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Roques M, Catalaa I, Raveneau M, Attal J, Siegfried A, Darcourt J, Cognard C, de Champfleur NM, Bonneville F. Assessment of the hypervascularized fraction of glioblastomas using a volume analysis of dynamic susceptibility contrast-enhanced MRI may help to identify pseudoprogression. PLoS One 2022; 17:e0270216. [PMID: 36227862 PMCID: PMC9560146 DOI: 10.1371/journal.pone.0270216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 06/07/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Although perfusion magnetic resonance imaging (MRI) is widely used to identify pseudoprogression, this advanced technique lacks clinical reliability. Our aim was to develop a parameter assessing the hypervascularized fraction of glioblastomas based on volume analysis of dynamic susceptibility contrast-enhanced MRI and evaluate its performance in the diagnosis of pseudoprogression. METHODS Patients with primary glioblastoma showing lesion progression on the first follow-up MRI after chemoradiotherapy were enrolled retrospectively. On both initial and first follow-up MRIs, the leakage-corrected cerebral blood volume (CBV) maps were post-processed using the conventional hot-spot method and a volume method, after manual segmentation of the contrast-enhanced delineated lesion. The maximum CBV (rCBVmax) was calculated with both methods. Secondly, the threshold of 2 was applied to the CBV values contained in the entire segmented volume, defining our new parameter: %rCBV>2. The probability of pseudoprogression based on rCBVmax and %rCBV>2 was calculated in logistic regression models and diagnostic performance assessed by receiving operator characteristic curves. RESULTS Out of 25 patients, 11 (44%) were classified with pseudoprogression and 14 (56%) with true progression based on the Response Assessement in Neuro-Oncology criteria. rCBVmax was lower for pseudoprogression (3.4 vs. 7.6; p = 0.033) on early follow-up MRI. %rCBV>2, was lower for pseudoprogression on both initial (57.5% vs. 71.3%; p = 0.033) and early follow-up MRIs (22.1% vs. 51.8%; p = 0.0006). On early follow-up MRI, %rCBV>2 had the largest area under the curve for the diagnosis of pseudoprogression: 0.909 [0.725-0.986]. CONCLUSION The fraction of hypervascularization of glioblastomas as assessed by %rCBV>2 was lower in tumours that subsequently developed pseudoprogression both on the initial and early follow-up MRIs. This fractional parameter may help identify pseudoprogression with greater accuracy than rCBVmax.
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Affiliation(s)
- Margaux Roques
- Department of Neuroradiology, Toulouse Hospital, Toulouse, France
- * E-mail:
| | - Isabelle Catalaa
- Department of Neuroradiology, Toulouse Hospital, Toulouse, France
| | - Magali Raveneau
- Department of Neuroradiology, Toulouse Hospital, Toulouse, France
| | - Justine Attal
- Department of Radiotherapy, IUCT Toulouse (Toulouse University Cancer Institute), Toulouse, France
| | | | - Jean Darcourt
- Department of Neuroradiology, Toulouse Hospital, Toulouse, France
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Dissaux G, Dissaux B, Kabbaj OE, Gujral DM, Pradier O, Salaün PY, Seizeur R, Bourhis D, Ben Salem D, Querellou S, Schick U. Radiotherapy target volume definition in newly diagnosed high grade glioma using 18F-FET PET imaging and multiparametric perfusion MRI: A prospective study (IMAGG). Radiother Oncol 2020; 150:164-171. [PMID: 32580001 DOI: 10.1016/j.radonc.2020.06.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE The aim of this study was to prospectively investigate tumor volume delineation by amino acid PET and multiparametric perfusion magnetic resonance imaging (MRI) in patients with newly diagnosed, untreated high grade glioma (HGG). MATERIALS AND METHODS Thirty patients with histologically confirmed HGG underwent O-(2-[18F]-fluoroethyl)-l-tyrosine (18F-FET) positron emission tomography (PET), conventional Magnetic Resonance Imaging (MRI) as contrast-enhanced (CE) and fluid-attenuated inversion recovery (FLAIR) and multiparametric MRI as relative cerebral blood volume (rCBV) and permeability estimation map (K2). Areas of MRI volumes were semi-automatically segmented. The percentage overlap volumes, Dice and Jaccard spatial similarity coefficients (OV, DSC, JSC) were calculated. RESULTS The 18F-FET tumor volume was significantly larger than the CE volume (median 43.5 mL (2.5-124.9) vs. 23.8 mL (1.4-80.3), p = 0.005). The OV between 18F-FET uptake and CE volume was low (median OV 0.59 (0.10-1)), as well as spatial similarity (median DSC 0.52 (0.07-0.78); median JSC 0.35 (0.03-0.64)). Twenty-five