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Individual patient risk stratification for better treatment planning is needed; however, standard prognostic models rely on clinical and histologic parameters as well as MRI, which may not fully reflect the tumor\u2019s biological behavior. Positron emission tomography (PET) imaging of the 18\u00a0kDa translocator protein (TSPO) is known as surrogate marker of activated microglia and macrophages and enables non-invasive assessment of the tumor microenvironment and peri-\/intratumoral inflammation as well as TSPO-positive tumor cells. The aim of this study was to investigate TSPO-PET imaging in IDH-mutant glioma and its association with outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this monocentric, retrospective study, 46 patients with newly diagnosed IDH-mutant glioma who had undergone TSPO-PET imaging with [\u00b9\u2078F]GE180 prior to any therapeutic intervention were included. Quantitative PET parameters including mean and maximum standardized uptake values (SUV\n                      <jats:sub>max<\/jats:sub>\n                      , SUV\n                      <jats:sub>mean<\/jats:sub>\n                      ) and the respective PET-positive tumor volumes were evaluated for their association with clinical data and time to next intervention (TTNI), and overall survival (OS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort consisted of 27 patients (58.7%) with astrocytoma, IDH-mutant (median age 36 years (30\u201351)) and 19 patients (41.3%) with oligodendroglioma, IDH-mutant and 1p\/19q-codeleted (median age 41 years (36\u201348)). High SUV\n                      <jats:sub>max<\/jats:sub>\n                      on TSPO-PET imaging was associated with shorter TTNI, and OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0118 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0459, respectively). In multivariate analyses adjusting for age, KPS, WHO grade, FET-PET-positive volume, and tumor volume on contrast-enhanced MRI, the TSPO-PET-positive volume was associated with TTNI (hazard ratio (HR)\u2009=\u20091.037, 95% CI: 1.009\u20131.064,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0106).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights the potential prognostic utility of TSPO-PET imaging in newly diagnosed IDH-mutant glioma. Our findings support the inclusion of PET imaging in future clinical trials to develop imaging-based risk models for better prognostication and individualized treatment guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-07926-y","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T07:29:49Z","timestamp":1780126189000},"page":"5733-5744","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The prognostic significance of TSPO-PET imaging in IDH-mutant glioma: a single-center, retrospective study"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7098-4744","authenticated-orcid":false,"given":"Katharina J.","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"St\u00fcrzl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Kirchleitner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"von Polenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Ruf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veit M.","family":"Stoecklein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8932-2265","authenticated-orcid":false,"given":"Jonas","family":"Reis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Quach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Kaiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Lorenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Zounek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick N.","family":"Harter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Rupprecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus J.","family":"Riemenschneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Brendel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Thon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1756-423X","authenticated-orcid":false,"given":"Joerg-Christian","family":"Tonn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6634-0927","authenticated-orcid":false,"given":"Louisa","family":"von Baumgarten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0953-7624","authenticated-orcid":false,"given":"Nathalie L.","family":"Albert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"7926_CR1","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","volume":"23","author":"DN Louis","year":"2021","unstructured":"Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, et al. 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All patients provided written informed consent prior to each [\n                      18\n                      F]FET-PET\/CT scan which was performed as part of clinical routine.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The patient provided written informed consent to publication of this report.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"KJM received grant support by the Friedrich-Baur-Stiftung and the Deutsche Forschungsgemeinschaft (DFG - German Research Foundation).LvB has received honoraria for lectures, consultation or advisory board participation from Servier, Merck and research funding from Novocure.NLA has received honoraria for lectures, consultation or advisory board participation from Novartis \/ Advanced Accelerator Applications, ABX, ITM Oncologics GmbH, Carthera, OncLive, Medsir, Telix Pharmaceuticals and Servier and research funding from Novocure, Telix Pharmaceuticals and Servier.JCT has received honoraria for consultation or advisory board participation from Servier, Carthera and ERCM.MB received speaker honoraria from GE healthcare, Roche, and Life Molecular Imaging and advised GE healthcare, MIAC, and Life Molecular Imaging.VR received speaker honoraria from Novocure.","order":3,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}