Residual tumor volume, cell volume fraction, and tumor cell kill during fractionated chemoradiation therapy of human glioblastoma using quantitative sodium MR imaging Journal Article


Authors: Thulborn, K. R.; Lu, A.; Atkinson, I. C.; Pauliah, M.; Beal, K.; Chan, T. A.; Omuro, A.; Yamada, J.; Bradbury, M. S.
Article Title: Residual tumor volume, cell volume fraction, and tumor cell kill during fractionated chemoradiation therapy of human glioblastoma using quantitative sodium MR imaging
Abstract: Purpose: Spatial and temporal patterns of response of human glioblastoma to fractionated chemoradiation are described by changes in the bioscales of residual tumor volume (RTV), tumor cell volume fraction (CVF), and tumor cell kill (TCK), as derived from tissue sodium concentration (TSC) measured by quantitative sodium MRI at 3 Tesla. These near real-time patterns during treatment are compared with overall survival. Experimental Design: Bioscales were mapped during fractionated chemoradiation therapy in patients with glioblastomas (n 1⁄4 20) using TSC obtained from serial quantitative sodium MRI at 3 Tesla and a two-compartment model of tissue sodium distribution. The responses of these parameters in newly diagnosed human glioblastomas undergoing treatment were compared with time-to-disease progression and survival. Results: RTV following tumor resection showed decreased CVF due to disruption of normal cell packing by edema and infiltrating tumor cells. CVF showed either increases back toward normal as infiltrating tumor cells were killed, or decreases as cancer cells continued to infiltrate and extend tumor margins. These highly variable tumor responses showed no correlation with time-to-progression or overall survival. Conclusions: These bioscales indicate that fractionated chemoradiotherapy of glioblastomas produces variable responses with low cell killing efficiency. These parameters are sensitive to real-time changes within the treatment volume while remaining stable elsewhere, highlighting the potential to individualize therapy earlier in management, should alternative strategies be available. © 2018 American Association for Cancer Research.
Journal Title: Clinical Cancer Research
Volume: 25
Issue: 4
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2019-02-15
Start Page: 1226
End Page: 1232
Language: English
DOI: 10.1158/1078-0432.Ccr-18-2079
PUBMED: 30487127
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. Timothy Chan
    221 Chan
  2. Yoshiya Yamada
    359 Yamada
  3. Antonio Marcilio Padula Omuro
    177 Omuro
  4. Kathryn Beal
    157 Beal