glioblastoma, ECOG PS 0-2, adjuvant treatment with RT plus TMZ. We enrolled 237 patients; the average age was 71 and ECOG PS was 0-1 in 196 patients; gross total resection was performed in 174 cases. MGMT was analyzed in 151 persons and was methylated in 56 %. IDH1 was assessed in 100 patients and was mutated in 6 %. Seventy-one patients were treated with RT 40 Gy and 166 with RT 60 Gy. Progression-free survival and overall survival (OS) were 11.3 and 17.3 months, respectively. Overall survival was 19.4 vs 13.8 months for patients treated with RT 60 Gy and 40 Gy (p = 0.02); OS was 17.7 versus 16.1 months for patients treated with gross total resection vs partial surgery (p = 0.02); OS was 21.2 versus 13.6 months for methylated and unmethylated MGMT (p < 0.001). On multivariate analysis, gross total resection, RT 60 Gy, methylated MGMT and ECOG PS 0-1 were independent predictors of longer survival. Twenty-five patients (10 %) had grade 3-4 haematological toxicity during the concomitant treatment. We showed that, in elderly patients in good clinical condition treated with concomitant treatment, standard-course irradiation might be more effective than short-course irradiation. Methylated MGMT remains the most important prognostic factor.

2900 Predictors of survival in glioblastoma patients treated with fotemustine at first relapse after Stupp regimen: Analysis of GLIOSTRY (GLIOblastoma regiSTRY) of the AINO (Italian Association of Neuro-Oncology)

2900 Predictors of survival in glioblastoma patients treated with fotemustine at first relapse after Stupp regimen: Analysis of GLIOSTRY (GLIOblastoma regiSTRY) of the AINO (Italian Association of Neuro-Oncology)

Temozolomide (TMZ) and radiation therapy (RT) combination in elderly patients with glioblastoma: A multicenter retrospective study of AINO (Italian Association of Neuro-Oncology).

e13003 Background: the efficacy of TMZ plus RT in elderly patients (PTS) with glioblastoma (GBM) is unclear. We performed a multicenter retrospective study to analyze prognostic factors and clinica...

GLIOSTRY (GLIOblastoma regiSTRY) of the AINO (Italian Association of Neuro-Oncology): Analysis of factors influencing survival in glioblastoma patients receiving the nitrosourea fotemustine at first relapse following Stupp regimen.

2054 Background: patients with glioblastoma failing radiotherapy plus temozolomide are treated in Europe with nitrosourea-based regimens, but factors influencing survival are not entirely known.We ...

SP-04 * INTERNATIONAL PATTERNS OF PALLIATIVE CARE IN NEURO-ONCOLOGY: A PHYSICIAN SURVEY OF MEMBERS OF THE ASIAN SOCIETY OF NEURO-ONCOLOGY, THE EUROPEAN ASSOCIATION OF NEURO-ONCOLOGY AND THE SOCIETY FOR NEURO-ONCOLOGY

INTRODUCTION: Brain tumor patients have limited survival and suffer from high morbidity requiring specific symptom management. Specialized palliative care (PC) services have been developed to address these symptoms and provide end of life management for patients with such malignancies. Global utilization patterns of PC in neuro-oncology are unknown. METHODS: In a collaborative effort of the Society for Neuro-Oncology (SNO), the European Association of Neuro-Oncology (EANO) and the Asian Society of Neuro-Oncology (ASNO), a 22 question survey was distributed to members. An additional paper copy was distributed at the SNO meeting quality of life session (2012) and the ASNO meeting (2013). Only physician responses are included in this report. Nonparametric methods including Wilcoxon two sample and Kruskal-Wallis tests were used to assess differences in responses. Demographic information included academic degree, specialty, formal training in neuro-oncology and PC, practice patterns and geographic locations. RESULTS: 487 evaluable responses were received (Asia-Oceania (AO) 234, Europe 74, US 179). AO providers received more formal training in PC than European physicians (p = 0.0377). Provider in all 3 regions agreed on referring patients at the onset of symptoms requiring palliation, but responders from AO refer a larger total proportion of patients to PC than provider in Europe (p <0.001). US respondents were less likely to utilize PC at the point of disease onset than providers in AO (p = 0065). US provider felt more comfortable dealing with end of life issues than AO physicians (p <0.001), but more patients were referred to formal hospice care in the US than in Europe or AO (p <0.001). CONCLUSION: This is the first report describing global differences of PC utilization in neuro-oncology. Significant differences in provider training, culture, access and utilization were mainly found between AO and the US or AO and Europe. PC patterns are more similar in Europe and the US.

