Apparent transverse relaxation (R2∗) on MRI as a method to differentiate treatment effect (pseudoprogression) versus progressive disease in chemoradiation for malignant glioma
| Autor: | Ravi S. Menon, Jean Guy Belliveau, Maria MacDonald, L. Martyn Klassen, David R. Macdonald, Glenn Bauman |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Gadolinium Contrast Media pseudoprogression chemistry.chemical_element Fluid-attenuated inversion recovery 030218 nuclear medicine & medical imaging concurrent chemoradiotherapy Lesion 03 medical and health sciences 0302 clinical medicine glioma Glioma Image Interpretation Computer-Assisted medicine Humans Radiology Nuclear Medicine and imaging Pseudoprogression medicine.diagnostic_test Brain Neoplasms business.industry Magnetic resonance imaging Chemoradiotherapy medicine.disease Magnetic Resonance Imaging Hyperintensity Treatment Outcome R 2 ∗ Oncology chemistry Disease Progression Female progression medicine.symptom business Nuclear medicine 030217 neurology & neurosurgery Progressive disease |
| Zdroj: | Medical Biophysics Publications |
| ISSN: | 1754-9477 |
| Popis: | Introduction: Pseudoprogression (psPD) is a transient post-treatment imaging change that is commonly seen when treating glioma with chemotherapy and radiation. The use of apparent transverse relaxation rate (R *), which is calculated from a contrast-free multi-echo gradient echo Magnetic Resonance Imaging (MRI) sequence, may allow for quantitative identification of patients with suspected psPD. Methods: We acquired a multi-echo gradient echo sequence using a 3T-Siemens Prisma MRI. The signal decay through the echoes was fitted to provide the (R *) coefficient. We segmented the T -gadolinium enhancing the image to provide a contrast enhancing lesion (CEL) and the FLAIR hyperintensity to provide a non-enhancing lesion (NEL). These regions of interest were applied to the multi-echo gradient echo to acquire a mean (R *) within the CEL and NEL. We additionally acquired ADC data to attempt to corroborate our findings. Results: We found that patients who later exhibited PD exhibited a higher (R *) within the CEL as well as a higher ratio of CEL to NEL. Our data correctly distinguished pseudoprogression from treatment effect in 9/9 patients, while ADC corrected identified 7/9 patients using an absolute ADC of 1200 × 10 mm /s. Conclusions: Our method seems promising for the accurate identification of psPD, and the technique is amenable to evaluation in larger, multi-centre patient cohorts. 2 2 1 2 2 −6 2 |
| Databáze: | OpenAIRE |
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