Advanced Magnetic Resonance Imaging in Glioblastoma: A Review

Shukla, Gaurav; Alexander, Gregory S.; Bakas, Spyridon; Nikam, Rahul; Talekar, Kiran; Palmer, Joshua D.; Shi, Wenyin

doi:10.29046/jhnj.013.1.005

Cited by 30 publications

(38 citation statements)

References 36 publications

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“…Radiosensitization using Gd-based NPs in GBM is attractive because Gd-based NPs can be used as an MRI contrast agent, and MRI is the image of choice for the management of GBM [101]. Activation and Guidance of Irradiation by X-ray (AGuIX) are theranostic NPs that can be used as a radiosensitizers and contrast agents for MRI.…”

Section: Gd-based Nanoparticlesmentioning

confidence: 99%

Radiosensitizing high-Z metal nanoparticles for enhanced radiotherapy of glioblastoma multiforme

et al. 2020

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Radiotherapy is an essential step during the treatment of glioblastoma multiforme (GBM), one of the most lethal malignancies. The survival in patients with GBM was improved by the current standard of care for GBM established in 2005 but has stagnated since then. Since GBM is a radioresistant malignancy and the most of GBM recurrences occur in the radiotherapy field, increasing the effectiveness of radiotherapy using high-Z metal nanoparticles (NPs) has recently attracted attention. This review summarizes the progress in radiotherapy approaches for the current treatment of GBM, the physical and biological mechanisms of radiosensitization through high-Z metal NPs, and the results of studies on radiosensitization in the in vitro and in vivo GBM models using high-Z metal NPs to date.

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Section: Gd-based Nanoparticlesmentioning

confidence: 99%

Radiosensitizing high-Z metal nanoparticles for enhanced radiotherapy of glioblastoma multiforme

et al. 2020

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“…Among MR images, the tumor region enhanced by gadolinium in T1-weighted (T1W) contrast-enhanced (CE) sequence is regarded as the wellperfused region with high density of tumor cell (8), which is useful in evaluating GBM heterogeneity (9). Besides the T1W-CE sequence, the T1W, T2-weighted (T2W), and FLAIR sequences are also recommended for the diagnosis of brain tumors (10,11), suggesting their bright prospects in comprehensive evaluation of GBM heterogeneity (12,13).…”

Section: Introductionmentioning

confidence: 99%

“…Currently, texture analysis on enhanced regions of T1W-CE images has been used to evaluate GBM heterogeneity (9) and its impact on survival time, with an approximate accuracy of 80% for the survival stratification (7). Considering the diagnostic value of multimodal MR images in GBM (10), texture features derived from other sequences, such as T1W, T2W, and FLAIR, would be beneficial for the evaluation of GBM heterogeneity and survival stratification. However, when evaluating GBM heterogeneity and its effect on survival stratification using multimodal images, which sequence is the most effective and whether their combinations can improve the performance are still unknown.…”

Section: Introductionmentioning

confidence: 99%

The effect of glioblastoma heterogeneity on survival stratification: a multimodal MR imaging texture analysis

et al. 2018

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Background Quantitative evaluation of the effect of glioblastoma (GBM) heterogeneity on survival stratification would be critical for the diagnosis, treatment decision, and follow-up management. Purpose To evaluate the effect of GBM heterogeneity on survival stratification, using texture analysis on multimodal magnetic resonance (MR) imaging. Material and Methods A total of 119 GBM patients (65 in long-term and 54 in short-term survival group, separated by overall survival of 12 months) were selected from the Cancer Genome Atlas, who underwent the T1-weighted (T1W) contrast-enhanced (CE), T1W, T2-weighted (T2W), and FLAIR sequences. For each sequence, the co-occurrence matrix, run-length matrix, and histogram features were extracted to reflect GBM heterogeneity on different scale. The recursive feature elimination based support vector machine was adopted to find an optimal subset. Then the stratification performance of four MR sequences was evaluated, both alone and in combination. Results When each sequence used alone, the T1W-CE sequence performed best, with an area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity of 0.7915, 80.67%, 78.45%, and 83.33%, respectively. When the four sequences combined, the stratification performance was basically equal to that of T1W-CE sequence. In the optimal subset of features extracted from multimodality, those from the T2W sequence weighted the most. Conclusion All the four sequences could reflect heterogeneous distribution of GBM and thereby affect the survival stratification, especially T1W-CE and T2W sequences. However, the stratification performance using only the T1W-CE sequence can be preserved with omission of other three sequences, when investigating the effect of GBM heterogeneity on survival stratification.

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“…12 A hallmark feature of GBM on magnetic resonance imaging (MRI) is the presence of two contrasting regions composed of a central necrotic zone encompassed by a leading edge of mobile, rapidly proliferating tumor cells. 13 This thinlayer of cells, migrating away from the necrotic core, are commonly referred to as "pseudo palisades," and are a wellknown feature of GBM. 14 This pattern is felt to arise from a prothrombotic environment within the tumor that ultimately promotes the development of a systemic hypercoagulable state.…”

Section: Discussionmentioning

confidence: 99%

Successful Free Tissue Transfer in the Profoundly Hypercoagulable Glioblastoma Multiforme Patient: Surgical Experience and Anticoagulation Protocol

Niziol

Doval

Jalalabadi

et al. 2020

Journal of Reconstructive Microsurgery Open

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Background Glioblastoma multiforme (GBM) produces a hypercoagulable environment and is associated the highest rates of deep venous thrombosis (DVT) and pulmonary emboli (PE) of any malignancy. The use of postoperative radiation in this generally compromised patient group is associated with the development of complex scalp wounds. Free tissue transfer reconstruction will be essential in selected cases despite the presence of an underlying hypercoagulable state. Methods A 67-year-old female with a history of previous DVT presented with osteoradionecrosis and infected scalp wound following GBM treatment. She underwent reconstruction with a free vastus lateralis flap and skin graft. Initial anticoagulation was provided with intravenous heparin and transitioned to oral apixaban. Wound cultures demonstrated coagulase-negative Staphylococcus, Actinomyces neuii, and Peptoniphilus harei and were treated with a 6-week course of intravenous cefepime and vancomycin. Results Despite the initial failure of a local scalp rotation flap, successful wound healing was achieved with a free muscle flap and a course of culture specific antibiotics. The patient succumbed to recurrent disease 22 months after surgery, underscoring the importance of limiting hospitalization and maximizing quality of life in this group of patients. Conclusion Free tissue transfer can be successfully achieved in the hypercoagulable GBM patient. Heparin and apixaban were employed successfully in the prevention of thrombotic events. Antiplatelet therapy should also be considered to counteract platelet aggregation induced by the transmembrane glycoprotein (podoplanin) that is expressed on GBM tumor cells. Enzyme-linked immunosorbent assay testing (ELISA) of blood soluble podoplanin may help determine the degree of hypercoagulability and guide therapy.

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Advanced Magnetic Resonance Imaging in Glioblastoma: A Review

Cited by 30 publications

References 36 publications

Radiosensitizing high-Z metal nanoparticles for enhanced radiotherapy of glioblastoma multiforme

Radiosensitizing high-Z metal nanoparticles for enhanced radiotherapy of glioblastoma multiforme

The effect of glioblastoma heterogeneity on survival stratification: a multimodal MR imaging texture analysis

Successful Free Tissue Transfer in the Profoundly Hypercoagulable Glioblastoma Multiforme Patient: Surgical Experience and Anticoagulation Protocol

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