Reevaluating the imaging definition of tumor progression: perfusion MRI quantifies recurrent glioblastoma tumor fraction, pseudoprogression, and radiation necrosis to predict survival
Contrast-enhanced MRI (CE-MRI) represents the current mainstay for monitoring treatment response in glioblastoma multiforme (GBM), based on the premise that enlarging lesions reflect increasing tumor burden, treatment failure, and poor prognosis. Unfortunately, irradiating such tumors can induce cha...
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| Veröffentlicht in: | Neuro-oncology (Charlottesville, Va.) Va.), 2012-07, Vol.14 (7), p.919-930 |
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| creator | Hu, Leland S Eschbacher, Jennifer M Heiserman, Joseph E Dueck, Amylou C Shapiro, William R Liu, Seban Karis, John P Smith, Kris A Coons, Stephen W Nakaji, Peter Spetzler, Robert F Feuerstein, Burt G Debbins, Josef Baxter, Leslie C |
| description | Contrast-enhanced MRI (CE-MRI) represents the current mainstay for monitoring treatment response in glioblastoma multiforme (GBM), based on the premise that enlarging lesions reflect increasing tumor burden, treatment failure, and poor prognosis. Unfortunately, irradiating such tumors can induce changes in CE-MRI that mimic tumor recurrence, so called post treatment radiation effect (PTRE), and in fact, both PTRE and tumor re-growth can occur together. Because PTRE represents treatment success, the relative histologic fraction of tumor growth versus PTRE affects survival. Studies suggest that Perfusion MRI (pMRI)-based measures of relative cerebral blood volume (rCBV) can noninvasively estimate histologic tumor fraction to predict clinical outcome. There are several proposed pMRI-based analytic methods, although none have been correlated with overall survival (OS). This study compares how well histologic tumor fraction and OS correlate with several pMRI-based metrics.
We recruited previously treated patients with GBM undergoing surgical re-resection for suspected tumor recurrence and calculated preoperative pMRI-based metrics within CE-MRI enhancing lesions: rCBV mean, mode, maximum, width, and a new thresholding metric called pMRI-fractional tumor burden (pMRI-FTB). We correlated all pMRI-based metrics with histologic tumor fraction and OS.
Among 25 recurrent patients with GBM, histologic tumor fraction correlated most strongly with pMRI-FTB (r = 0.82; P < .0001), which was the only imaging metric that correlated with OS (P |
| doi_str_mv | 10.1093/neuonc/nos112 |
| format | Article |
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We recruited previously treated patients with GBM undergoing surgical re-resection for suspected tumor recurrence and calculated preoperative pMRI-based metrics within CE-MRI enhancing lesions: rCBV mean, mode, maximum, width, and a new thresholding metric called pMRI-fractional tumor burden (pMRI-FTB). We correlated all pMRI-based metrics with histologic tumor fraction and OS.
Among 25 recurrent patients with GBM, histologic tumor fraction correlated most strongly with pMRI-FTB (r = 0.82; P < .0001), which was the only imaging metric that correlated with OS (P<.02).