patients demonstrated both rCBV and CE on MRI: The median rCBV tumor volume was significantly smaller than the median CE volume (p < 0.001). The OV was high (median 0.83 (0.54-1)), but the spatial similarity was low (median DSC 0.45 (0.04-0.83); median JSC 0.29 (0.07-0.71)). Twenty-eight patients demonstrated both K2 and CE on MRI. The median K2 tumor volume was not significantly larger than the median CE volume. The OV was high (median OV 0.90 (0.61-1)), and the spatial similarity was moderate (median DSC 0.75 (0.01-0.83); median JSC 0.60 (0.11-0.89)). CONCLUSION We demonstrated that multiparametric perfusion MRI volumes (rCBV, K2) were highly correlated with CE T1 gadolinium volumes whereas 18F-FET PET provided complementary information, suggesting that the metabolically active tumor volume in patients with newly diagnosed untreated HGG is critically underestimated by contrast enhanced MRI. 18F-FET PET imaging may help to improve target volume delineation accuracy for radiotherapy planning.
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Affiliation(s)
- Gurvan Dissaux
- Radiation Oncology Department, University Hospital, Brest, France; Université de Bretagne Occidentale, Brest, France; LaTIM, INSERM 1101, Brest, France.
| | - Brieg Dissaux
- Radiology Department, University Hospital, Brest, France; EA 3878 GETBO IFR 148, Brest, France; Université de Bretagne Occidentale, Brest, France
| | - Osman El Kabbaj
- Radiation Oncology Department, University Hospital, Brest, France
| | - Dorothy M Gujral
- Clinical Oncology Department, Imperial College Healthcare NHS Trust, Charing Cross Hospital, Hammersmith, London, United Kingdom; Department of Cancer and Surgery, Imperial College London, London, United Kingdom
| | - Olivier Pradier
- Radiation Oncology Department, University Hospital, Brest, France; Université de Bretagne Occidentale, Brest, France; LaTIM, INSERM 1101, Brest, France
| | - Pierre-Yves Salaün
- Nuclear Medicine Department, University Hospital, Brest, France; EA 3878 GETBO IFR 148, Brest, France; Université de Bretagne Occidentale, Brest, France
| | - Romuald Seizeur
- Neurosurgery Department, University Hospital, Brest, France; Université de Bretagne Occidentale, Brest, France; LaTIM, INSERM 1101, Brest, France
| | - David Bourhis
- Nuclear Medicine Department, University Hospital, Brest, France; EA 3878 GETBO IFR 148, Brest, France; Université de Bretagne Occidentale, Brest, France
| | - Douraied Ben Salem
- Radiology Department, University Hospital, Brest, France; Université de Bretagne Occidentale, Brest, France; LaTIM, INSERM 1101, Brest, France
| | - Solène Querellou
- Nuclear Medicine Department, University Hospital, Brest, France; EA 3878 GETBO IFR 148, Brest, France; Université de Bretagne Occidentale, Brest, France
| | - Ulrike Schick
- Radiation Oncology Department, University Hospital, Brest, France; Université de Bretagne Occidentale, Brest, France; LaTIM, INSERM 1101, Brest, France
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3
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Analysis of three leakage-correction methods for DSC-based measurement of relative cerebral blood volume with respect to heterogeneity in human gliomas. Magn Reson Imaging 2016; 34:410-21. [DOI: 10.1016/j.mri.2015.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 12/13/2015] [Indexed: 11/21/2022]
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4
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Khalifa J, Tensaouti F, Chaltiel L, Lotterie JA, Catalaa I, Sunyach MP, Ibarrola D, Noël G, Truc G, Walker P, Magné N, Charissoux M, Ken S, Peran P, Berry I, Moyal ECJ, Laprie A. Identification of a candidate biomarker from perfusion MRI to anticipate glioblastoma progression after chemoradiation. Eur Radiol 2016; 26:4194-4203. [PMID: 26843012 DOI: 10.1007/s00330-016-4234-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/13/2016] [Accepted: 01/20/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To identify relevant relative cerebral blood volume biomarkers from T2* dynamic-susceptibility contrast magnetic resonance imaging to anticipate glioblastoma progression after chemoradiation. METHODS Twenty-five patients from a prospective study with glioblastoma, primarily treated by chemoradiation, were included. According to the last follow-up MRI confirmed status, patients were divided into: relapse group (n = 13) and control group (n = 12). The time of last MR acquisition was tend; MR acquisitions performed at tend-2M, tend-4M and tend-6M (respectively 2, 4 and 6 months before tend) were analyzed to extract relevant variations among eleven perfusion biomarkers (B). These variations