Differentiation of progressive disease from pseudoprogression using 3D PCASL and DSC perfusion MRI in patients with glioblastoma.

Published on Apr 1, 2020in Journal of Neuro-oncology4.13
路 DOI :10.1007/S11060-020-03475-Y
Paul Manning5
Estimated H-index: 5
(UCSD: University of California, San Diego),
Shadi Daghighi2
Estimated H-index: 2
(UCSD: University of California, San Diego)
+ 7 AuthorsNikdokht Farid19
Estimated H-index: 19
(UCSD: University of California, San Diego)
Sources
Abstract
PURPOSE: To use 3D pseudocontinuous arterial spin labeling (3D PCASL) and dynamic susceptibility contrast-enhanced (DSC) perfusion MRI to differentiate progressive disease from pseudoprogression in patients with glioblastoma (GBM). METHODS: Thirty-two patients with GBM who developed progressively enhancing lesions within the radiation field following resection and chemoradiation were included in this retrospective, single-institution study. The updated modified RANO criteria were used to establish progressive disease or pseudoprogression. Following 3D PCASL and DSC MR imaging, perfusion parameter estimates of cerebral blood flow (ASL-nCBF and DSC-nrCBF) and cerebral blood volume (DSC-nrCBV) were calculated. Additionally, contrast enhanced volumes were measured. Mann-Whitney U tests were used to compare groups. Linear discriminant analysis (LDA) and area under receiver operator characteristic curve (AUC) analyses were used to evaluate performance of each perfusion parameter and to determine optimal cut-off points. RESULTS: All perfusion parameter measurements were higher in patients with progressive disease (mean, 95% CI ASL-nCBF 2.48, [2.03, 2.93]; DSC-nrCBF = 2.27, [1.85, 2.69]; DSC-nrCBV = 3.51, [2.37, 4.66]) compared to pseudoprogression (mean, 95% CI ASL-nCBF 0.99, [0.47, 1.52]; DSC-nrCBF = 1.05, [0.36, 1.74]; DSC-nCBV = 1.19, [0.34, 2.05]), and findings were significant at the p 0.447). All perfusion parameters demonstrated high AUC (0.954 for ASL-nCBF, 0.867 for DSC-nrCBF, and 0.891 for DSC-nrCBV), however, ASL-nCBF demonstrated the highest AUC and misclassified the fewest cases (N = 6). Lesions correctly classified by ASL but misclassified by DSC were located along the skull base or adjacent to large resection cavities with residual blood products, at areas of increased susceptibility. CONCLUSION: Both 3D PCASL and DSC perfusion MRI techniques have nearly equivalent performance for the differentiation of progressive disease from pseudoprogression in patients with GBM. However, 3D PCASL is less sensitive to susceptibility artifact and may allow for improved classification in select cases.
馃摉 Papers frequently viewed together
References46
Newest
#1Yu-Lin WangH-Index: 3
#2Si ChenH-Index: 1
Last. Lin MaH-Index: 14
view all 8 authors...
Abstract Purpose This study was performed to validate the efficacy of three-dimensional pseudocontinuous arterial spin labeling (pCASL) compared with dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) in distinguishing radiation-induced brain injury from glioma recurrence in patients with glioma. Methods Both 3D pCASL and DSC-PWI were performed using a 3.0鈥疶esla scanner in 69 patients with previously resected and irradiated glioma who displayed newly developed abnormal...
Source
#1Stefanie Thust (UCL Institute of Neurology)H-Index: 10
#2Martin J. van den Bent (EUR: Erasmus University Rotterdam)H-Index: 101
Last. Marion Smits (EUR: Erasmus University Rotterdam)H-Index: 36
view all 3 authors...
textabstractThis review describes the definition, incidence, clinical implications, and magnetic resonance imaging (MRI) findings of pseudoprogression of brain tumors, in particular, but not limited to, high-grade glioma. Pseudoprogression is an important clinical problem after brain tumor treatment, interfering not only with day-to-day patient care but also the execution and interpretation of clinical trials. Radiologically, pseudoprogression is defined as a new or enlarging area(s) of contrast...
Source
#1Qian Xu (Nanjing Medical University)H-Index: 1
#2Qi LiuH-Index: 1
Last. Kai Xu (Nanjing Medical University)H-Index: 16
view all 7 authors...