New Neuro-Oncology Practice Journal to Launch in 2014

We are excited to announce the launch of Neuro-Oncology Practice, a quarterly journal focused on the clinical aspects of neuro-oncology. Last year, Oxford Journals issued a supplement of Neuro-Oncology (Volume 14, Supplement 4, 2012) with articles dedicated solely to applied neuro-oncology. Topics ranged from palliative care and quality of life to molecular markers and ongoing developments in personalized medicine. The overwhelmingly positive response from our readership made clear the need for a journal devoted to clinical issues in neuro-oncology. Both the Society of Neuro-Oncology and Oxford University Press have collaborated on launching this new journal, due to launch in March 2014, as a complement to Neuro-Oncology. Neuro-Oncology Practice will retain the multi-national emphasis that was an integral part of the initial supplement so that we may continue to share and compare findings from different medical systems and societies. The editorial board will include prominent members of the Society for Neuro-Oncology, the European Association for Neuro-Oncology, and the Asian Society for Neuro-Oncology. The new journal aims to be a resource for practicing clinicians and healthcare specialists from a variety of disciplines, including physicians, nurses, physical and occupational therapists, neuropsychologists, and palliative care specialists, who have dedicated their careers to clinical patient care and who want to apply the latest treatment advances to their practice. Issues will focus on topics such as Applying new trial results to improve standards of patient care; Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies; and Raising awareness in the areas of symptom management, survivorship, neurocognitive function, end-of-life issues, and caregiving. The launch of this exciting new journal reflects the ongoing growth of the neuro-oncology field and the increasingly pressing need to address practical issues in patient care. We believe that Neuro-Oncology Practice will complement Neuro-Oncology's research focus and will serve as a valuable guide for the professionals dedicated to neuro-oncology patient care.

Ependymoma: current treatment options and a look to the future.

Riccardo Soffietti is Professor of Neurology/Neuro-Oncology at the University of Torino Medical School (Torino, Italy), and Head of the Department of Neuro-Oncology, University Hospital Città della Salute e della Scienza (Torino, Italy). His research focuses on neuro-oncology, neuropathology and neuroimaging. He is the author of over 300 publications. Dr Soffietti served as President of the Italian Association for Neuro-Oncology (AINO), is Chairman of the Research Group for Neuro-Oncology of the Italian Society of Neurology (SIN), Chairperson of the Panel of Neuro-Oncology of the European Federation on Neurological Societies (EFNS) and Chair of the Sub-Committee of Neuro-Oncology of the European Neurological Society (ENS). He is the President of the European Association of Neuro-Oncology (EANO) and a member of the Steering Committee of the Brain Tumor Group of the European Organisation for Research and Treatment of Cancer (EORTC). He received an award for Excellence in Clinical Research in 2009 from the Society for Neuro-Oncology.

Phase II trial of dose-dense temozolomide as initial treatment for progressive low-grade oligodendroglial tumors: A multicentric study of the Italian Association of Neuro-Oncology (AINO).

2037 Background: Standard temozolomide has been shown to be active in progressive low grade gliomas after surgery, whereas few data are available on the impact of dose dense regimens. Thus, we developed a phase II single arm multicenter study to evaluate the efficacy and toxicity of a regimen of dose dense temozolomide in progressive low grade oligodendroglial tumors. Methods: The inclusion criteria of the study were as follows: 1)biopsy-proven supratentorial WHO grade II oligodendroglioma and oligoastrocytoma; 2)progressive disease, clinically (epileptic seizures)or radiologically; 3)measurable disease on MRI (at least 1 cm); 4)age ≥18 years; 5)Karnofsky Performance Status ≥70. Temozolomide was administered at 150mg/m2 1 week on/1 week off up to a maximum of 18 cycles or unacceptable toxicity. The primary end-point was response rate (RR) according to RANO criteria, whereas secondary end-points were clinical benefit in terms of reduction of epileptic seizures ≥50%, progression-free survival (PFS), quality of life and toxicity. Results: From January 2005 until December 2010 60 patients (median age 39 and median KPS 80) have been accrued and are now evaluable for response. Response rates on T2/FLAIR images were as follows: CR 0/60, PR 21/60 (35%), MR 14/60 (23%), SD 21/60 (35%) and PD 4/60 (7%). The clinical benefit was significant in 29/34 patients (85%). As for toxicity 5/60 (8%) patients stopped treatment for lymphopenia grade IV, whereas 11/31 patients (35%) were switched to the standard regimen of temozolomide. PET with methionine was added to MRI in 17 patients: in 10/17 (59%) a disappearance or a significant reduction of uptake was observed, being the reduction of seizures better correlated with the response on PET rather than that on MRI. 1p/19q codeletion was not associated with either the response or the clinical benefit, whereas the analysis of MGMT methylation and IDH1 mutations are ongoing. Thirty-nine (65%) patients are still free of tumor progression. Conclusions: Dose-dense TMZ seems to be active, especially in terms of clinical benefit, but the myelotoxicity could be a concern.

