Perfusion MRI in treatment evaluation of glioblastomas: Clinical relevance of current and future techniques

Dijken, Bart R. J. van; Laar, Peter Jan van; Smits, Marion; Dankbaar, Jan Willem; Enting, Roelien H.; Hoorn, Anouk van der

doi:10.1002/jmri.26306

Cited by 90 publications

(92 citation statements)

References 81 publications

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“…Comparison of apparent diffusion coefficients calculated with DWI can distinguish tumor from non-tumor tissue [ 28 , 29 ] and even GBM from central nervous system lymphoma [ 30 , 31 ]. Moreover, dynamic contrast-enhanced (DCE) MRI and dynamic susceptibility (DSC) MRI are two other advanced MRI techniques that can help in monitoring physiological and biological processes in GBM [ 32 , 33 ]. DSC and DCE-MRI are based on modulation and modification of T1 and T2 relaxation time.…”

Section: History and Current Status Of Gbm Detection And Imaging Tmentioning

confidence: 99%

Radioresistance in Glioblastoma and the Development of Radiosensitizers

Ali

Oliva

Noman

et al. 2020

Cancers

107

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Ionizing radiation is a common and effective therapeutic option for the treatment of glioblastoma (GBM). Unfortunately, some GBMs are relatively radioresistant and patients have worse outcomes after radiation treatment. The mechanisms underlying intrinsic radioresistance in GBM has been rigorously investigated over the past several years, but the complex interaction of the cellular molecules and signaling pathways involved in radioresistance remains incompletely defined. A clinically effective radiosensitizer that overcomes radioresistance has yet to be identified. In this review, we discuss the current status of radiation treatment in GBM, including advances in imaging techniques that have facilitated more accurate diagnosis, and the identified mechanisms of GBM radioresistance. In addition, we provide a summary of the candidate GBM radiosensitizers being investigated, including an update of subjects enrolled in clinical trials. Overall, this review highlights the importance of understanding the mechanisms of GBM radioresistance to facilitate the development of effective radiosensitizers.

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Section: History and Current Status Of Gbm Detection And Imaging Tmentioning

confidence: 99%

Radioresistance in Glioblastoma and the Development of Radiosensitizers

Ali

Oliva

Noman

et al. 2020

Cancers

107

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“…DCE-derived parameters include volume transfer constant (K trans ), extravascular extracellular space per unit volume of tissue (Ve), and plasma volume (Vp). 4,29 Yun et al 21 found mean K trans as the most promising parameter in differentiating true progression from pseudo-progression (sensitivity, 59%; specificity, 94%) compared with Vp. On the contrary, Thomas et al 20 found higher area under curve (AUC) for Vp compared with K trans in differentiating pseudoprogression (Vp cutoff, ,3.7; sensitivity, 85%; specificity, 79%) from true progression (mean K trans .3.6; sensitivity, 69%; specificity, 79%).…”

Section: Perfusion-weighted Imagingmentioning

confidence: 99%

“…Pseudoresponse refers to a transient rapid decrease in lesion enhancement and surrounding edema after antiangiogenic treatment (ie, bevacizumab) by normalizing the BBB and mimicking favorable tumor response while the actual tumor remains viable or progresses. 2,4,5 Contrast-enhanced MR imaging remains the primary imaging technique in HGG follow-up because of its widespread availability and excellent soft-tissue and contrast resolution. A recent meta-analysis of glioblastoma with enhancing lesions on posttreatment MR imaging revealed true progression in 60% and treatment-related changes in 36% of patients.…”

mentioning

confidence: 99%

Diagnostic Performance of PET and Perfusion-Weighted Imaging in Differentiating Tumor Recurrence or Progression from Radiation Necrosis in Posttreatment Gliomas: A Review of Literature

Soni¹,

Ora²,

Mohindra³

et al. 2020

AJNR Am J Neuroradiol

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Tumor resection followed by chemoradiation remains the current criterion standard treatment for high-grade gliomas. Regardless of aggressive treatment, tumor recurrence and radiation necrosis are 2 different outcomes. Differentiation of tumor recurrence from radiation necrosis remains a critical problem in these patients because of considerable overlap in clinical and imaging presentations. Contrast-enhanced MR imaging is the universal imaging technique for diagnosis, treatment evaluation, and detection of recurrence of high-grade gliomas. PWI and PET with novel radiotracers have an evolving role for monitoring treatment response in high-grade gliomas. In the literature, there is no clear consensus on the superiority of either technique or their complementary information. This review aims to elucidate the diagnostic performance of individual and combined use of functional (PWI) and metabolic (PET) imaging modalities to distinguish recurrence from posttreatment changes in gliomas. ABBREVIATIONS: AAT ¼ amino acid tracer; ASL ¼ arterial spin-labeling; AUC ¼ area under the curve; 11 C-MET ¼ 11 C-methionine; DCE ¼ dynamic contrastenhanced; FDOPA ¼ 6-[ 18 F]fluoro-L-dopa; FET ¼ [ 18 F]fluoroethyl-L-tyrosine; FLT ¼ 18 F-fluorothymidine; HGG ¼ high-grade glioma; K trans ¼ volume transfer constant; rCBV ¼ relative cerebral blood volume; RN ¼ radiation necrosis; TBR ¼ tumor-to-background ratio; TR ¼ tumor recurrence; Ve ¼ volume of tissue; Vp ¼ plasma volume

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“…It was assumed that this high response rate was due to the use of contrast enhancement as the primary tool for evaluation in the “Macdonald criteria,” which resulted in a phenomenon called “pseudoresponse” (PsR), where contrast enhancement is falsely reduced due to changes in vascular permeability independent of an antineoplastic effect. Therefore, posttherapy effects such as PsP and PsR hinder a reliable assessment of treatment evaluation …”

Section: Response Assessmentmentioning

confidence: 99%

Emerging MRI Techniques to Redefine Treatment Response in Patients With Glioblastoma

Gonçalves

Chawla

Mohan

2020

Magnetic Resonance Imaging

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Glioblastoma is the most common and most malignant primary brain tumor. Despite aggressive multimodal treatment, its prognosis remains poor. Even with continuous developments in MRI, which has provided us with newer insights into the diagnosis and understanding of tumor biology, response assessment in the posttherapy setting remains challenging. We believe that the integration of additional information from advanced neuroimaging techniques can further improve the diagnostic accuracy of conventional MRI. In this article, we review the utility of advanced neuroimaging techniques such as diffusion‐weighted imaging, diffusion tensor imaging, perfusion‐weighted imaging, proton magnetic resonance spectroscopy, and chemical exchange saturation transfer in characterizing and evaluating treatment response in patients with glioblastoma. We will also discuss the existing challenges and limitations of using these techniques in clinical settings and possible solutions to avoiding pitfalls in study design, data acquisition, and analysis for future studies. Level of Evidence 2 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2020;52:978–997.

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Perfusion MRI in treatment evaluation of glioblastomas: Clinical relevance of current and future techniques

Cited by 90 publications

References 81 publications

Radioresistance in Glioblastoma and the Development of Radiosensitizers

Radioresistance in Glioblastoma and the Development of Radiosensitizers

Diagnostic Performance of PET and Perfusion-Weighted Imaging in Differentiating Tumor Recurrence or Progression from Radiation Necrosis in Posttreatment Gliomas: A Review of Literature

Emerging MRI Techniques to Redefine Treatment Response in Patients With Glioblastoma

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