Combined iron oxide nanoparticle ferumoxytol and gadolinium contrast enhanced MRI define glioblastoma pseudoprogression
Combined iron oxide nanoparticle ferumoxytol and gadolinium contrast enhanced MRI define glioblastoma pseudoprogression
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DOI：
10.1093/neuonc/noy160
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发表时间：
2019-04-01
期刊：
影响因子：
15.9
通讯作者：
Neuwelt, Edward A.
中科院分区：
文献类型：
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作者：
Barajas, Ramon F., Jr.;Hamilton, Bronwyn E.;Neuwelt, Edward A.
背景：在胶质母细胞瘤患者中，非侵入性地区分治疗引起的假性进展和复发是很困难的，因为目前缺乏生物特异性的影像指标。阿魏酸亚铁纳米颗粒MRI增强是先天免疫介导的神经炎症的特征，因此，我们假设阿魏酸甘油增强MRI可作为胶质母细胞瘤假性进展的生物标志物。方法在这项机构回顾委员会批准的回顾性研究中，我们分析了45例胶质母细胞瘤患者多个临床时间点的阿魏酸甘油酯增强3T磁共振成像。外显子组测序分析异柠檬酸脱氢酶1(IDH-1)基因突变状态。产品直径测量的总和根据神经肿瘤学标准中的响应评估计算，这些标准来自于Gd和阿魏酸甘油酯增强序列。增强失配被计算为阿魏酸甘油酯和产物直径比之和的自然对数。方差分析和学生t检验评估了失配率的差异。P值
Background Noninvasively differentiating therapy-induced pseudoprogression from recurrent disease in patients with glioblastoma is prospectively difficult due to the current lack of a biologically specific imaging metric. Ferumoxytol iron oxide nanoparticle MRI contrast characterizes innate immunity mediated neuroinflammation; therefore, we hypothesized that combined ferumoxytol and gadolinium enhanced MRI could serve as a biomarker of glioblastoma pseudoprogression.Methods In this institutional review board-approved, retrospective study, we analyzed ferumoxytol and gadolinium contrast enhanced T1-weighted 3T MRI in 45 patients with glioblastoma over multiple clinical timepoints. Isocitrate dehydrogenase 1 (IDH-1) mutational status was characterized by exome sequencing. Sum of products diameter measurements were calculated according to Response Assessment in Neuro-Oncology criteria from both gadolinium and ferumoxytol enhanced sequences. Enhancement mismatch was calculated as the natural log of the ferumoxytol to gadolinium sum of products diameter ratio. Analysis of variance and Student's t-test assessed differences in mismatch ratios. P-value