8703 ORAL Bevacizumab and Fotemustine for Recurrent Glioblastoma – Final Results of a Multicenter Phase II Study of AINO (Italian Association of Neuro-Oncology)

8703 ORAL Bevacizumab and Fotemustine for Recurrent Glioblastoma – Final Results of a Multicenter Phase II Study of AINO (Italian Association of Neuro-Oncology)

New impact factor number reflects sustained and enhanced growth

Neuro-Oncology is delighted to announce that our 2010 Impact Factor, a metric used to assess journal quality, is 5.483, a substantial increase from the previous year's Impact Factor (4.984). The 2010 number reflects the citation rate for the years 2008 and 2009. Of note, the journal increased its publication frequency from quarterly to bimonthly in 2008, so we are very pleased that our rapid growth was accompanied by sustained quality. Next year's Impact Factor will begin to reflect our increase to a monthly publication schedule in 2010. We are also now ranked 15th of 185 clinical neurology journals (top 8%) and 24th of 184 oncology journals (top 13%); both rankings are higher than last year's rankings (see table). Year Impact Factor Rank Oncology Clinical neurology 2010 5.483 24 of 184 15 of 185 2009 4.984 26 of 165 17 of 167 2008 5.000 25 of 141 15 of 156 2007 5.806 16 of 132 6 of 146 View it in a separate window The Impact Factor, published annually by Thomson Scientific in the Journal Citation Reports, is calculated by dividing the number of articles published in the previous two years into the number of citations of those articles in the current year (i.e., the 2010 number was determined by dividing the number of 2010 citations of articles published in 2008 and 2009 by the total number of articles published in 2008 and 2009). We believe that our new Impact Factor reflects our commitment to sustained and enhanced growth while maintaining a high quality standard. During the past year, Neuro-Oncology has experienced a few changes, such as the appointment of a new managing and assistant managing editor and the development of a mobile version of our website. We are also pleased to report that members of the European Association of Neuro-Oncology began receiving the journal as part of their membership benefits this year, increasing our circulation. Beginning with volume 14 (January 2012), we will enhance the journal further by requiring structured abstracts for all submitted articles.We believe that this change will make writing and reviewing easier for our contributors. More information about structured abstracts is available from the National Library of Medicine at http://www.nlm.nih.gov/bsd/policy/structured_abstracts.html. We thank all of you for your contributions as authors, reviewers, editors, or readers during the past year, and we hope you will continue to ensure that Neuro-Oncology remains the top journal in its field.

Phase II trial of bevacizumab with fotemustine in recurrent glioblastoma: Final results of a multicenter study of AINO (Italian Association of Neuro-oncology).

2027 Background: Bevacizumab has shown activity in recurrent glioblastoma (GBM), and few data are available on the combination of bevacizumab and nitrosoureas, that represent the standard cytotoxic option. Fotemustine (FTM) is a nitrosourea with elevated lipophilic properties. Methods: In this phase II study patients with GBM recurrent after surgery, radiation therapy, and concomitant/adjuvant temozolomide were elegible. The treatment consisted of an induction phase with BV at 10 mg/kg intravenously on day 1 and 15 and fotemustine (FTM) at 75mg/m2intravenously on day 1 and 8, followed after 3 week interval by a maintenance phase with BV at 10 mg/kg i.v. and FTM 75mg/ m2 every 3 weeks until tumor progression or unacceptable toxicity. Patients had undergone clinical and MRI assessment 1 month after the start of treatment and thereafter every 2 months. The primary endpoint was progression-free survival at 6 months (PFS6), whereas secondary endpoints were response rate (RR), based on RANO criteria, progression-free (PFS) and overall survival (OS), and safety. Results: From April 2008 until November 2010, 54 patients (males 35, females 19, median age 57) were enrolled. PFS6, PFS12 and mPFS were 44%, 21% and 5.29 months respectively. mOS was 9.13 months with 77.4% and 31% of patients surviving at 6 and 12 months respectively. Response rates were as follows: 2CR (4%), 24 PR (44%), 22 SD (41%) and 6 PD (11%). A significant neurological improvement was observed in 57 % of patients, being steroids reduced or interrupted in 64%. 44/54 (81%) patients have progressed and patterns of progression were local in 29/44 (66%), multicentric 10/44 (23%), gliomatosis 3/44 (6%) and isolated leptomeningeal spread 2/44 (5%). 12/54 (22%) patients with grade 3/4 piastrinopenia/leukopenia discontinued fotemustine, whereas 4/54 (7.4%)discontinued bevacizumab (1 stroke, 1 intratumoral haemorrhage, 1 GI perforation and 1 pulmonary embolism). Conclusions: Combination of bevacizumab and fotemustine in glioblastomas recurrent after standard radiotherapy + temozolomide is safe and promising. The analysis of MGMT methylation status is ongoing.