were assessed through R(B), as the absolute value of the ratio between ∆B from tend-4M to tend-2M and ∆B from tend-6M to tend-4M. The optimal cut-off for R(B) was determined using receiver-operating-characteristic curve analysis. RESULTS The fraction of hypoperfused tumor volume (F_hPg) was a relevant biomarker. A ratio R(F_hPg) ≥ 0.61 would have been able to anticipate relapse at the next follow-up with a sensitivity/specificity/accuracy of 92.3 %/63.6 %/79.2 %. High R(F_hPg) (≥0.61) was associated with more relapse at tend compared to low R(F_hPg) (75 % vs 12.5 %, p = 0.008). CONCLUSION Iterative analysis of F_hPg from consecutive examinations could provide surrogate markers to predict progression at the next follow-up. KEY POINTS • Related rCBV biomarkers from DSC were assessed to anticipate GBM progression. • Biomarkers were assessed through their patterns of variation during the follow-up. • The fraction of hypoperfused tumour volume (F_hP g ) seemed to be a relevant biomarker. • An innovative ratio R(F_hP g ) could be an early surrogate marker of relapse. • A significant time gain could be achieved in the management of GBM patients.
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Affiliation(s)
- J Khalifa
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France. .,Department of Radiation Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.
| | - F Tensaouti
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France
| | - L Chaltiel
- Department of Biostatistics, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France
| | - J-A Lotterie
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Nuclear Medicine, CHU Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400, Toulouse, France
| | - I Catalaa
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Radiology, CHU Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400, Toulouse, France
| | - M P Sunyach
- Department of Radiation Oncology, Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon, France
| | - D Ibarrola
- CERMEP - Imagerie du Vivant, Lyon, France
| | - G Noël
- Department of Radiation Oncology, Centre Paul Strauss, EA 3430, University of Strasbourg, 3 rue de la Porte de l'Hôpital, 67065, Strasbourg, France
| | - G Truc
- Department of Radiation Oncology, Centre Georges-François Leclerc, 1 rue Professeur Marion, 21079, Dijon, France
| | - P Walker
- Laboratory of Electronics, Computer Science and Imaging (Le2I), UMR 6306 CNRS, University of Burgundy, Dijon, France
| | - N Magné
- Department of Radiation Oncology, Institut de cancérologie Lucien-Neuwirth, 108 bis, avenue Albert-Raimond, 42271, Saint-Priest-en-Jarez, France
| | - M Charissoux
- Department of Radiation Oncology, Institut du Cancer de Montpellier, 208 avenue des Apothicaires, parc Euromédecine, 34298, Montpellier cedex 5, France
| | - S Ken
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Medical Physics, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France
| | - P Peran
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Université Toulouse III Paul Sabatier, UMR 1214, 31059, Toulouse, France
| | - I Berry
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Nuclear Medicine, CHU Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400, Toulouse, France.,Université Toulouse III Paul Sabatier, UMR 1214, 31059, Toulouse, France
| | - E Cohen-Jonathan Moyal
- Department of Radiation Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.,Université Toulouse III Paul Sabatier, 31000, Toulouse, France.,INSERM U1037, Centre de Recherches contre le Cancer de Toulouse, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France
| | - A Laprie
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Radiation Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.,Université Toulouse III Paul Sabatier, 31000, Toulouse, France
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Nguyen TB, Cron GO, Perdrizet K, Bezzina K, Torres CH, Chakraborty S, Woulfe J, Jansen GH, Sinclair J, Thornhill RE, Foottit C, Zanette B, Cameron IG. Comparison of the Diagnostic Accuracy of DSC- and Dynamic Contrast-Enhanced MRI in the Preoperative Grading of Astrocytomas. AJNR Am J Neuroradiol 2015; 36:2017-22. [PMID: 26228886 DOI: 10.3174/ajnr.a4398] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 03/24/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Dynamic contrast-enhanced MR imaging parameters can be biased by poor measurement of the vascular input function. We have compared the diagnostic accuracy of dynamic contrast-enhanced MR imaging by using a phase-derived vascular input function and "bookend" T1 measurements with DSC MR imaging for preoperative grading of