Visual Inspection of MR Relative Cerebral Blood Volume Maps Has Limited Value for Distinguishing Progression from Pseudoprogression in Glioblastoma Multiforme Patients

Overview

Journal CNS Oncol

Specialty Oncology

Date 2017 Oct 7

PMID 28984142

Citations 2

Authors

Melissa Kerkhof

Pauline L Tans

Rogier E Hagenbeek

Geert J Lycklama A Nijeholt

Finn K Holla

Tjeerd J Postma

Chiara S Straathof

Linda Dirven

Martin Jb Taphoorn

Maaike J Vos

Affiliations

Soon will be listed here.

Abstract

Aim: We examined whether visual interpretation of relative cerebral blood volume (rCBV) color maps made with dynamic susceptibility-weighted perfusion MRI can reliably distinguish progressive disease (PD) from pseudoprogression (PsPD) in glioblastoma patients during treatment with temozolomide chemoradiation.

Materials & Methods: Magnetic resonance (MR) perfusion-weighted images were evaluated based on visual inspection of rCBV maps. Sensitivity and specificity were calculated to assess if rCBV can reliably differentiate between PD and PsPD, during standard chemoradiation therapy.

Results: Evaluation of dynamic susceptibility-weighted contrast-enhanced perfusion MRI by visual interpretation of rCBV maps did not differentiate PD from PsPD (sensitivity = 72%; specificity = 23%). Furthermore, the interpretation of the rCBV maps had no prognostic value regarding survival.

Conclusion: Qualitative rCBV-based dynamic susceptibility-weighted contrast-enhanced perfusion MRI does not reliably differentiate PD from PsPD, and is not prognostic for survival in glioblastoma multiforme patients during treatment with temozolomide chemoradiation.

Citing Articles

Added prognostic value of DCE blood volume imaging in patients with suspected recurrent or residual glioblastoma-A hybrid [F]FET PET/MRI study.

Henriksen O, Muhic A, Lundemann M, Larsson H, Lindberg U, Andersen T Neurooncol Adv. 2024; 6(1):vdae196.

PMID: 39664680 PMC: 11632823. DOI: 10.1093/noajnl/vdae196.

Discriminators of pseudoprogression and true progression in high-grade gliomas: A systematic review and meta-analysis.

Taylor C, Ekert J, Sefcikova V, Fersht N, Samandouras G Sci Rep. 2022; 12(1):13258.

PMID: 35918373 PMC: 9345984. DOI: 10.1038/s41598-022-16726-x.

References

Gunjur A, Lau E, Taouk Y, Ryan G . Early post-treatment pseudo-progression amongst glioblastoma multiforme patients treated with radiotherapy and temozolomide: a retrospective analysis. J Med Imaging Radiat Oncol. 2011; 55(6):603-10. DOI: 10.1111/j.1754-9485.2011.02319.x. View

Sugahara T, Korogi Y, Kochi M, Ikushima I, Hirai T, Okuda T . Correlation of MR imaging-determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas. AJR Am J Roentgenol. 1998; 171(6):1479-86. DOI: 10.2214/ajr.171.6.9843274. View

Oh J, Henry R, Pirzkall A, Lu Y, Li X, Catalaa I . Survival analysis in patients with glioblastoma multiforme: predictive value of choline-to-N-acetylaspartate index, apparent diffusion coefficient, and relative cerebral blood volume. J Magn Reson Imaging. 2004; 19(5):546-54. DOI: 10.1002/jmri.20039. View

Hu L, Baxter L, Smith K, Feuerstein B, Karis J, Eschbacher J . Relative cerebral blood volume values to differentiate high-grade glioma recurrence from posttreatment radiation effect: direct correlation between image-guided tissue histopathology and localized dynamic susceptibility-weighted contrast-enhanced.... AJNR Am J Neuroradiol. 2008; 30(3):552-8. PMC: 7051449. DOI: 10.3174/ajnr.A1377. View

Arvinda H, Kesavadas C, Sarma P, Thomas B, Radhakrishnan V, Gupta A . Glioma grading: sensitivity, specificity, positive and negative predictive values of diffusion and perfusion imaging. J Neurooncol. 2009; 94(1):87-96. DOI: 10.1007/s11060-009-9807-6. View

Emblem K, Nedregaard B, Nome T, Due-Tonnessen P, Hald J, Scheie D . Glioma grading by using histogram analysis of blood volume heterogeneity from MR-derived cerebral blood volume maps. Radiology. 2008; 247(3):808-17. DOI: 10.1148/radiol.2473070571. View