Abstracts for the Eighth Congress of the European Association for Neuro-Oncology (EANO)

Abstracts for the Eighth Congress of the European Association for Neuro-Oncology (EANO)

Value of Meetings Is Far from Abstract

It’s that time of year again—if you aren’t at a meeting, you are preparing to go to a meeting or submitting an abstract for a meeting or reading about all the meetings you will miss. Naturally, most of us have to pick and choose where to spend our travel budgets and how best to leverage our time away from our practices and laboratories. Meetings are vital for keeping up-to-date with the rapid advances in the practice of neuro-oncology and the scientific breakthroughs that engender those advances. On a practical level, nothing can replace the face-to-face contact that comes from attending professional conferences and seminars, and many successful collaborations have originated in the chance (or not so chance) conversations that occurred at a reception or outside the meeting room after a particularly lively Q&A during a scientific session. As editors, we take the opportunity of a good conference to hear what you are working on and seeing in your research, the problems you face as clinicians— in short, the questions you are trying to answer and the questions you need answered to guide your work. But because you cannot be at every meeting, we feel it is important for Neuro-Oncology to give you the opportunity to at least get a feel for the “meeting space” by showcasing the abstracts of the oral presentations and posters from some key venues. For instance, the International Symposium on Pediatric Neuro-Oncology, now in its thirteenth iteration, has worked with this journal many times in the past to facilitate publication of its meeting abstracts. This year’s offerings begin on page 369 and faithfully reflect the full spectrum of the symposium’s technical and scientific program (a program that is unique in its ability to include first-hand accounts of patients’ and families’ experiences of pediatric CNS cancers). Later this year, we will publish abstracts from the Eighth Congress of the European Association of Neuro-Oncology (EANO), which is being held in Barcelona. EANO is, of course, one of our sponsoring societies and so has premier access to our pages. Likewise, this fall you will receive an issue that contains all the meeting abstracts for SNO 2008, which is being held in Las Vegas, Nevada, in November. This year’s meeting is anticipated to be bigger and better than ever, with updated presentation categories (to reflect the evolving science) and a new feature: Select Poster Review sessions, which will feature the top-rated posters for attendee review and related discussion by an invited speaker. We still hope to bump into you at a meeting, but if you cannot make it, we hope that giving you access to the abstracts will still help you gain some of the advantages of attending by keeping you up-to-date on the cutting-edge work that hasn’t quite reached the manuscript stage and that otherwise might not make it into our pages at all.

Changes Continue to Enhance Journal

At the last full meeting of the Neuro-Oncology Editorial Board (during the SNO Annual Meeting in Orlando, Florida, last November), the editors in chief proposed a revised editorial structure for Neuro-Oncology, which would allow regional executive editors for the journal to be chosen by the sponsoring organizations (SNO, the European Association for Neuro-Oncology [EANO], and the Japan Society for Neuro-Oncology [JSNO]). This change in editorial leadership was conceived as a means of ensuring that the journal achieves its sponsors’ long-term goal: to enhance the quality of information Neuro-Oncology provides to the international community of professionals it serves. The proposal was approved, the EANO and JSNO boards have concurred, and the changes are being implemented now—all to promote a more integrated form of journal governance and decision making. Accordingly, I am happy to welcome onboard three executive editors for the journal, one representing each organization named above. Effective July 1, 2007, C. David James, who has ably served as co-editor in chief for the journal since its transition from Dr. Darell Bigner and his team at Duke, has assumed his new position as executive editor, SNO. Michael Weller, a longtime editorial board member and reviewer, has joined the revamped editorial team as executive editor, EANO. And Ryo Nishikawa, formerly senior editor for Asia, has been named executive editor, JSNO. While it has long been my pleasure to work with these gentlemen on the journal, I look forward to having even greater access to their expertise and experience going forward.

