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Parametric Response Map As an Imaging Biomarker to Distinguish Progression From Pseudoprogression in High-Grade Glioma
Open accessAbstract
Purpose: To assess whether a new method of quantifying therapy-associated hemodynamic alterations may help to distinguish pseudoprogression from true progression in patients with high-grade glioma. Patients and Methods: Patients with high-grade glioma received concurrent chemoradiotherapy. Relative cerebral blood volume (rCBV) and blood flow (rCBF) maps were acquired before chemoradiotherapy and at week 3 during treatment on a prospective institutional review board–approved study. Pseudoprogression was defined as imaging changes 1 to 3 months after chemoradiotherapy that mimic tumor progression but stabilized or improved without change in treatment or for which resection revealed radiation effects only. Clinical and conventional magnetic resonance (MR) parameters, including average percent change of rCBV and CBF, were evaluated as potential predictors of pseudoprogression. Parametric response map (PRM), an innovative, voxel-by-voxel method of image analysis, was also performed. Results: Median radiation dose was 72 Gy (range, 60 to 78 Gy). Of 27 patients, stable disease/partial response was noted in 13 patients and apparent progression was noted in 14 patients. Adjuvant temozolomide was continued in all patients. Pseudoprogression occurred in six patients. Based on PRM analysis, a significantly reduced blood volume (PRM rCBV ) at week 3 was noted in patients with progressive disease as compared with those with pseudoprogression (P < .01). In contrast, change in average percent rCBV or rCBF, MR tumor volume changes, age, extent of resection, and Radiation Therapy Oncology Group recursive partitioning analysis classification did not distinguish progression from pseudoprogression. Conclusion: PRM rCBV at week 3 during chemoradiotherapy is a potential early imaging biomarker of response that may be helpful in distinguishing pseudoprogression from true progression in patients with high-grade glioma.
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Cites
Radiotherapy Plus Concomitant and Adjuvant Temozolomide for Glioblastoma
Stupp, R., Mason, W. P., van den Bent, M. J., Weller, M., Fisher, B., Taphoorn, M. J. B., Belanger, K., Brandes, A. A., Marosi, C., Bogdahn, U., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043330 · Cited by 21,807
Response criteria for phase II studies of supratentorial malignant glioma.
Macdonald, D. R., Cascino, T. L., Schold, S. C., & Cairncross, J. G. (1990) · Journal of Clinical Oncology · doi:10.1200/jco.1990.8.7.1277 · Cited by 2,409
Cited by
Protein typing of circulating microvesicles allows real-time monitoring of glioblastoma therapy
Shao, H., Chung, J., Balaj, L., Charest, A., Bigner, D. D., Carter, B. S., Hochberg, F. H., Breakefield, X. O., Weissleder, R., & Lee, H. (2012) · Nature Medicine · doi:10.1038/nm.2994 · Cited by 759
Metadata
- Authors
- Tsien, C., Galbán, C. J., Chenevert, T. L., Johnson, T. D., Hamstra, D. A., Sundgren, P. C., Junck, L., Meyer, C. R., Rehemtulla, A., Lawrence, T., & Ross, B. D.
- Venue
- Journal of Clinical Oncology
- Published
- 2010-05-01
- Volume
- 28
- Issue
- 13
- Pages
- 2293-2299
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2097181552
- Cited by
- 214
- References
- 2
- FWCI
- 8.42
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Tsien, C., Galbán, C. J., Chenevert, T. L., Johnson, T. D., Hamstra, D. A., Sundgren, P. C., Junck, L., Meyer, C. R., Rehemtulla, A., Lawrence, T., & Ross, B. D. (2010). Parametric Response Map As an Imaging Biomarker to Distinguish Progression From Pseudoprogression in High-Grade Glioma. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2009.25.3971
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