Imaging modalities in high-grade gliomas: Pseudoprogression, recurrence, or necrosis?

Caroline, Isabelle; Rosenthal, MA

doi:10.1016/j.jocn.2011.10.003

Cited by 45 publications

(27 citation statements)

References 39 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 However, during the treatment, subacute treatment-related reactions called pseudoprogression frequently occur as edema and contrast enhancement on MR imaging. [2][3][4][5] Pseudoprogression is most commonly seen on the first MR imaging performed within 2 months after CCRT. Tumors with hypermethylation of the O 6 -methylguanine-DNA methyltransferase promoter gene show pseudoprogression more frequently.…”

mentioning

confidence: 99%

Differentiation of Tumor Progression from Pseudoprogression in Patients with Posttreatment Glioblastoma Using Multiparametric Histogram Analysis

Cha¹,

Kim²,

Kim³

et al. 2014

AJNR Am J Neuroradiol

105

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE:The multiparametric imaging can show us different aspects of tumor behavior and may help differentiation of tumor recurrence from treatment related change. Our aim was to differentiate tumor progression from pseudoprogression in patients with glioblastoma by using multiparametric histogram analysis of 2 consecutive MR imaging studies with relative cerebral blood volume and ADC values.

show abstract

mentioning

confidence: 99%

Differentiation of Tumor Progression from Pseudoprogression in Patients with Posttreatment Glioblastoma Using Multiparametric Histogram Analysis

Cha¹,

Kim²,

Kim³

et al. 2014

AJNR Am J Neuroradiol

105

View full text Add to dashboard Cite

show abstract

“…The latter was not shown in RN (51,52). In the literature, 18 F-FDG PET has been found to be of only moderate additional value to MRI for differentiation between glioma recurrence and RN, especially due to low specificity (6,21,28,30,48,53,54). A potentially useful approach for …”

Section: Pet For Therapy Response Assessment In Gbmentioning

confidence: 99%

PET for Therapy Response Assessment in Glioblastoma

et al. 2017

View full text Add to dashboard Cite

Glioblastoma (GB) is the most malignant and the most common type of glioma in adults, accounting for 60-70% of all malignant gliomas. Despite the current therapy, the clinical course of GB is usually rapid, with a mean survival time of approximately 1 year. For therapy response assessment in GB, magnetic resonance imaging (MRI) is the method of choice. In 2010, the Response Assessment in Neuro-Oncology (RANO) was introduced, including the tumor size (in 2D) as measured on T2-weighted and Fluid Attenuated Inversion Recovery (FLAIR)-weighted images, in addition to the contrast-enhancing tumor part. Although the RANO criteria addressed some of the limitations of the previous MacDonald criteria for therapy evaluation in high-grade glioma, treatment-related side effects hamper correct response assessment. To address the above-mentioned drawbacks in the follow-up of GB, incorporating changes in tumor biology measured by advanced MRI and positron emission tomography (PET) imaging, which may precede anatomical changes of the tumor volume, is promising. Imaging biomarkers capable of predicting response at an early time point after treatment initiation are the premise of personalized treatment enabling change or GB Treatment Response Using PET 176 discontinuation of therapy to prevent ineffective treatment or adverse events of treatment. In this chapter, an overview of applicable PET tracers for the therapy response assessment in GB and the determination of tumor recurrence versus treatment-related effects is given.

show abstract

“…3 Magnetic resonance spectroscopy appears to be more sensitive (89-100%) months following RT but more specific (100%) if performed six weeks after RT. 4 Positron emission tomography with 18F-fluorodeoxyglucose (FDG) was found to low cumulative sensitivity (70%) and specificity (65%) in four studies (n=33) and is not recommended to reliably differentiate TPR and RN by Shah et al 3 Novel tracers have produced encouraging results. Amino acid tracers are particularly useful due to high uptake in proliferating tumors but not surrounding normal brain or RN.…”