Treatment of gliomatosis cerebri with temozolomide: A retrospective study of the AINO (Italian Association for Neuro- Oncology)

2033 Background: The optimal management for patients with primary gliomatosis cerebri is unknown, and some recent studies suggest that temozolomide could be useful as an upfront treatment. Methods: Between 1999 and 2005, 46 patients with biopsy proven gliomatosis cerebri were treated with temozolomide either upfront or at progression after prior radiotherapy/chemotherapy. Histological diagnoses were as follows: glioblastoma in 3 patients, malignant glioma in 8, anaplastic astrocytoma in 8, gemistocytic astrocytoma in 2, astrocytoma in 13, anaplastic oligodendroglioma in 1, anaplastic oligoastrocytoma in 1, oligoastrocytoma in 1, oligodendroglioma in 4, glial proliferation consistent with GC in 5. Median age was 49 years (range 14–70), with 20 males and 26 females and a median KPS at diagnosis of 80 (range 50–90). Twenty-three out of 46 (50%) pre-treatment MRI demonstrated some degree of contrast enhancement. Twenty-three of 46 patients were treated upfront, while 23 had received prior radiation therapy or nitrosourea-based chemotherapy. All patients received temozolomide 200 mg/m2 die for 5 days every 4 weeks until progression or unacceptable toxicity. Response was evaluated, according to Macdonald criteria, on T1-weighted with Gadolinium and FLAIR images. Results: Two patients (4%) showed a CR of the contrast enhancing area, 2 patients (4%) a PR, 5 (11%) a minor response, 18 (39%) a SD and 19 (42%) a PD. Overall response rate (CR + PR + “minor response”) was 19%, while a clinical benefit was observed in 13/46 patients (28%). Median TTP was 9 months (range 1–27), and median survival 14 months (range 3–123). PFS at 6 months was 57%, at 12 months 35%. Oligodendroglial tumours showed a 38% response rate and a TTP of 11 months. Response rate was higher among patients treated at progression compared to those treated upfront (13% versus 26%). Grade III-IV haematological toxicity was mild. Conclusions: Temozolomide has some activity in primary GC (19% response rate), and is well tolerated. A significant neurological improvement can be observed in patients with either response or stable disease on MRI. To improve the efficacy of temozolomide in the upfront setting (in order to delay a large field RT), a phase II study with a dose-dense regimen is ongoing. No significant financial relationships to disclose.

Abstracts from the Seventh Congress of the European Association for Neuro-Oncology

BACKGROUND: Conventional interpretation of methionine PET (Met-PET) scans in suspected brain tumors uses the ratio of the tracer uptake within the lesion to the corresponding contralateral area. The precise location at which the region of interest used to calculate the reference value is placed is vital, because local variations in methionine uptake may significantly alter the calculated ratio. Identifying a precise mirror region is complicated by the distorting effect of the tumor and the need for manual realignment of the image. METHOD: Patients with low-grade primary brain tumors or benignlesions were identified on the basis of a tissue diagnosis or surveillance neuroimaging that excluded a high-grade tumor. These conditions were selected because they primarily involve a single hemisphere, with methionine uptake in the unaffected hemisphere being essentially normal. A total of 180 Met-PET scans performed during 2003 – 2005 were identified from the database at the Max Planck Institute for Neurological Research, coded, and anonymized for analysis. Scans demonstrating midline lesions, significant mass effect, or evidence of substantial previous surgery were then excluded. A methionine template was prepared using data from patients who had undergone both FDG and Met-PET scans within eight weeks, with normalization to a previously developed FDG template. Methionine scans were coregistered to the template, after masking of any tumor, and the diseased hemispheres stripped. Mean uptake maps for each hemisphere were calculated on a voxel-by-voxel basis and merged to create the normal methionine uptake map. Scans unsuitable for inclusion into the normal map were reanalyzed using the contralateral hemisphere and the normal uptake map for reference values, allowing the methods to be compared. RESULTS: Good correlation was found between uptake ratios using reference values calculated by both methods. Reference values could be reliably calculated in tumors that were previously problematic to analyze, such as those that cross the midline. Coregistration of the normal map was impaired in some cases by loss of the normal architecture, but valid reference values were obtained despite this. CONCLUSION: Use of a normal uptake may facilitate calculation of PET uptake ratios in brain tumors. Further research is required to evaluate the correlation with histological findings and the accuracy of image coregistration in the presence of distorting tumors.

Seventh Congress of the Italian Association of Neuro-Oncology (AINO)&lt;subtitle&gt;October 29–31, 2001 Turin, Italy&lt;/subtitle&gt;

Seventh Congress of the Italian Association of Neuro-Oncology (AINO)&lt;subtitle&gt;October 29–31, 2001 Turin, Italy&lt;/subtitle&gt;