Quantification of edema reduction using differential quantitative T2 (DQT2) relaxometry mapping in recurrent glioblastoma treated with bevacizumab

Ellingson, Benjamin M.; Cloughesy, Timothy F.; Lai, Albert; Nghiemphu, Phioanh L.; Lalezari, Shadi; Zaw, Taryar; Motevalibashinaeini, Kourosh; Mischel, Paul S.; Pope, Whitney B.

doi:10.1007/s11060-011-0638-x

Cited by 67 publications

(54 citation statements)

References 38 publications

(50 reference statements)

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“…[108] The assessment of these changes might benefit from relaxometry mapping. [109] A limitation of this study is the lack of histopathological correlation of the relaxometry measurements in the peritumoral oedema, which makes the findings circumstantial, even though they seem to be in line with other studies showing tumour extension beyond radiological borders in gliomas. [110] The patient cohorts in papers III and IV were relatively small, 19 and 20 respectively, and a higher number of participants would have benefited the analysis.…”

Section: Paper IIsupporting

confidence: 59%

Clinical Applications of Synthetic MRI of the Brain

Blystad¹

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Magnetic Resonance Imaging (MRI) has a high soft-tissue contrast with a high sensitivity for detecting pathological changes in the brain. Conventional MRI is a time-consuming method with multiple scans that relies on the visual assessment of the neuroradiologist. Synthetic MRI uses one scan to produce conventional images, but also quantitative maps based on relaxometry, that can be used to quantitatively analyse tissue properties and pathological changes. The studies presented here apply the use of synthetic MRI of the brain in different clinical settings. In the first study, synthetic MR images were compared to conventional MR images in 22 patients. The contrast, the contrast-to-noise ratio, and the diagnostic quality were assessed. Image quality was perceived to be inferior in the synthetic images, but synthetic images agreed with the clinical diagnoses to the same extent as the conventional images. Patients with early multiple sclerosis were analysed in the second study. In patients with multiple sclerosis, contrast-enhancing white matter lesions are a sign of active disease and can indicate a need for a change in therapy. Gadolinium-based contrast agents are used to detect active lesions, but concern has been raised regarding the long-term effects of repeated use of gadolinium. In this study, relaxometry was used to evaluate whether pre-contrast injection tissue-relaxation rates and proton density can identify active lesions without gadolinium. The findings suggest that active lesions often have relaxation times and proton density that differ from non-enhancing lesions, but with some overlap. This makes it difficult to replace gadolinium-based contrast agent injection with synthetic MRI in the monitoring of MS patients. Malignant gliomas are primary brain tumours with contrast enhancement due to a defective blood-brain barrier. However, they also grow in an infiltrative, diffuse manner, making it difficult to clearly delineate them from surrounding normal brain tissue in the diagnostic workup, at surgery, and during follow-up. The contrast-enhancing part of the tumour is easily visualised, but not the diffuse infiltration. In studies three and four, synthetic MRI was used to analyse the peritumoral area of malignant gliomas, and revealed quantitative findings regarding peritumoral relaxation changes and non-visible contrast enhancement suggestive of non-visible infiltrative tumour growth. In conclusion, synthetic MRI provides quantitative information about the brain tissue and this could improve the diagnosis and treatment for patients

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Section: Paper IIsupporting

confidence: 59%

Clinical Applications of Synthetic MRI of the Brain

Blystad¹

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“…On the other hand, the source of signal abnormality could be anything from radiation effect to that of postoperative gliosis. A quantitative mapping (here it is called T2) engages analysis of individual voxels relaxation time by acquiring T2-weighed images in order to identify tumors and post-operative outcome more specifically [11,12] . We have frequently used these two techniques while analyzing all our MRS results.…”

Section: Age and Sexmentioning

confidence: 99%

Magnetic Resonance Spectroscopy — Revisiting the Imaging Aspects of Brain Tumors

Parida¹

2017

jmscr

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Imaging still remains one of the powerful and non-invasive tools in the field of medicine and biological research. Over time, various imaging tools continue to develop, especially when it comes to the management of brain tumor patients. This research article summarizes the state-of-the art Magnetic Resonance Spectroscopy (MRS) applications in the etiology of brain tumors. In this article, we discuss MR imaging as a tool to diagnose patients with different kinds of brain tumors. This article also discuss the application of MR

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“…Using such a method in 160 patients, Ellingson et al 64 demonstrated improved visualization and quantification of tumour volume that was predictive of overall survival and progression-free survival. Similarly, T2 subtraction mapping has been used to quantify voxel-wise changes, allowing visualization of persistent abnormality in patients that appear improved in conventional imaging 65 .…”

Section: Subtraction Mappingmentioning

confidence: 99%

High-Grade Glioma Management and Response Assessment—Recent Advances and Current Challenges

et al. 2016

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The management of high-grade gliomas (hggs) is complex and ever-evolving. The standard of care for the treatment of hggs consists of surgery, chemotherapy, and radiotherapy. However, treatment options are influenced by multiple factors such as patient age and performance status, extent of tumour resection, biomarker profile, and tumour histology and grade. Follow-up cranial magnetic resonance imaging (mri) to differentiate treatment response from treatment effect can be challenging and affects clinical decision-making. An assortment of advanced radiologic techniques-including perfusion imaging with dynamic susceptibility contrast mri, dynamic contrast-enhanced mri, diffusion-weighted imaging, proton spectroscopy, mri subtraction imaging, and amino acid radiotracer imaging-can now incorporate novel physiologic data, providing new methods to help characterize tumour progression, pseudoprogression, and pseudoresponse. In the present review, we provide an overview of current treatment options for hgg and summarize recent advances and challenges in imaging technology.

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Quantification of edema reduction using differential quantitative T2 (DQT2) relaxometry mapping in recurrent glioblastoma treated with bevacizumab

Cited by 67 publications

References 38 publications

Clinical Applications of Synthetic MRI of the Brain

Clinical Applications of Synthetic MRI of the Brain

Magnetic Resonance Spectroscopy — Revisiting the Imaging Aspects of Brain Tumors

High-Grade Glioma Management and Response Assessment—Recent Advances and Current Challenges

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