Evidence map›Paper›PMID 42875659›Full record

ArticleJournal of neuro-oncology2026

Volumetric discordance between ¹⁸F-FET-PET/MRI and MRI-based radiotherapy target volumes in high-grade glioma: a prospective pilot study (FETSMaRT).

Amit Singnurkar, Arjun Sahgal, Eli Lechtman, Mary-Jane Lim-Fat, Simon J Graham, Nir Lipsman, Pejman Maralani, Gregory Pond, Jay S Detsky

Registry-linked trialAbstract read
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In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06499831 (18F-FET-PET/MRI Versus Standard MRI Alone for Stereotactic RadioTherapy Planning for High Grade Brain Gliomas), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT06499831 naunknown statusnot on this map

18F-FET-PET/MRI Versus Standard MRI Alone for Stereotactic RadioTherapy Planning for High Grade Brain Gliomas: A Pilot Study

TypeinterventionalSponsorSunnybrook Health Sciences CentreRan2021 to 2026Enrolled30ConditionsGlioma, MalignantArms0-(2-18F-Fluoroethyl)-L-Tyrosine
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Amit SingnurkarDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. amit.singnurkar@sunnybrook.ca.ORCID http://orcid.org/0000-0002-1731-9507
Arjun SahgalDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Eli LechtmanDepartment of Medical Imaging, North York General Hospital, Toronto, ON, Canada.
Mary-Jane Lim-FatDivision of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Simon J GrahamPhysical Sciences Platform, Sunnybrook Research Institute of Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Nir LipsmanDivision of Neurosurgery, Harquail Centre for Neuromodulation, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Pejman MaralaniDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Gregory PondDepartment of Oncology, McMaster University, Hamilton, ON, Canada.
Jay S DetskyDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHigh-grade gliomas carry a poor prognosis, and MRI-based radiotherapy (RT) planning may inadequately capture metabolically active tumor infiltration. ¹⁸F-fluoroethyl-tyrosine (FET) PET provides superior tumor delineation, yet prospective North American evidence supporting integration with RT planning remains limited.

methodsFETSMaRT enrolled 30 patients with WHO grade 3 or 4 high-grade glioma receiving post-operative RT. FET-PET/MRI was acquired before RT with the radiation oncologist blinded to PET, enabling retrospective quantification of discordance between MRI-based and FET-PET/MRI-derived gross tumor (GTV), clinical target (CTV), and planning target (PTV) volumes. In the glioblastoma subgroup (n = 23), Kaplan-Meier and Cox analyses related GTV and CTV discordance to time to progression.

resultsMedian age was 60 years; 77% had glioblastoma and 60% MGMT promoter methylation. GTV discordance occurred in 17/30 patients (56.7%) and CTV discordance in 15/30 (50.0%). FET-PET/MRI-derived volumes significantly exceeded MRI-based volumes for GTV (43.6 vs. 38.6 cc; p < 0.0001), CTV (119.2 vs. 110.8 cc; p = 0.0045), and PTV (171.1 vs. 159.6 cc; p = 0.0003). Larger GTV∆ and CTV∆ change values were associated with numerically shorter median time to progression, but neither association was statistically significant. Radiation treatment failures were predominantly central (60.0%).

conclusionFET-PET/MRI-derived target volumes were significantly larger than MRI-based volumes, confirming systematic underestimation of metabolically active tumor extent by anatomical MRI. While not meeting significance in this pilot study, directional CTV and GTV discordance suggests a possible association with progression; the hypothesis generating exploratory pilot data nonetheless justify a prospective trial of FET-PET-guided RT in high-grade glioma. NCT06499831.

Indexed as

Brain NeoplasmsGliomaMagnetic Resonance ImagingPositron-Emission TomographyTyrosineAdultAgedFemaleHumansMaleMiddle AgedMultimodal ImagingNeoplasm GradingPilot ProjectsPrognosisProspective Studies(18F)fluoroethyltyrosineRadiopharmaceuticalsTyrosine18F-FET-PETGlioblastomaHigh-grade gliomaRadiotherapy planning

Identifiers

PMID42875659

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Registered trials

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.