astrocytomas. MATERIALS AND METHODS This prospective study included 48 patients with a new pathologic diagnosis of an astrocytoma. Preoperative MR imaging was performed at 3T, which included 2 injections of 5-mL gadobutrol for dynamic contrast-enhanced and DSC MR imaging. During dynamic contrast-enhanced MR imaging, both magnitude and phase images were acquired to estimate plasma volume obtained from phase-derived vascular input function (Vp_Φ) and volume transfer constant obtained from phase-derived vascular input function (K(trans)_Φ) as well as plasma volume obtained from magnitude-derived vascular input function (Vp_SI) and volume transfer constant obtained from magnitude-derived vascular input function (K(trans)_SI). From DSC MR imaging, corrected relative CBV was computed. Four ROIs were placed over the solid part of the tumor, and the highest value among the ROIs was recorded. A Mann-Whitney U test was used to test for difference between grades. Diagnostic accuracy was assessed by using receiver operating characteristic analysis. RESULTS Vp_ Φ and K(trans)_Φ values were lower for grade II compared with grade III astrocytomas (P < .05). Vp_SI and K(trans)_SI were not significantly different between grade II and grade III astrocytomas (P = .08-0.15). Relative CBV and dynamic contrast-enhanced MR imaging parameters except for K(trans)_SI were lower for grade III compared with grade IV (P ≤ .05). In differentiating low- and high-grade astrocytomas, we found no statistically significant difference in diagnostic accuracy between relative CBV and dynamic contrast-enhanced MR imaging parameters. CONCLUSIONS In the preoperative grading of astrocytomas, the diagnostic accuracy of dynamic contrast-enhanced MR imaging parameters is similar to that of relative CBV.
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Affiliation(s)
- T B Nguyen
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | - G O Cron
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | | | - K Bezzina
- Faculty of Medicine (K.B.), Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - C H Torres
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | - S Chakraborty
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | | | | | - J Sinclair
- Surgery, Division of Neurosurgery (J.S.)
| | - R E Thornhill
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | | | - B Zanette
- Department of Medical Biophysics (B.Z.), University of Toronto, Toronto, Ontario, Canada
| | - I G Cameron
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.) Medical Physics (C.F., I.G.C.)
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6
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Kelm ZS, Korfiatis PD, Lingineni RK, Daniels JR, Buckner JC, Lachance DH, Parney IF, Carter RE, Erickson BJ. Variability and accuracy of different software packages for dynamic susceptibility contrast magnetic resonance imaging for distinguishing glioblastoma progression from pseudoprogression. J Med Imaging (Bellingham) 2015; 2:026001. [PMID: 26158114 DOI: 10.1117/1.jmi.2.2.026001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 04/17/2015] [Indexed: 11/14/2022] Open
Abstract
Determining whether glioblastoma multiforme (GBM) is progressing despite treatment is challenging due to the pseudoprogression phenomenon seen on conventional MRIs, but relative cerebral blood volume (CBV) has been shown to be helpful. As CBV's calculation from perfusion-weighted images is not standardized, we investigated whether there were differences between three FDA-cleared software packages in their CBV output values and subsequent performance regarding predicting survival/progression. Forty-five postradiation therapy GBM cases were retrospectively identified as having indeterminate MRI findings of progression versus pseudoprogression. The dynamic susceptibility contrast MR images were processed with different software and three different relative CBV metrics based on the abnormally enhancing regions were computed. The intersoftware intraclass correlation coefficients were 0.8 and below, depending on the metric used. No statistically significant difference in progression determination performance was found between the software packages, but performance was better for the cohort imaged at 3.0 T versus those imaged at 1.5 T for many relative CBV metric and classification criteria combinations. The results revealed clinically significant variation in relative CBV measures based on the software used, but minimal interoperator variation. We recommend against using specific relative CBV measurement thresholds for GBM progression determination unless the same software or processing algorithm is used.
