Reevaluating the imaging definition of tumor progression: perfusion MRI quantifies recurrent glioblastoma tumor fraction, pseudoprogression, and radiation necrosis to predict survival.
Reevaluating the imaging definition of tumor progression: perfusion MRI quantifies recurrent glioblastoma tumor fraction, pseudoprogression, and radiation necrosis to predict survival.
复制标题
DOI：
10.1093/neuonc/nos112
复制
发表时间：
2012-07
期刊：
影响因子：
15.9
通讯作者：
Baxter LC
中科院分区：
文献类型：
--
作者：
Hu LS;Eschbacher JM;Heiserman JE;Dueck AC;Shapiro WR;Liu S;Karis JP;Smith KA;Coons SW;Nakaji P;Spetzler RF;Feuerstein BG;Debbins J;Baxter LC
简介：对比增强MRI（CE-MRI）是目前监测多形性胶质母细胞瘤（GBM）治疗反应的主要方法，其前提是病变扩大反映了肿瘤负荷增加、治疗失败和预后不良。不幸的是，照射这种肿瘤可以诱导CE-MRI的变化，模拟肿瘤复发，所谓的治疗后辐射效应（PTRE），事实上，PTRE和肿瘤再生长可以同时发生。因为PTRE代表治疗成功，肿瘤生长与PTRE的相对组织学分数影响生存。研究表明，基于灌注MRI（pMRI）的相对脑血容量（rCBV）测量可以无创地估计组织学肿瘤分数，以预测临床结局。有几种基于pMRI的分析方法，尽管没有一种与总生存期（OS）相关。本研究比较了组织学肿瘤分数和OS与几种基于pMRI的指标的相关性。方法：我们招募了既往接受过治疗的GBM患者，这些患者因疑似肿瘤复发而接受手术再切除，并计算了CE-MRI增强病变内基于术前pMRI的指标：rCBV平均值、模式、最大值、宽度和称为pMRI肿瘤负荷分数（pMRI-FTB）的新阈值指标。结果：在25例复发性GBM患者中，组织学肿瘤分数与pMRI-FTB的相关性最强（r = 0.82; P <0.0001），这是唯一与OS相关的成像指标（P<0.02）。结论：pMRI-FTB度量可靠地估计组织学肿瘤分数（即，肿瘤负荷），并与复发性GBM背景下的OS相关。该技术可能为未来的临床试验提供一种有希望的肿瘤进展和临床结果的生物标志物。
INTRODUCTION: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
登录
查看更多内容
影响因子：
158.5
作者：
Stupp, R;Mason, WP;Ryan, G
通讯作者：
Ryan, G
DOI：
10.1158/1078-0432.ccr-10-2098
发表时间：
2011-07-15
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Galbán CJ;Chenevert TL;Meyer CR;Tsien C;Lawrence TS;Hamstra DA;Junck L;Sundgren PC;Johnson TD;Galbán S;Sebolt-Leopold JS;Rehemtulla A;Ross BD
通讯作者：
Ross BD
影响因子：
19.7
作者：
Emblem, Kyrre E.;Nedregaard, Baard;Bjornerud, Atle
通讯作者：
Bjornerud, Atle
影响因子：
19.7
作者：
Kim, Ho Sung;Kim, Jang-Hee;Kim, Sun Yong
通讯作者：
Kim, Sun Yong
影响因子：
4.1
作者：
FORSYTH, PA;KELLY, PJ;ATKINSON, EJ
通讯作者：
ATKINSON, EJ