18-kDa转运蛋白（TSPO）作为一种相关的靶点在胶质母细胞瘤成像中的认可度日益增加。然而，关于TSPO PET成像在胶质母细胞瘤潜在预后价值的数据尚缺乏。因此，我们研究了TSPO PET成像结果与胶质母细胞瘤患者存活预后的关联。方法：纳入了新诊断、组织学确认为异柠檬酸脱氢酶（IDH）野生型胶质母细胞瘤患者，这些患者在常规分次放疗联合替莫唑胺或分次放疗之前进行了TSPO PET检查。与患者存活相关的指标包括TSPO PET的SUVmax，TSPO结合亲和力状态，MRI上的肿瘤体积，以及其他临床数据，如O^6-烷基鸟嘌呤DNA甲基转移酶（MGMT）和端粒酶逆转录酶（TERT）基因启动子突变状态。结果：纳入了45例患者（中位年龄为63.3岁）。SUVmax的中位数为2.2（范围为1.0-4.7）。TSPO PET信号与存活相关：高吸收强度（SUVmax > 2.2）与明显较短的总体生存期相关（8.3 vs. 17.8个月，P = 0.037）。除了SUVmax外，影响总体生存期的预后因素还包括年龄（P = 0.046），MGMT启动子甲基化状态（P = 0.032）和T2加权MRI体积（P = 0.031）。在多变量生存分析中，TSPO PET的SUVmax仍然是总体生存期的独立预后因素（P = 0.023），高TSPO PET信号（SUVmax > 2.2）的死亡风险比为2.212（95%可信区间，1.115-4.386）。结论：放疗前高TSPO PET信号与新诊断IDH野生型胶质母细胞瘤患者的明显较短存活期相关。TSPO PET似乎能够提供超越已建立的临床参数的预后信息，并可能作为一种信息工具，帮助临床医生对胶质母细胞瘤患者进行生存预测。 © 2023 by the Society of Nuclear Medicine and Molecular Imaging.

The 18-kDa translocator protein (TSPO) is gaining recognition as a relevant target in glioblastoma imaging. However, data on the potential prognostic value of TSPO PET imaging in glioblastoma are lacking. Therefore, we investigated the association of TSPO PET imaging results with survival outcome in a homogeneous cohort of glioblastoma patients. Methods: Patients were included who had newly diagnosed, histologically confirmed isocitrate dehydrogenase (IDH)-wild-type glioblastoma with available TSPO PET before either normofractionated radiotherapy combined with temozolomide or hypofractionated radiotherapy. SUVmax on TSPO PET, TSPO binding affinity status, tumor volumes on MRI, and further clinical data, such as O 6-alkylguanine DNA methyltransferase (MGMT) and telomerase reverse transcriptase (TERT) gene promoter mutation status, were correlated with patient survival. Results: Forty-five patients (median age, 63.3 y) were included. Median SUVmax was 2.2 (range, 1.0-4.7). A TSPO PET signal was associated with survival: High uptake intensity (SUVmax > 2.2) was related to significantly shorter overall survival (OS; 8.3 vs. 17.8 mo, P = 0.037). Besides SUVmax, prognostic factors for OS were age (P = 0.046), MGMT promoter methylation status (P = 0.032), and T2-weighted MRI volume (P = 0.031). In the multivariate survival analysis, SUVmax in TSPO PET remained an independent prognostic factor for OS (P = 0.023), with a hazard ratio of 2.212 (95% CI, 1.115-4.386) for death in cases with a high TSPO PET signal (SUVmax > 2.2). Conclusion: A high TSPO PET signal before radiotherapy is associated with significantly shorter survival in patients with newly diagnosed IDH-wild-type glioblastoma. TSPO PET seems to add prognostic insights beyond established clinical parameters and might serve as an informative tool as clinicians make survival predictions for patients with glioblastoma.© 2023 by the Society of Nuclear Medicine and Molecular Imaging.