MRI and 18FET-PET Predict Survival Benefit from Bevacizumab Plus Radiotherapy in Patients with Isocitrate Dehydrogenase Wild-type Glioblastoma: Results from the Randomized ARTE Trial

Wirsching, Hans-Georg; Roelcke, Ulrich; Weller, Jonathan; Hundsberger, Thomas; Hottinger, Andreas F.; Moos, Roger von; Caparrotti, Francesca; Conen, Katrin; Remonda, Luca; Roth, Patrick; Ochsenbein, Adrian F.; Tabatabai, Ghazaleh

doi:10.1158/1078-0432.ccr-20-2096

Cited by 17 publications

(16 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MRI is indispensable in neuro-oncology practice, yet quantitative, standardized, and robust MRI-based biomarkers are currently sparse ( 16 ). Recent clinical studies demonstrated the potential of MRI in predicting the response to antiangiogenic treatment in pediatric and adult brain tumors ( 48 , 49 ). Quantitative characterization of vascular properties is a common MRI application in the imaging of brain tumors, due to the ability of gadolinium-based contrast agents to penetrate and enhance those tumor regions with a disrupted BBB ( 50 , 51 ).…”

Section: Discussionmentioning

confidence: 99%

Multispectral fluorine-19 MRI enables longitudinal and noninvasive monitoring of tumor-associated macrophages

et al. 2022

View full text Add to dashboard Cite

High-grade gliomas, the most common and aggressive primary brain tumors, are characterized by a complex tumor microenvironment (TME). Among the immune cells infiltrating the glioma TME, tumor-associated microglia and macrophages (TAMs) constitute the major compartment. In patients with gliomas, increased TAM abundance is associated with more aggressive disease. Alterations in TAM phenotypes and functions have been reported in preclinical models of multiple cancers during tumor development and after therapeutic interventions, including radiotherapy and molecular targeted therapies. These findings indicate that it is crucial to evaluate TAM abundance and dynamics over time. Current techniques to quantify TAMs in patients rely mainly on histological staining of tumor biopsies. Although informative, these techniques require an invasive procedure to harvest the tissue sample and typically only result in a snapshot of a small region at a single point in time. Fluorine isotope 19 MRI ( 19 F MRI) represents a powerful means to noninvasively and longitudinally monitor myeloid cells in pathological conditions by intravenously injecting perfluorocarbon-containing nanoparticles (PFC-NP). In this study, we demonstrated the feasibility and power of 19 F MRI in preclinical models of gliomagenesis, breast-to-brain metastasis, and breast cancer and showed that the major cellular source of 19 F signal consists of TAMs. Moreover, multispectral 19 F MRI with two different PFC-NP allowed us to identify spatially and temporally distinct TAM niches in radiotherapy-recurrent murine gliomas. Together, we have imaged TAMs noninvasively and longitudinally with integrated cellular, spatial, and temporal resolution, thus revealing important biological insights into the critical functions of TAMs, including in disease recurrence.

show abstract

Section: Discussionmentioning

confidence: 99%

Multispectral fluorine-19 MRI enables longitudinal and noninvasive monitoring of tumor-associated macrophages

et al. 2022

View full text Add to dashboard Cite

show abstract

“…AA PET has been reported as a potentially viable adjunct in analyzing pseudoresponse. As a prognostication tool in the context of pseudoresponse, AA PET shows promise with existing evidence showing that persistent 18 FET-PET signal on NCE tumor during bevacizumab treatment is predictive of a significant decrease in OS ( Wirsching et al, 2021 ).…”

Section: Imaging To Assess For Pseudoresponse Following Immunotherapymentioning

confidence: 99%

Advanced Imaging Techniques for Newly Diagnosed and Recurrent Gliomas

Carrete

Young

2022

Front. Neurosci.

