Differentiation between Brain Glioblastoma Multiforme and Solitary Metastasis: Qualitative and Quantitative Analysis Based on Routine MR Imaging

Chen, X.Z.; Yin, Xiaoming; Lin, Aiming; Chen, Q.; Li, S.W.; Dai, Jianping

doi:10.3174/ajnr.a3106

Cited by 37 publications

(33 citation statements)

References 29 publications

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“…The numerical values for tumor ADC are in line with previous investigations of cerebral metastases which would be expected given the standard methods and protocols used for imaging and analysis [6,7,10,13,14,22,23]. We used a variety of methods of taking measurements from the ADC maps so as not to miss an effect due to our measurement technique.…”

Section: Discussionsupporting

confidence: 61%

Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes

et al. 2014

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BackgroundDiffusion-weighted MRI (DWI) has been used in neurosurgical practice mainly to distinguish cerebral metastases from abscess and glioma. There is evidence from other solid organ cancers and metastases that DWI may be used as a biomarker of prognosis and treatment response. We therefore investigated DWI characteristics of cerebral metastases and their peritumoral region recorded pre-operatively and related these to patient outcomes.MethodsRetrospective analysis of 76 cases operated upon at a single institution with DWI performed pre-operatively at 1.5T. Maps of apparent diffusion coefficient (ADC) were generated using standard protocols. Readings were taken from the tumor, peritumoral region and across the brain-tumor interface. Patient outcomes were overall survival and time to local recurrence.ResultsA minimum ADC greater than 919.4 × 10-6 mm2/s within a metastasis predicted longer overall survival regardless of adjuvant therapies. This was not simply due to differences between the types of primary cancer because the effect was observed even in a subgroup of 36 patients with the same primary, non-small cell lung cancer. The change in diffusion across the tumor border and into peritumoral brain was measured by the “ADC transition coefficient” or ATC and this was more strongly predictive than ADC readings alone. Metastases with a sharp change in diffusion across their border (ATC >0.279) showed shorter overall survival compared to those with a more diffuse edge. The ATC was the only imaging measurement which independently predicted overall survival in multivariate analysis (hazard ratio 0.54, 95% CI 0.3 – 0.97, p = 0.04).ConclusionsDWI demonstrates changes in the tumor, across the tumor edge and in the peritumoral region which may not be visible on conventional MRI and this may be useful in predicting patient outcomes for operated cerebral metastases.

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Section: Discussionsupporting

confidence: 61%

Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes

et al. 2014

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“…GBM typically presents with both gadolinium-enhancement, as visible by T1-weighted MRI with contrast, and significant peritumoral edema, as seen by T2-weighted imaging [52][53][54]. Tumor response and relapse have historically been detected following the same criteria.…”

Section: Discussionmentioning

confidence: 99%

“…The GL261-Quad cell line is engineered to express the model antigens human gp100 [25][26][27][28][29][30][31][32][33] , chicken OVA 257-264 , chicken OVA [323][324][325][326][327][328][329][330][331][332][333][334][335][336][337][338][339] , and mouse alloantigen I-Ea [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] . Female 6-8-week-old C57BL/6 mice (The Jackson Laboratory, Bar Harbor, ME, USA) were inoculated by stereotactic injection of 6.0×10 4 -1.0×10 5 GL261 or GL261-Quad cells into the right striatum.…”

Section: Gl261 Tumor Implantationmentioning

confidence: 99%

Improved Treatment Efficacy of Antiangiogenic Therapy when Combined with Picornavirus Vaccination in the GL261 Glioma Model

et al. 2016

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The addition of antiangiogenic therapy to the standard-of-care treatment regimen for recurring glioblastoma has provided some clinical benefits while also delineating numerous caveats, prompting evaluation of the elicited alterations to the tumor microenvironment. Of critical importance, given the steadily increasing incorporation of immunotherapeutic approaches clinically, is an enhanced understanding of the interplay between angiogenic and immune response pathways within tumors. In the present study, the GL261 glioma mouse model was used to determine the effects of antiangiogenic treatment in an immune-competent host. Following weekly systemic administration of aflibercept, an inhibitor of vascular endothelial growth factor, tumor volume was assessed by magnetic resonance imaging and changes to the tumor microenvironment were determined. Treatment with aflibercept resulted in reduced tumor burden and increased survival compared with controls. Additionally, decreased vascular permeability and preservation of the integrity of tight junction proteins were observed. Treated tumors also displayed hallmarks of anti-angiogenic evasion, including marked upregulation of vascular endothelial growth factor expression and increased tumor invasiveness. Aflibercept was then administered in combination with a picornavirusbased antitumor vaccine and tumor progression was evaluated. This combination therapy significantly delayed tumor progression and extended survival beyond that observed for either therapy alone. As such, this work demonstrates the efficacy of combined antiangiogenic and immunotherapy approaches for treating established gliomas and provides a foundation for further evaluation of the effects of antiangiogenic therapy in the context of endogenous or vaccine-induced inflammatory responses.

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“…Moreover, lower classification rates (60-F o r P e e r R e v i e w 6 80%) or <0.8 average AUC were reported to distinguish GBM and MET in other previous studies (13,14,16,17,(22)(23)(24)(25).…”

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confidence: 99%

Morphometric model for discrimination between glioblastoma multiforme and solitary metastasis using three‐dimensional shape analysis

Yang

Jones

Howe

et al. 2015

Magnetic Resonance in Med

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Purpose: Glioblastoma multiforme (GBM) and brain metastasis (MET) are the most common intra-axial brain neoplasms in adults and often pose a diagnostic dilemma using standard clinical MRI. These tumor types require different oncological and surgical management, which subsequently influence prognosis and clinical outcome. Methods: Here, we hypothesize that GBM and MET possess different three-dimensional (3D) morphological attributes based on their physical characteristics. A 3D morphological analysis was applied on the tumor surface defined by our diffusion tensor imaging (DTI) segmentation technique. It segments the DTI data into clusters representing different isotropic and anisotropic water diffusion characteristics, from which a distinct surface boundary between healthy and pathological tissue was identified. Morphometric features of shape index and curvedness were then computed for each tumor surface and used to build a morphometric model of GBM and MET pathology with the goal of developing a tumor classification method based on shape characteristics. Results: Our 3D morphometric method was applied on 48 untreated brain tumor patients. Cross-validation resulted in a 95.8% accuracy classification with only two shape features needed and that can be objectively derived from quantitative imaging methods. Conclusion: The proposed 3D morphometric analysis framework can be applied to distinguish GBMs from solitary METs

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Differentiation between Brain Glioblastoma Multiforme and Solitary Metastasis: Qualitative and Quantitative Analysis Based on Routine MR Imaging

Abstract: BACKGROUND AND PURPOSE:The differentiation between cerebral GBM and solitary MET is clinically important and may be radiologically challenging. Our hypothesis is that routine MR imaging with qualitative and quantitative analysis is helpful for this differentiation.

Cited by 37 publications

References 29 publications

Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes

Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes

Improved Treatment Efficacy of Antiangiogenic Therapy when Combined with Picornavirus Vaccination in the GL261 Glioma Model

Morphometric model for discrimination between glioblastoma multiforme and solitary metastasis using three‐dimensional shape analysis

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