Section: Diagnostic Challenges Of Radiation Necrosismentioning

confidence: 99%

“…Several reviews of the use of MRI, magnetic resonance spectroscopy (MRS), positron emission tomography (PET) and single photon emission CT (SPECT) in this setting have been recently published for patients with glioma. [3][4][5] Shah et al systematically reviewed 17 studies (7 prospective, 10 retrospective) published between 2007 and 2012. 3 Histology or clinical/radiological follow-up confirmed TPR in 282 cases (69%) and RN in 100 cases (24%).…”

mentioning

confidence: 99%

Diagnostic Challenges of Radiation Necrosis

Patel¹,

Mehta²

2013

Can. J. Neurol. Sci.

View full text Add to dashboard Cite

Radiation necrosis (RN) may closely mimic tumor progression or recurrence (TPR) in its clinical presentation and imaging findings in brain tumor patients. In this issue, Korchi et al describe imaging appearances of five consecutive cases of RN from 73 skull-based tumors treated with proton-beam radiotherapy (RT) in Switzerland. 1 An important feature of this study is the selection of patients with extra-axial tumors that tend to recur locally. As such, intra-axial lesions detected following RT more likely represent radiation injury rather than TPR-an interesting model to study imaging findings of RN. Their findings are concordant with those seen with photon RT suggesting that the process of RN may be partly independent of underlying pathology and radiation modality. This study, however, does not help us understand how to distinguish these lesions from TPR.Although challenging, differentiating TPR from RN is becoming more relevant with increasing availability of newer targeted therapies and salvage RT for TPR. Conversely, patients that are accurately diagnosed with RN may not only be treated conservatively with steroids, but also offered hyperbaric oxygen or bevacizumab in refractory cases. A recent double-blinded randomized controlled trial showed improvement in neurological symptoms or signs in all bevacizumab-treated patients with RN. 2 Although surgical resection has been the historical gold standard for diagnosis, non-invasive techniques have become increasingly preferred. Several reviews of the use of MRI, magnetic resonance spectroscopy (MRS), positron emission tomography (PET) and single photon emission CT (SPECT) in this setting have been recently published for patients with glioma. [3][4][5] Shah et al systematically reviewed 17 studies (7 prospective, 10 retrospective) published between 2007 and 2012. 3 Histology or clinical/radiological follow-up confirmed TPR in 282 cases (69%) and RN in 100 cases (24%). Discovery of the recurrent lesion was most often by MRI, and at a mean interval of 13.2 months following RT. Two studies (n=104) of standard MRI protocols comparing lesion enhancement to the contralateral hemisphere demonstrate a cumulative sensitivity of 89% but poor specificity of 33%, indicating that MRI alone appears insufficient for reliably differentiating TPR from RN.Specialized protocols may improve performance of MRI. Dynamic susceptibility contrast enhanced (DCE) perfusion MRI measures relative cerebral blood volume (rCBV). Radiation necrosis shows low perfusion, whereas the high metabolic activity and angiogenesis of TPR results in high rCBV. Pseudoresponse from bevacizumab, an antiangiogenic agent used in the management of glioblastoma, may limit interpretability of perfusion MRI. Six studies (n=136) measuring rCBV within the lesion yield cumulative sensitivity and specificity of 80% and 77%, respectively. Diagnostic Challenges of Radiation NecrosisCan J Neurol Sci. 2013; 40: 763-764 EDITORIAL weighted imaging (DWI) allows the microscopic diffusion of water molecules to be quantified in ...

show abstract

Imaging modalities in high-grade gliomas: Pseudoprogression, recurrence, or necrosis?

Cited by 45 publications

References 39 publications

Differentiation of Tumor Progression from Pseudoprogression in Patients with Posttreatment Glioblastoma Using Multiparametric Histogram Analysis

Differentiation of Tumor Progression from Pseudoprogression in Patients with Posttreatment Glioblastoma Using Multiparametric Histogram Analysis

PET for Therapy Response Assessment in Glioblastoma

Diagnostic Challenges of Radiation Necrosis

Contact Info

Product

Resources

About