Wong E, Jackson E, Hess K, Schomer D, Hazle J, Kyritsis A . Correlation between dynamic MRI and outcome in patients with malignant gliomas. Neurology. 1998; 50(3):777-81. DOI: 10.1212/wnl.50.3.777. View

Law M, Oh S, Babb J, Wang E, Inglese M, Zagzag D . Low-grade gliomas: dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging--prediction of patient clinical response. Radiology. 2006; 238(2):658-67. DOI: 10.1148/radiol.2382042180. View

Tsien C, Galban C, Chenevert T, Johnson T, Hamstra D, Sundgren P . Parametric response map as an imaging biomarker to distinguish progression from pseudoprogression in high-grade glioma. J Clin Oncol. 2010; 28(13):2293-9. PMC: 2860441. DOI: 10.1200/JCO.2009.25.3971. View

10.

Chamberlain M, Glantz M, Chalmers L, Van Horn A, Sloan A . Early necrosis following concurrent Temodar and radiotherapy in patients with glioblastoma. J Neurooncol. 2006; 82(1):81-3. DOI: 10.1007/s11060-006-9241-y. View

11.

Wen P, Macdonald D, Reardon D, Cloughesy T, Sorensen A, Galanis E . Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010; 28(11):1963-72. DOI: 10.1200/JCO.2009.26.3541. View

12.

Brandes A, Franceschi E, Tosoni A, Blatt V, Pession A, Tallini G . MGMT promoter methylation status can predict the incidence and outcome of pseudoprogression after concomitant radiochemotherapy in newly diagnosed glioblastoma patients. J Clin Oncol. 2008; 26(13):2192-7. DOI: 10.1200/JCO.2007.14.8163. View

13.

Cao Y, Nagesh V, Hamstra D, Tsien C, Ross B, Chenevert T . The extent and severity of vascular leakage as evidence of tumor aggressiveness in high-grade gliomas. Cancer Res. 2006; 66(17):8912-7. DOI: 10.1158/0008-5472.CAN-05-4328. View

14.

Kerkhof M, Ganeff I, Wiggenraad R, Lycklama A Nijeholt G, Hammer S, Taphoorn M . Clinical applicability of and changes in perfusion MR imaging in brain metastases after stereotactic radiotherapy. J Neurooncol. 2018; 138(1):133-139. PMC: 5928168. DOI: 10.1007/s11060-018-2779-7. View

15.

de Wit M, de Bruin H, Eijkenboom W, Sillevis Smitt P, van den Bent M . Immediate post-radiotherapy changes in malignant glioma can mimic tumor progression. Neurology. 2004; 63(3):535-7. DOI: 10.1212/01.wnl.0000133398.11870.9a. View

16.

Boxerman J, Ellingson B, Jeyapalan S, Elinzano H, Harris R, Rogg J . Longitudinal DSC-MRI for Distinguishing Tumor Recurrence From Pseudoprogression in Patients With a High-grade Glioma. Am J Clin Oncol. 2014; 40(3):228-234. DOI: 10.1097/COC.0000000000000156. View

17.

Wong E, Hess K, Gleason M, Jaeckle K, Kyritsis A, PRADOS M . Outcomes and prognostic factors in recurrent glioma patients enrolled onto phase II clinical trials. J Clin Oncol. 1999; 17(8):2572-8. DOI: 10.1200/JCO.1999.17.8.2572. View

18.

Lamborn K, Yung W, Chang S, Wen P, Cloughesy T, DeAngelis L . Progression-free survival: an important end point in evaluating therapy for recurrent high-grade gliomas. Neuro Oncol. 2008; 10(2):162-70. PMC: 2613818. DOI: 10.1215/15228517-2007-062. View

19.

Sugahara T, Korogi Y, Tomiguchi S, Shigematsu Y, Ikushima I, Kira T . Posttherapeutic intraaxial brain tumor: the value of perfusion-sensitive contrast-enhanced MR imaging for differentiating tumor recurrence from nonneoplastic contrast-enhancing tissue. AJNR Am J Neuroradiol. 2000; 21(5):901-9. PMC: 7976740. View

20.

Patel P, Baradaran H, Delgado D, Askin G, Christos P, Tsiouris A . MR perfusion-weighted imaging in the evaluation of high-grade gliomas after treatment: a systematic review and meta-analysis. Neuro Oncol. 2016; 19(1):118-127. PMC: 5193025. DOI: 10.1093/neuonc/now148. View