The pMRI-FTB metric reliably estimates histologic tumor fraction (i.e., tumor burden) and correlates with OS in the context of recurrent GBM. This technique may offer a promising biomarker of tumor progression and clinical outcome for future clinical trials.</description><identifier>ISSN: 1522-8517</identifier><identifier>ISSN: 1523-5866</identifier><identifier>EISSN: 1523-5866</identifier><identifier>DOI: 10.1093/neuonc/nos112</identifier><identifier>PMID: 22561797</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Aged ; Blood Volume ; Brain Neoplasms - mortality ; Brain Neoplasms - pathology ; Brain Neoplasms - therapy ; Clinical Investigations ; Cohort Studies ; Disease Progression ; Female ; Follow-Up Studies ; Glioblastoma - mortality ; Glioblastoma - pathology ; Glioblastoma - therapy ; Humans ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Necrosis ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - therapy ; Neoplasm Staging ; Prognosis ; Radiation Injuries - diagnosis ; Radiation Injuries - etiology ; Survival Rate ; Tumor Burden</subject><ispartof>Neuro-oncology (Charlottesville, Va.), 2012-07, Vol.14 (7), p.919-930</ispartof><rights>The Author(s) 2012. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c486t-f0e783c5afa742fd7eb9b640ea8fa1c2a9eca2973c108c425c8acfd1acd23e323</citedby><cites>FETCH-LOGICAL-c486t-f0e783c5afa742fd7eb9b640ea8fa1c2a9eca2973c108c425c8acfd1acd23e323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3379799/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3379799/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22561797$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hu, Leland S</creatorcontrib><creatorcontrib>Eschbacher, Jennifer M</creatorcontrib><creatorcontrib>Heiserman, Joseph E</creatorcontrib><creatorcontrib>Dueck, Amylou C</creatorcontrib><creatorcontrib>Shapiro, William R</creatorcontrib><creatorcontrib>Liu, Seban</creatorcontrib><creatorcontrib>Karis, John P</creatorcontrib><creatorcontrib>Smith, Kris A</creatorcontrib><creatorcontrib>Coons, Stephen W</creatorcontrib><creatorcontrib>Nakaji, Peter</creatorcontrib><creatorcontrib>Spetzler, Robert F</creatorcontrib><creatorcontrib>Feuerstein, Burt G</creatorcontrib><creatorcontrib>Debbins, Josef</creatorcontrib><creatorcontrib>Baxter, Leslie C</creatorcontrib><title>Reevaluating the imaging definition of tumor progression: perfusion MRI quantifies recurrent glioblastoma tumor fraction, pseudoprogression, and radiation necrosis to predict survival</title><title>Neuro-oncology (Charlottesville, Va.)</title><addtitle>Neuro Oncol</addtitle><description>Contrast-enhanced MRI (CE-MRI) represents the current mainstay for monitoring treatment response in glioblastoma multiforme (GBM), based on the premise that enlarging lesions reflect increasing tumor burden, treatment failure, and poor prognosis. Unfortunately, irradiating such tumors can induce changes in CE-MRI that mimic tumor recurrence, so called post treatment radiation effect (PTRE), and in fact, both PTRE and tumor re-growth can occur together. Because PTRE represents treatment success, the relative histologic fraction of tumor growth versus PTRE affects survival. Studies suggest that Perfusion MRI (pMRI)-based measures of relative cerebral blood volume (rCBV) can noninvasively estimate histologic tumor fraction to predict clinical outcome. There are several proposed pMRI-based analytic methods, although none have been correlated with overall survival (OS). This study compares how well histologic tumor fraction and OS correlate with several pMRI-based metrics.
We recruited previously treated patients with GBM undergoing surgical re-resection for suspected tumor recurrence and calculated preoperative pMRI-based metrics within CE-MRI enhancing lesions: rCBV mean, mode, maximum, width, and a new thresholding metric called pMRI-fractional tumor burden (pMRI-FTB). We correlated all pMRI-based metrics with histologic tumor fraction and OS.
Among 25 recurrent patients with GBM, histologic tumor fraction correlated most strongly with pMRI-FTB (r = 0.82; P < .0001), which was the only imaging metric that correlated with OS (P<.02).
