Aims and objectives
Glioblastoma nowadays is still one of the most malignant brain tumors with low median overall survival of 14-18 months . Standart treatment is surgery followed by chemoradiation.
Evaluation of tumor progressionon MRI is often made with RANO Criteria based on measurements of tumor size on contrast-enhanced T1W. However,
with advanced techniques there are options to measure tumor perfusion characteristics with DSC,
DCE or ASL techniques,
tumor cellularity with DWI,
vascular architecture with...
Methods and materials
63 patients with postoperative glioblastoma (GB) were examined on 1.5T-MRI with multiparametric protocol before the radiotherapy (RT),
after 1 month,
3 months and 6 months after completing radiotherapy course.
Protocol included T2W,
DSC-perfusion and contrast-enhanced 3DT1W. Invasion of CP was concluded by detection of feeding arteries and drainage veins on SWI and contrast-enhanced T1W as well as hyperperfusion in the region of interest by ASL and DSC perfusion...
Among 63 patients 42 (66.7%) showed progressive disease and 21 (33.3%) were stable or showed partial response in 6-months period after competing chemoradiation.
Data optained within 1 month and 3 months after postoperative treatment showed similar results. Patients with invaded CP showed progression after therapy in 80.8% cases while patients without invasion of CP - in 56.6%.
The sensitivity and specificity of method were 0.50 and 0.76,
but the positive predictive value showed 80.8%...
With achieved data we consider that invasion of CP by GB could be named as one of the risk factor of early GB progression and expect that possible additional antiangiogenic chemotherapy or other treatment options could be selected to improve the treatment results. Therefore,
further studies are needed to clarify that point.
Mason WP et al (2009) Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial.
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Ziegelitz D et al (2010) Changes in relative cerebral blood volume 1 month after radiation-temozolomide therapy can help predict overall survival in patients with glioblastoma.