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Affiliation(s)
- Zachary S Kelm
- Mayo Clinic, Department of Radiology , 200 1st Street SW, Rochester, Minnesota 55905, United States
| | - Panagiotis D Korfiatis
- Mayo Clinic, Department of Radiology , 200 1st Street SW, Rochester, Minnesota 55905, United States
| | - Ravi K Lingineni
- Mayo Clinic , Department of Health Sciences Research, 200 1st Street SW, Rochester, Minnesota 55905, United States
| | - John R Daniels
- Mayo Clinic , Department of Radiology, 13400 E. Shea Boulevard, Scottsdale, Arizona 85259, United States
| | - Jan C Buckner
- Mayo Clinic , Department of Medical Oncology, 200 1st Street SW, Rochester, Minnesota 55905, United States
| | - Daniel H Lachance
- Mayo Clinic , Department of Neurology, 200 1st Street SW, Rochester, Minnesota 55905, United States
| | - Ian F Parney
- Mayo Clinic , Department of Neurologic Surgery, 200 1st Street SW, Rochester, Minnesota 55905, United States
| | - Rickey E Carter
- Mayo Clinic , Department of Health Sciences Research, 200 1st Street SW, Rochester, Minnesota 55905, United States
| | - Bradley J Erickson
- Mayo Clinic, Department of Radiology , 200 1st Street SW, Rochester, Minnesota 55905, United States
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7
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Tselikas L, Souillard-Scemama R, Naggara O, Mellerio C, Varlet P, Dezamis E, Domont J, Dhermain F, Devaux B, Chrétien F, Meder JF, Pallud J, Oppenheim C. Imaging of gliomas at 1.5 and 3 Tesla - A comparative study. Neuro Oncol 2014; 17:895-900. [PMID: 25526734 DOI: 10.1093/neuonc/nou332] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 11/03/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Glioma follow-up is based on MRI parameters, which are correlated with survival. Although established criteria are used to evaluate tumor response, radiological markers may be confounded by differences in instrumentation including the magnetic field strength. We assessed whether MRIs obtained at 3 Tesla (T) and 1.5T provided similar information. METHODS We retrospectively compared imaging features of 30 consecutive patients with WHO grades II and III gliomas who underwent MRI at 1.5T and 3T within a month of each other, without any clinical changes during the same period. We compared lesion volumes on fluid attenuation inversion recovery (FLAIR), ratio of cerebral blood volume (rCBV) on perfusion-weighted imaging, contrast-to-noise ratio (CNR) on FLAIR, and on post-gadolinium 3D T1-weighted sequences between 1.5T and 3T using intraclass correlation coefficient (ICC). Concordance between observers within and between modalities was evaluated using weighted-kappa coefficient (wκ). RESULTS The mean ± SD delay between modalities (1.5T and 3T MRI) was 8.6 ± 5.6 days. Interobserver/intraobserver concordance for lesion volume was almost perfect for 1.5T (ICC = 0.96/0.97) and 3T (ICC = 0.99/0.98). Agreement between observers for contrast enhancement was excellent at 1.5T (wκ = 0.92) and 3T (wκ = 0.92). The tumor CNR was significantly higher for FLAIR at 1.5T (P < .001), but it was higher at 3T (P = .012) for contrast enhancement. Correlations between modalities for lesion volume (ICC = 0.97) and for rCBV values (ICC = 0.92) were almost perfect. CONCLUSIONS In the follow-up of WHO grades II and III gliomas, 1.5T and 3T provide similar MRI features, suggesting that monitoring could be performed on either a 1.5 or a 3T MR magnet.