The pMRI-FTB metric reliably estimates histologic tumor fraction (i.e., tumor burden) and correlates with OS in the context of recurrent GBM. This technique may offer a promising biomarker of tumor progression and clinical outcome for future clinical trials.</description><subject>Adult</subject><subject>Aged</subject><subject>Blood Volume</subject><subject>Brain Neoplasms - mortality</subject><subject>Brain Neoplasms - pathology</subject><subject>Brain Neoplasms - therapy</subject><subject>Clinical Investigations</subject><subject>Cohort Studies</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glioblastoma - mortality</subject><subject>Glioblastoma - pathology</subject><subject>Glioblastoma - therapy</subject><subject>Humans</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Necrosis</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - therapy</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Radiation Injuries - diagnosis</subject><subject>Radiation Injuries - etiology</subject><subject>Survival Rate</subject><subject>Tumor Burden</subject><issn>1522-8517</issn><issn>1523-5866</issn><issn>1523-5866</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUstuFDEQtBAReZAjV-QjhwwZ2_PkgBRFBCIFIUXkbPV62hOjGXvix0p8Gb-HJ7tE4ZRTl9yl6u5yEfKOlR9Z2Ytzi8lZdW5dYIy_Ikes5qKou6Z5_Yh50dWsPSTHIfwqS87qhr0hh5zn2vbtEflzi7iFKUE0dqTxHqmZYVzxgNpYE42z1Gka0-w8XbwbPYaQHz_RBb1OK6Tfb6_pQwIbjTYYqEeVvEcb6TgZt5kgRDfDXkJ7UKvoGV0CpsE9kzyjYAfqYTDwONai8i6YQKPLk3EwKtKQ_Nbkhd-SAw1TwNN9PSF3V19-Xn4rbn58vb68uClU1TWx0CW2nVA1aGgrrocWN_2mqUqETgNTHHpUwPtWKFZ2quK16kDpgYEauEDBxQn5vNNd0mbGQeWrPExy8dkm_1s6MPL_jjX3cnRbKUT2t--zwIe9gHcPCUOUswkKpwksuhQkq2vWsIqz5mVq_r--Y21bZ2qxo64OBY_6aSNWyjUXcpcLuctF5r9_fsYT-18QxF9Xpb72</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Hu, Leland S</creator><creator>Eschbacher, Jennifer M</creator><creator>Heiserman, Joseph E</creator><creator>Dueck, Amylou C</creator><creator>Shapiro, William R</creator><creator>Liu, Seban</creator><creator>Karis, John P</creator><creator>Smith, Kris A</creator><creator>Coons, Stephen W</creator><creator>Nakaji, Peter</creator><creator>Spetzler, Robert F</creator><creator>Feuerstein, Burt G</creator><creator>Debbins, Josef</creator><creator>Baxter, Leslie C</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>20120701</creationdate><title>Reevaluating the imaging definition of tumor progression: perfusion MRI quantifies recurrent glioblastoma tumor fraction, pseudoprogression, and radiation necrosis to predict survival</title><author>Hu, Leland S ; Eschbacher, Jennifer M ; Heiserman, Joseph E ; Dueck, Amylou C ; Shapiro, William R ; Liu, Seban ; Karis, John P ; Smith, Kris A ; Coons, Stephen W ; Nakaji, Peter ; Spetzler, Robert F ; Feuerstein, Burt G ; Debbins, Josef ; Baxter, Leslie C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c486t-f0e783c5afa742fd7eb9b640ea8fa1c2a9eca2973c108c425c8acfd1acd23e323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Blood Volume</topic><topic>Brain Neoplasms - mortality</topic><topic>Brain Neoplasms - pathology</topic><topic>Brain Neoplasms - therapy</topic><topic>Clinical Investigations</topic><topic>Cohort Studies</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glioblastoma - mortality</topic><topic>Glioblastoma - pathology</topic><topic>Glioblastoma - therapy</topic><topic>Humans</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Necrosis</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - therapy</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Radiation Injuries - diagnosis</topic><topic>Radiation Injuries - etiology</topic><topic>Survival Rate</topic><topic>Tumor Burden</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hu, Leland S</creatorcontrib><creatorcontrib>Eschbacher, Jennifer M</creatorcontrib><creatorcontrib>Heiserman, Joseph E</creatorcontrib><creatorcontrib>Dueck, Amylou C</creatorcontrib><creatorcontrib>Shapiro, William R</creatorcontrib><creatorcontrib>Liu, Seban</creatorcontrib><creatorcontrib>Karis, John P</creatorcontrib><creatorcontrib>Smith, Kris A</creatorcontrib><creatorcontrib>Coons, Stephen W</creatorcontrib><creatorcontrib>Nakaji, Peter</creatorcontrib><creatorcontrib>Spetzler, Robert F</creatorcontrib><creatorcontrib>Feuerstein, Burt G</creatorcontrib><creatorcontrib>Debbins, Josef</creatorcontrib><creatorcontrib>Baxter, Leslie C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neuro-oncology (Charlottesville, Va.