MRI in Glioma Immunotherapy: Evidence, Pitfalls, and Perspectives.
MRI in Glioma Immunotherapy: Evidence, Pitfalls, and Perspectives.
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DOI：
10.1155/2017/5813951
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发表时间：
2017
影响因子：
4.1
通讯作者：
Cuccarini V
中科院分区：
文献类型：
--
作者：
Aquino D;Gioppo A;Finocchiaro G;Bruzzone MG;Cuccarini V
假表现症，即由于治疗而不是肿瘤演变引起的影像改变，对胶质瘤患者的治疗和临床试验的结果有重要影响。RANO(神经肿瘤学反应评估)标准，包括常规MRI(CMRI)，解决了放射治疗和伴随化疗后的假进展问题，以及胶质母细胞瘤(GBM)和其他胶质瘤抗血管生成治疗中的假反应问题。癌症免疫疗法的发展迫使进一步确定相关的反应标准，伊朗工作组在2015年总结了这一标准。尽管如此，CMRI对胶质瘤进展的明确定义仍然很困难，特别是在检查点抑制剂和树突状细胞提供的免疫治疗方法的设置中。高级核磁共振成像(AMRI)原则上可以解决这一未得到满足的临床需求。在这里，我们讨论了不同的AMRI技术的潜在贡献，以及它们在胶质瘤的生物学和影像特征以及免疫系统相互作用方面的适应症和缺陷。
Pseudophenomena, that is, imaging alterations due to therapy rather than tumor evolution, have an important impact on the management of glioma patients and the results of clinical trials. RANO (response assessment in neurooncology) criteria, including conventional MRI (cMRI), addressed the issues of pseudoprogression after radiotherapy and concomitant chemotherapy and pseudoresponse during antiangiogenic therapy of glioblastomas (GBM) and other gliomas. The development of cancer immunotherapy forced the identification of further relevant response criteria, summarized by the iRANO working group in 2015. In spite of this, the unequivocal definition of glioma progression by cMRI remains difficult particularly in the setting of immunotherapy approaches provided by checkpoint inhibitors and dendritic cells. Advanced MRI (aMRI) may in principle address this unmet clinical need. Here, we discuss the potential contribution of different aMRI techniques and their indications and pitfalls in relation to biological and imaging features of glioma and immune system interactions.