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Affiliation(s)
- Lambros Tselikas
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Raphaëlle Souillard-Scemama
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Olivier Naggara
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Charles Mellerio
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Pascale Varlet
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Edouard Dezamis
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Julien Domont
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Frédéric Dhermain
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Bertrand Devaux
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Fabrice Chrétien
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Jean-François Meder
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Johan Pallud
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Catherine Oppenheim
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
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8
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Grand S, Pasteris C, Attye A, Le Bas JF, Krainik A. The different faces of central nervous system metastases. Diagn Interv Imaging 2014; 95:917-31. [DOI: 10.1016/j.diii.2014.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Guillevin R, Herpe G, Verdier M, Guillevin C. Low-grade gliomas: the challenges of imaging. Diagn Interv Imaging 2014; 95:957-63. [PMID: 25195186 DOI: 10.1016/j.diii.2014.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
WHO grade II gliomas are a major challenge for magnetic resonance imaging (MRI) due to their delayed anaplastic transformation. Today it is possible to individually characterize tumor progression from diagnosis to anaplastic transformation based on the many parameters identified in studies in the literature and the possibility of integrating these data into mathematical models. Early identification of negative morphological and metabolic factors, as well as treatment follow-up, help identify predictive factors of tumor progression, as well as determine treatment response to adapt management of this disease.
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Affiliation(s)
- R Guillevin
- Laboratoire DACTIM, service de radiologie, université de Poitiers, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
| | - G Herpe
- Laboratoire DACTIM, service de radiologie, université de Poitiers, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - M Verdier
- Laboratoire DACTIM, service de radiologie, université de Poitiers, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - C Guillevin
- Laboratoire DACTIM, service de radiologie, université de Poitiers, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
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10
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Hoang DH, Pagnier A, Guichardet K, Dubois-Teklali F, Schiff I, Lyard G, Cousin E, Krainik A. Cognitive disorders in pediatric medulloblastoma: what neuroimaging has to offer. J Neurosurg Pediatr 2014; 14:136-44. [PMID: 24950472 DOI: 10.3171/2014.5.peds13571] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Medulloblastomas are the most common malignant childhood brain tumors arising in the posterior fossa. Treatment improvements for these tumors have meant that there are a greater number of survivors, but this long-term patient survival has increased the awareness of resulting neurocognitive deficits. Impairments in attention, memory, executive functions, and intelligence quotient demonstrate that the cerebellum likely plays a significant role in numerous higher cognitive functions such as language, cognitive, and emotional functions. In addition, children with medulloblastoma not only have cerebellar lesions but also brain white matter damages due to radiation and chemotherapy. Functional neuroimaging, a noninvasive method with many advantages, has become the standard tool in clinical and cognitive neuroscience research. By reviewing functional neuroimaging studies, this review aims to clarify the role of the cerebellum in cognitive function and explain more clearly cognitive sequelae due to polytherapy in children with medulloblastoma. This review suggests that the posterior cerebellar lobes are crucial to maintaining cognitive performance. Clinical investigations could help to better assess the involvement of these lobes in cognitive functions.
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Affiliation(s)
- Duc Ha Hoang
- Department of Radiology, University Hospital Viettiep, Haiphong, Vietnam
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11
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Raimbault A, Cazals X, Lauvin MA, Destrieux C, Chapet S, Cottier JP. Radionecrosis of malignant glioma and cerebral metastasis: a diagnostic challenge in MRI. Diagn Interv Imaging 2014; 95:985-1000. [PMID: 25001364 DOI: 10.1016/j.diii.2014.06.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Detecting a new area of contrast-enhancement at MRI after irradiation of malignant brain tumor arises the problem of differential diagnosis between tumor recurrence and radiation necrosis induced by the treatment. The challenge for imaging is to distinguish the two diagnoses given: the prognostic and therapeutic issues. Various criteria have been proposed in the literature based on morphological, functional or metabolic MRI. The purpose of this study was to perform an analysis of these tools to identify MRI best criteria to differentiate radiation necrosis lesions from malignant gliomas and brain metastases recurrence. For gliomas, the morphology of the contrast-enhancement cannot guide the diagnosis and the use of perfusion techniques and spectroscopy (multivoxels if possible) are necessary. In the follow-up of metastasis, a transient increase and moderate lesion volume is possible with a good prognosis. Morphological characteristics (volume ratio T2/T1Gd) and perfusion analysis provide valuable tools for approaching the diagnosis of radionecrosis.
