Quantitative T2 mapping of recurrent glioblastoma under bevacizumab improves monitoring for non-enhancing tumor progression and predicts overall survival

Hattingen, Elke; Jurcoane, Alina; Daneshvar, Keivan; Pilatus, Ulrich; Mittelbronn, Michel; Steinbach, Joachim P.; Bähr, Oliver

doi:10.1093/neuonc/not105

Cited by 81 publications

(81 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Volume of the CEL may not be a reliable predictor of outcome because the volume of contrast-enhancement may be affected by many nontumoral processes including inflammation, postsurgical changes, pseudoprogression, and treatment-induced necrosis [33][34][35][36]. Similarly, the volume of the NEL encompasses many causes of T2 hyperintensity such as vasogenic edema, gliosis, cystic changes, inflammation, and tumor infiltration [37][38][39]. It is evident from Fig.…”

Section: Discussionmentioning

confidence: 99%

Survival prediction in high-grade gliomas using CT perfusion imaging

Yeung

Wang

et al. 2015

J Neurooncol

View full text Add to dashboard Cite

Patients with high-grade gliomas usually have heterogeneous response to surgery and chemoirradiation. The objectives of this study were (1) to evaluate serial changes in tumor volume and perfusion imaging parameters and (2) to determine the value of these data in predicting overall survival (OS). Twenty-nine patients with World Health Organization grades III and IV gliomas underwent magnetic resonance (MR) and computed tomography (CT) perfusion examinations before surgery, and 1, 3, 6, 9, and 12 months after radiotherapy. Serial measurements of tumor volumes and perfusion parameters were evaluated by receiver operating characteristic analysis, Cox proportional hazards regression, and Kaplan-Meier survival analysis to determine their values in predicting OS. Higher trends in blood flow (BF), blood volume (BV), and permeability-surface area product in the contrast-enhancing lesions (CEL) and the non-enhancing lesions (NEL) were found in patients with OS \ 18 months compared to those with OS C 18 months, and these values were significant at selected time points (P \ 0.05). Only CT perfusion parameters yielded sensitivities and specificities of C70 % in predicting 18 and 24 months OS. Pre-surgery BF in the NEL and BV in the CEL and NEL 3 months after radiotherapy had sensitivities and specificities [80 % in predicting 24 months OS in patients with grade IV gliomas. Our study indicated that CT perfusion parameters were predictive of survival and could be useful in assessing early response and in selecting adjuvant treatment to prolong survival if verified in a larger cohort of patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Survival prediction in high-grade gliomas using CT perfusion imaging

Yeung

Wang

et al. 2015

J Neurooncol

View full text Add to dashboard Cite

show abstract

“…Response rates for bevacizumab treatment have been challenged since response may only reflect the influence of bevacizumab on the contrast enhancement and edema without actually affecting tumor growth (37). Therefore, the present study also evaluated how the response to bevacizumab was associated with PFS and OS time.…”

Section: Discussionmentioning

confidence: 99%

Bevacizumab as a last-line treatment for glioblastoma following failure of radiotherapy, temozolomide and lomustine

et al. 2017

View full text Add to dashboard Cite

Abstract. In previous trials, bevacizumab failed to prolong the overall survival time in newly diagnosed glioblastoma and at the first recurrence. Randomized clinical trials at the second or further recurrence following the failure of radiotherapy, temozolomide and lomustine, and retrospective analyses focusing on this specific cohort, are not yet available. A total of 62 patients with glioblastoma who received bevacizumab after the failure of standard care, including radiotherapy, temozolomide and lomustine, were retrospectively identified. Patient characteristics, previous treatment details, concomitant therapy, response based on the Response Assessment in Neuro-Oncology criteria, and progression-free survival (PFS) and overall survival (OS) times and rates were evaluated. Furthermore, the PFS and OS times and rates were analyzed for responders and non-responders. Of the patients, 54.8% (n=34) responded to treatment [complete response (CR) 3.2%, n=2; partial response (PR) 51.6%, n=32]. The median PFS time was 3.5 months and the median OS time was 7.5 months. The PFS rate at 6 months was 21.5% and the OS rate at 12 months was 11.5%. Responders (CR or PR) experienced a superior median PFS time compared with non-responders (i.e. stable or progressive disease; 5.4 vs. 1.9 months; P<0.0001) and a superior PFS rate at 6 months (34.9 vs. 7.1%; P<0.0001). The median OS time (8.6 vs. 6.4 months; P<0.0001) and OS rate at 12 months (21.3 vs. 0%; P<0.0001) were also superior in patients who exhibited a response to bevacizumab treatment. In conclusion, the objective response rate and the PFS and OS times and rates indicate that bevacizumab has activity in patients with glioblastoma following the failure of radiotherapy, temozolomide, and lomustine. A randomized trial comparing bevacizumab with best supportive care in these patients is advised.

show abstract

“…qT2 mapping has been recommended for improved monitoring of glioblastoma patients under therapy. 35 The analytical advancement from the conventional MRI to our analysis approach is clearly noticeable by comparing Fig. 3 with Fig.…”

Section: Discussionmentioning

confidence: 94%

QuantitativeT2: interactive quantitative T2 MRI witnessed in mouse glioblastoma

et al. 2015

View full text Add to dashboard Cite

Abstract. The aim of this study was to establish an advanced analytical platform for complex in vivo pathologies. We have developed a software program, QuantitativeT2, for voxel-based real-time quantitative T2 magnetic resonance imaging. We analyzed murine brain tumors to confirm feasibility of our method for neurological conditions. Anesthetized mice (with invasive gliomas, and controls) were imaged on a 9.4 Tesla scanner using a Carr-Purcell-Meiboom-Gill sequence. The multiecho T2 decays from axial brain slices were analyzed using QuantitativeT2. T2 distribution histograms demonstrated substantial characteristic differences between normal and pathological brain tissues. Voxel-based quantitative maps of tissue water fraction (WF) and geometric mean T2 (gmT2) revealed the heterogeneous alterations to water compartmentalization caused by pathology. The numeric distribution of WF and gmT2 indicated the extent of tumor infiltration. Relative evaluations between in vivo scans and ex vivo histology indicated that the T2s between 30 and 150 ms were related to cellular density and the integrity of the extracellular matrix. Overall, QuantitativeT2 has demonstrated significant advancements in qT2 analysis with real-time operation. It is interactive with an intuitive workflow; can analyze data from many MR manufacturers; and is released as open-source code to encourage examination, improvement, and expansion of this method. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

show abstract

Quantitative T2 mapping of recurrent glioblastoma under bevacizumab improves monitoring for non-enhancing tumor progression and predicts overall survival

Cited by 81 publications

References 24 publications

Survival prediction in high-grade gliomas using CT perfusion imaging

Survival prediction in high-grade gliomas using CT perfusion imaging

Bevacizumab as a last-line treatment for glioblastoma following failure of radiotherapy, temozolomide and lomustine

QuantitativeT2: interactive quantitative T2 MRI witnessed in mouse glioblastoma

Contact Info

Product

Resources

About