AbstractBackground:Gliomas constitute over 90% of primary brain tumors. Accurate identification of glioma recurrence and treatment effects is important, as it can help determine whether to continue with standard adjuvant chemotherapy or to switch to a second-line therapy for recurrence. Our purpose
Source
PURPOSE: To compare arterial spin labeling (ASL) perfusion technique with the clinically established dynamic susceptibility contrast-enhanced (DSC) perfusion weighted-imaging (PWI), and to determine its value in routine MRI evaluation of disease progression in patients with glioblastoma multiforme (GBM). METHODS: A prospective intraindividual study was performed in 31 patients with histologically proven GBM who had clinical and/or radiological deterioration after treatment, including surgery, ra...
#1Benjamin M. Ellingson (UCLA: University of California, Los Angeles)H-Index: 56
#2Patrick Y. Wen (Brigham and Women's Hospital)H-Index: 122
Last. Timothy F. Cloughesy (UCLA: University of California, Los Angeles)H-Index: 123
view all 3 authors...
Radiographic endpoints including response and progression are important for the evaluation of new glioblastoma therapies. The current RANO criteria was developed to overcome many of the challenges identified with previous guidelines for response assessment, however, significant challenges and limitations remain. The current recommendations build on the strengths of the current RANO criteria, while addressing many of these limitations. Modifications to the current RANO criteria include suggestion...
Source
#1Jennifer LarsenH-Index: 2
#2Steve B Wharton (University of Sheffield)H-Index: 1
Last. Nigel HoggardH-Index: 28
view all 7 authors...
With the recent publication of a new World Health Organization brain tumour classification that reflects increased understanding of glioma tumour genetics, there is a need for radiologists to understand the changes and their implications for patient management. There has also been an increasing trend for adopting earlier, more aggressive surgical approaches to low-grade glioma (LGG) treatment. We will summarize these changes, give some context to the increased role of tumour genetics and discuss...
Source
#1Sophie E. van West (EUR: Erasmus University Rotterdam)H-Index: 1
#2Hein G. de Bruin (EUR: Erasmus University Rotterdam)H-Index: 10
Last. Walter Taal (EUR: Erasmus University Rotterdam)H-Index: 21
view all 6 authors...
textabstractBackground. As the incidence of pseudo-progressive disease (psPD), or pseudoprogression, in low-grade glioma (LGG) is unknown, we retrospectively investigated this phenomenon in a cohort of LGG patients given radiotherapy (RT). Methods. All MRI scans and clinical data from patients with histologically proven LGG treated with radiation between 2000 and 2011 were reviewed. PsPD was scored when a new enhancing lesion occurred after RT and subsequently disappeared or remained stable for ...
Source
Arterial spin labeling (ASL) magnetic resonance (MR) perfusion imaging has been proposed as an effective method to measure brain tumor perfusion. The aim of the present study was to evaluate the utility of this technique in the differentiation of recurrent gliomas from radiation necrosis. Twenty-one patients with surgically treated primary gliomas, including 16 cases of recurrent glioma and 5 of radiation necrosis were examined using 3.0T MR imaging (MRI). ASL and dynamic susceptibility contrast...
Source
#1Jan C. Buckner (Mayo Clinic)H-Index: 81
#2Edward G. Shaw (Wake Forest University)H-Index: 60
Last. Walter J. Curran (Emory University)H-Index: 101
view all 22 authors...
BackgroundGrade 2 gliomas occur most commonly in young adults and cause progressive neurologic deterioration and premature death. Early results of this trial showed that treatment with procarbazine, lomustine (also called CCNU), and vincristine after radiation therapy at the time of initial diagnosis resulted in longer progression-free survival, but not overall survival, than radiation therapy alone. We now report the long-term results. MethodsWe included patients with grade 2 astrocytoma, oligo...
Source
#1Madeline Grade (UCL Institute of Neurology)H-Index: 9
#2J. A Hernandez Tamames (EUR: Erasmus University Rotterdam)H-Index: 1
Last. Marion Smits (EUR: Erasmus University Rotterdam)H-Index: 20
view all 6 authors...
Arterial spin labeling (ASL) is a non-invasive MRI technique to measure cerebral blood flow (CBF). This review provides a practical guide and overview of the clinical applications of ASL of the brain, as well its potential pitfalls. The technical and physiological background is also addressed. At present, main areas of interest are cerebrovascular disease, dementia and neuro-oncology. In cerebrovascular disease, ASL is of particular interest owing to its quantitative nature and its capability to...
Source
Cited By1
Newest
#1Theo Demerath (University of Freiburg)H-Index: 5
#2Daniel Erny (University of Freiburg)H-Index: 16
Last. Christian Taschner (University of Freiburg)H-Index: 21
view all 6 authors...
Source
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.