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Affiliation(s)
- A Raimbault
- General Radiology - Diagnostic and Therapeutic Neuroradiology, Bretonneau Hospital, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - X Cazals
- General Radiology - Diagnostic and Therapeutic Neuroradiology, Bretonneau Hospital, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - M-A Lauvin
- General Radiology - Diagnostic and Therapeutic Neuroradiology, Bretonneau Hospital, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - C Destrieux
- Department of Neurosurgery, Bretonneau Hospital, Tours University Hospitals, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - S Chapet
- Department of radiotherapy, Bretonneau Hospital, Tours University Hospitals, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - J-P Cottier
- General Radiology - Diagnostic and Therapeutic Neuroradiology, Bretonneau Hospital, 2, boulevard Tonnellé, 37044 Tours cedex, France.
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12
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Tokgoz S, Paksoy Y, Tokgoz H, Demir O, Mutluer M. Perfusion-weighted cranial MR imaging findings in a patient with hemophagocytic lymphohistiocytosis. J Neuroradiol 2013; 40:307-10. [DOI: 10.1016/j.neurad.2012.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 07/02/2012] [Accepted: 07/25/2012] [Indexed: 11/25/2022]
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13
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Grand S, Tahon F, Attye A, Lefournier V, Le Bas JF, Krainik A. Perfusion imaging in brain disease. Diagn Interv Imaging 2013; 94:1241-57. [PMID: 23876408 DOI: 10.1016/j.diii.2013.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Perfusion CT or MRI have been extensively developed over the last years and are accessible on most imaging machines. Perfusion CT has taken a major place in the assessment of a stroke. Its role has to be specified for the diagnosis and treatment of the vasospasm, complicating a subarachnoid hemorrhage. Perfusion MRI should be included in the assessment of any brain tumor, both at the time of the diagnosis as well as in the post-treatment monitoring. It is included in the multimodal approach required for the optimum treatment of this disease. The applications in epilepsy and the neurodegenerative diseases are in the evaluation process.
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Affiliation(s)
- S Grand
- CHU de Grenoble, Cluni BP 217, 38043 Grenoble cedex 9, France; Grenoble institut des neurosciences, chemin Fortuné-Ferrini, 38042 Grenoble cedex 9, France.
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Zolal A, Hejcl A, Malucelli A, Novakova M, Vachata P, Bartos R, Derner M, Sames M. Distant white-matter diffusion changes caused by tumor growth. J Neuroradiol 2013; 40:71-80. [PMID: 23433909 DOI: 10.1016/j.neurad.2012.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 05/17/2012] [Accepted: 05/27/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Various reports have suggested that the involvement of normal-looking white matter with tumors is not limited to just signal abnormalities detectable on conventional imaging. Thus, the purpose of this study was to investigate the distant effects of glioblastomas and metastases on white matter using diffusion tensor imaging (DTI). MATERIALS AND METHODS Data for 21 patients harboring a glioblastoma (n=12) or a metastasis (n=9) located at a distance of smaller or equal to 10mm from a DTI-based reconstruction of the pyramidal tract were analyzed, using regions of interest (ROIs) placed along the pyramidal tracts in the cerebral peduncle distant (>15 mm) from the tumor. RESULTS For the whole study population, fractional anisotropy (FA) was significantly lower on the side ipsilateral to the tumor (P<0.001), a difference that was also observed in the glioblastoma and metastasis subgroups. The trace value was significantly higher on the ipsilateral side in the whole population and metastasis subgroup, but not in the glioblastoma subgroup. The decrease in FA and the trace value increase were significant in a subgroup of patients with motor deficits, but not in those without such deficits. CONCLUSION Hemispheric glioblastomas and metastases located close to the pyramidal tract induce diffusion changes in the tract that are observable at a distance of greater than 15 mm from the tumor border in the absence of T2 signal changes. These changes are different in glioblastomas and metastases, and mechanisms other than Wallerian degeneration may be contributing to the observed changes.
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Affiliation(s)
- Amir Zolal
- Department of Neurosurgery, J.E. Purkinje University, Masaryk Hospital, Socialni pece 12A, 401 00, Usti nad Labem, Czech Republic.
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