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hu, Leland S</au><au>Eschbacher, Jennifer M</au><au>Heiserman, Joseph E</au><au>Dueck, Amylou C</au><au>Shapiro, William R</au><au>Liu, Seban</au><au>Karis, John P</au><au>Smith, Kris A</au><au>Coons, Stephen W</au><au>Nakaji, Peter</au><au>Spetzler, Robert F</au><au>Feuerstein, Burt G</au><au>Debbins, Josef</au><au>Baxter, Leslie C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reevaluating the imaging definition of tumor progression: perfusion MRI quantifies recurrent glioblastoma tumor fraction, pseudoprogression, and radiation necrosis to predict survival</atitle><jtitle>Neuro-oncology (Charlottesville, Va.)</jtitle><addtitle>Neuro Oncol</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>14</volume><issue>7</issue><spage>919</spage><epage>930</epage><pages>919-930</pages><issn>1522-8517</issn><issn>1523-5866</issn><eissn>1523-5866</eissn><abstract>Contrast-enhanced MRI (CE-MRI) represents the current mainstay for monitoring treatment response in glioblastoma multiforme (GBM), based on the premise that enlarging lesions reflect increasing tumor burden, treatment failure, and poor prognosis. Unfortunately, irradiating such tumors can induce changes in CE-MRI that mimic tumor recurrence, so called post treatment radiation effect (PTRE), and in fact, both PTRE and tumor re-growth can occur together. Because PTRE represents treatment success, the relative histologic fraction of tumor growth versus PTRE affects survival. Studies suggest that Perfusion MRI (pMRI)-based measures of relative cerebral blood volume (rCBV) can noninvasively estimate histologic tumor fraction to predict clinical outcome. There are several proposed pMRI-based analytic methods, although none have been correlated with overall survival (OS). This study compares how well histologic tumor fraction and OS correlate with several pMRI-based metrics.
We recruited previously treated patients with GBM undergoing surgical re-resection for suspected tumor recurrence and calculated preoperative pMRI-based metrics within CE-MRI enhancing lesions: rCBV mean, mode, maximum, width, and a new thresholding metric called pMRI-fractional tumor burden (pMRI-FTB). We correlated all pMRI-based metrics with histologic tumor fraction and OS.
Among 25 recurrent patients with GBM, histologic tumor fraction correlated most strongly with pMRI-FTB (r = 0.82; P < .0001), which was the only imaging metric that correlated with OS (P<.02).
The pMRI-FTB metric reliably estimates histologic tumor fraction (i.e., tumor burden) and correlates with OS in the context of recurrent GBM. This technique may offer a promising biomarker of tumor progression and clinical outcome for future clinical trials.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>22561797</pmid><doi>10.1093/neuonc/nos112</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Adult Aged Blood Volume Brain Neoplasms - mortality Brain Neoplasms - pathology Brain Neoplasms - therapy Clinical Investigations Cohort Studies Disease Progression Female Follow-Up Studies Glioblastoma - mortality Glioblastoma - pathology Glioblastoma - therapy Humans Magnetic Resonance Angiography Male Middle Aged Necrosis Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - therapy Neoplasm Staging Prognosis Radiation Injuries - diagnosis Radiation Injuries - etiology Survival Rate Tumor Burden |
| title | Reevaluating the imaging definition of tumor progression: perfusion MRI quantifies recurrent glioblastoma tumor fraction, pseudoprogression, and radiation necrosis to predict survival |
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