Evidence map›Paper›PMID 40702228›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2026

Biological tumor volume predicts survival in recurrent High-Grade glioma: A multiparametric [

Dylan Henssen, Michael Rullmann, Anne I J Arens, Andreas Schildan, Stephan Striepe, Matti Schürer, Cordula Scherlach, Katja Jähne, Ruth Stassart, Osama Sabri and 2 more

Abstract read
In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Biologically Guided Gamma Knife Dose Painting for Recurrent High-Grade Gliomas: A Retrospective Study Using Functional MRI Techniques.Medical science monitor : international medical journal of experimental and clinical research · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Dylan HenssenDepartment of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany. dylan.henssen@medizin.uni-leipzig.de.ORCID 0000-0002-3915-3034
Michael RullmannDepartment of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
Anne I J ArensDepartment of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.
Andreas SchildanDepartment of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
Stephan StriepeDepartment of Radiation Oncology, University Hospital Leipzig, Leipzig, Germany.
Matti SchürerDepartment of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
Cordula ScherlachInstitute for Neuroradiology, University Hospital Leipzig, Leipzig, Germany.
Katja JähneDepartment of Neurosurgery, University Hospital Leipzig, Leipzig, Germany.
Ruth StassartInstitute of Neuropathology, University of Leipzig, Leipzig, Germany.
Osama SabriDepartment of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
Clemens Seidel *Department of Radiation Oncology, University Hospital Leipzig, Leipzig, Germany.
Swen Hesse *Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeSingle-session, multiparametric [¹⁸F]FET PET/MRI is used to detect tumor recurrence in high-grade glioma, but its prognostic value for overall survival remains uncertain. This study evaluated whether biological tumor volume, tumor-to-background ratio (TBRmax), cerebral blood volume (rCBVmax), and choline/NAA ratio (Cho/NAA) could predict survival in recurrent high-grade glioma. MATERIALS AND

methodsTwenty-six patients with histopathologically confirmed tumor progression underwent simultaneous [¹⁸F]FET PET/MRI. PET-derived biological tumor volume and TBRmax, MRI-derived rCBVmax, and Cho/NAA ratio were analyzed. A Cox proportional hazards model assessed associations with overall survival, adjusting for the number of lesions and treatment strategy.

resultsBiological tumor volume (hazard ratio = 2.22, 95%-CI: 1.035-4.762, p = 0.041) and the number of lesions (hazard ratio = 1.03, 95%-CI 1.00-1.06, p = 0.036) were significantly associated with survival. TBRmax (p = 0.089), rCBVmax (p = 0.088), and Cho/NAA ratio (p = 0.734) were not predictive. Treatment strategy after tumor recurrence diagnosis did not significantly impact overall-survival (HR = 0.208, p = 0.649). PET/MRI interaction terms did not enhance survival prediction.

conclusionBiological tumor volume is a significant prognostic imaging biomarker in recurrent high-grade glioma, emphasizing tumor burden over metabolic activity or perfusion of individual lesions. Volume-based PET metrics may offer better survival prediction than traditional PET or MRI parameters. Prospective multicenter studies are needed to validate these findings and explore automated segmentation and machine learning approaches for improved prognostication.

Indexed as

Brain NeoplasmsGliomaMagnetic Resonance ImagingMultimodal ImagingPositron-Emission TomographyTumor BurdenAdultAgedFemaleHumansMaleMiddle AgedNeoplasm GradingNeoplasm Recurrence, LocalPrognosis[¹⁸F]FET PET/MRIBiological tumor volumeHigh-grade gliomaOverall survivalTumor recurrence

Identifiers

PMID40702228
PMCPMC12830414

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.