View full text Add to dashboard Cite

Management of gliomas following initial diagnosis requires thoughtful presurgical planning followed by regular imaging to monitor treatment response and survey for new tumor growth. Traditional MR imaging modalities such as T1 post-contrast and T2-weighted sequences have long been a staple of tumor diagnosis, surgical planning, and post-treatment surveillance. While these sequences remain integral in the management of gliomas, advances in imaging techniques have allowed for a more detailed characterization of tumor characteristics. Advanced MR sequences such as perfusion, diffusion, and susceptibility weighted imaging, as well as PET scans have emerged as valuable tools to inform clinical decision making and provide a non-invasive way to help distinguish between tumor recurrence and pseudoprogression. Furthermore, these advances in imaging have extended to the operating room and assist in making surgical resections safer. Nevertheless, surgery, chemotherapy, and radiation treatment continue to make the interpretation of MR changes difficult for glioma patients. As analytics and machine learning techniques improve, radiomics offers the potential to be more quantitative and personalized in the interpretation of imaging data for gliomas. In this review, we describe the role of these newer imaging modalities during the different stages of management for patients with gliomas, focusing on the pre-operative, post-operative, and surveillance periods. Finally, we discuss radiomics as a means of promoting personalized patient care in the future.

show abstract

“…The prognostic performance of perfusion MRI parameters (DSC and DCE) and ADC values has been documented in patients with newly diagnosed and recurrent glioblastomas. [24][25][26][27][28] As a prognostic factor from different viewpoints, Schob et al reported that ADC histogram parameters were strongly correlated with the expression of the proliferation marker, Ki-67, and total nuclear area of MB. 29 However, for both PA and MB, the presence or absence of correlations between these MRI parameters and survival prognosis is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…Another important role of MRI is its prognostication. The prognostic performance of perfusion MRI parameters (DSC and DCE) and ADC values has been documented in patients with newly diagnosed and recurrent glioblastomas 24–28 . As a prognostic factor from different viewpoints, Schob et al.…”

Section: Introductionmentioning

confidence: 99%

Dynamic susceptibility contrast and diffusion‐weighted MRI in posterior fossa pilocytic astrocytoma and medulloblastoma

Kurokawa

Umemura

Capizzano

et al. 2022

Journal of Neuroimaging

View full text Add to dashboard Cite

Background and Purpose The utility of perfusion MRI in distinguishing between pilocytic astrocytoma (PA) and medulloblastoma (MB) is unclear. This study aimed to evaluate the diagnostic and prognostic performance of dynamic susceptibility contrast (DSC)‐MRI parameters and apparent diffusion coefficient (ADC) values between PA and MB. Methods Between January 2012 and August 2021, 49 (median, 7 years [range, 1‐28 years]; 28 females) and 35 (median, 8 years [1‐24 years]; 12 females) patients with pathologically confirmed PA and MB, respectively, were included. The normalized relative cerebral blood volume and flow (nrCBV and nrCBF) and mean and minimal normalized ADC (nADCmean and nADCmin) values were calculated using volume‐of‐interest analyses. Diagnostic performance and Pearson's correlation with progression‐free survival were also evaluated. Results The MB group showed a significantly higher nrCBV and nrCBF (nrCBV: 1.69 [0.93‐4.23] vs. 0.95 [range, 0.37‐2.28], p = .0032; nrCBF: 1.62 [0.93‐3.16] vs. 1.07 [0.46‐2.26], p = .0084) and significantly lower nADCmean and nADCmin (nADCmean: 0.97 [0.70‐1.68] vs. 2.21 [1.44‐2.80], p < .001; nADCmin: 0.50 [0.19‐0.89] vs. 1.42 [0.89‐2.20], p < .001) than the PA group. All parameters exhibited good diagnostic ability (accuracy >0.80) with nADCmin achieving the highest score (accuracy = 1). A moderate correlation was found between nADCmean and progression‐free survival for MB (r = 0.44, p = .0084). Conclusions DSC‐MRI parameters and ADC values were useful for distinguishing between PA and MB. A lower ADC indicated an unfavorable MB prognosis, but the DSC‐MRI parameters did not correlate with progression‐free survival in either group.

show abstract

MRI and 18FET-PET Predict Survival Benefit from Bevacizumab Plus Radiotherapy in Patients with Isocitrate Dehydrogenase Wild-type Glioblastoma: Results from the Randomized ARTE Trial

Cited by 17 publications

References 50 publications

Multispectral fluorine-19 MRI enables longitudinal and noninvasive monitoring of tumor-associated macrophages

Multispectral fluorine-19 MRI enables longitudinal and noninvasive monitoring of tumor-associated macrophages

Advanced Imaging Techniques for Newly Diagnosed and Recurrent Gliomas

Dynamic susceptibility contrast and diffusion‐weighted MRI in posterior fossa pilocytic astrocytoma and medulloblastoma

Contact Info

Product

Resources

About