POTENTIAL FOR DIFFERENTIATION OF PSEUDOPROGRESSION FROM TRUE TUMOR PROGRESSION WITH DYNAMIC SUSCEPTIBILITY-WEIGHTED CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING USING FERUMOXYTOL VS. GADOTERIDOL: A PILOT STUDY
POTENTIAL FOR DIFFERENTIATION OF PSEUDOPROGRESSION FROM TRUE TUMOR PROGRESSION WITH DYNAMIC SUSCEPTIBILITY-WEIGHTED CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING USING FERUMOXYTOL VS. GADOTERIDOL: A PILOT STUDY
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DOI：
10.1016/j.ijrobp.2009.10.072
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发表时间：
2011-02-01
影响因子：
7
通讯作者：
Neuwelt, Edward A.
中科院分区：
文献类型：
--
作者：
Gahramanov, Seymur;Raslan, Ahmed M.;Neuwelt, Edward A.
Purpose: We evaluated dynamic susceptibility-weighted contrast-enhanced magnetic resonance imaging (DSC-MRI) using gadoteridol in comparison to the iron oxide nanoparticle blood pool agent, ferumoxytol, in patients with glioblastoma multiforme (GBM) who received standard radiochemotherapy (RCT).Methods and Materials: Fourteen patients with GBM received standard RCT and underwent 19 MRI sessions that included DSC-MRI acquisitions with gadoteridol on Day 1 and ferumoxytol on Day 2. Relative cerebral blood volume (rCBV) values were calculated from DSC data obtained from each contrast agent. T1-weighted acquisition post-gadoteridol administration was used to identify enhancing regions.Results: In seven MRI sessions of clinically presumptive active tumor, gadoteridol-DSC showed low rCBV in three and high rCBV in four, whereas ferumoxytol-DSC showed high rCBV in all seven sessions (p = 0.002). After RCT, seven MRI sessions showed increased gadoteridol contrast enhancement on T1-weighted scans coupled with low rCBV without significant differences between contrast agents (p = 0.9). Based on post-gadoteridol T1-weighted scans, DSC-MRI, and clinical presentation, four patterns of response to RCT were observed: regression, pseudoprogression, true progression, and mixed response.Conclusion: We conclude that DSC-MRI with a blood pool agent such as ferumoxytol may provide a better monitor of tumor rCBV than DSC-MRI with gadoteridol. Lesions demonstrating increased enhancement on T1-weighted MRI coupled with low ferumoxytol rCBV are likely exhibiting pseudoprogression, whereas high rCBV with ferumoxytol is a better marker than gadoteridol for determining active tumor. These interesting pilot observations suggest that ferumoxytol may differentiate tumor progression from pseudoprogression and warrant further investigation. (C) 2011 Elsevier Inc.
