Longitudinal evaluation of DCE-MRI as an early indicator of progression after standard therapy in glioblastoma Journal Article

   

Authors:	Arevalo-Perez, J.; Trang, A.; Yllera-Contreras, E.; Yildirim, O.; Saha, A.; Young, R.; Lyo, J.; Peck, K. K.; Holodny, A. I.
Article Title:	Longitudinal evaluation of DCE-MRI as an early indicator of progression after standard therapy in glioblastoma
Abstract:	Background and Purpose: Distinguishing treatment-induced imaging changes from progressive disease has important implications for avoiding inappropriate discontinuation of a treatment. Our goal in this study is to evaluate the utility of dynamic contrast-enhanced (DCE) perfusion MRI as a biomarker for the early detection of progression. We hypothesize that DCE-MRI may have the potential as an early predictor for the progression of disease in GBM patients when compared to the current standard of conventional MRI. Methods: We identified 26 patients from 2011 to 2023 with newly diagnosed primary glioblastoma by histopathology and gross or subtotal resection of the tumor. Then, we classified them into two groups: patients with progression of disease (POD) confirmed by pathology or change in chemotherapy and patients with stable disease without evidence of progression or need for therapy change. Finally, at least three DCE-MRI scans were performed prior to POD for the progression cohort, and three consecutive DCE-MRI scans were performed for those with stable disease. The volume of interest (VOI) was delineated by a neuroradiologist to measure the maximum values for Ktrans and plasma volume (Vp). A Friedman test was conducted to evaluate the statistical significance of the parameter changes between scans. Results: The mean interval between subsequent scans was 57.94 days, with POD-1 representing the first scan prior to POD and POD-3 representing the third scan. The normalized maximum Vp values for POD-3, POD-2, and POD-1 are 1.40, 1.86, and 3.24, respectively (FS = 18.00, p = 0.0001). It demonstrates that Vp max values are progressively increasing in the three scans prior to POD when measured by routine MRI scans. The normalized maximum Ktrans values for POD-1, POD-2, and POD-3 are 0.51, 0.09, and 0.51, respectively (FS = 1.13, p < 0.57). Conclusions: Our analysis of the longitudinal scans leading up to POD significantly correlated with increasing plasma volume (Vp). A longitudinal study for tumor perfusion change demonstrated that DCE perfusion could be utilized as an early predictor of tumor progression.
Keywords:	radiotherapy; tumor; volume; parameters; apparent diffusion-coefficient; perfusion mri; progression of disease; gbm; max; ktrans; dynamic contrast-enhanced (dce) perfusion mri; maximum plasma volume vp; pod
Journal Title:	Cancers
Volume:	16
Issue:	10
ISSN:	2072-6694
Publisher:	MDPI
Date Published:	2024-05-02
Start Page:	1839
Language:	English
ACCESSION:	WOS:001233161300001
DOI:	10.3390/cancers16101839
PROVIDER:	wos
PMCID:	PMC11119591
PUBMED:	38791921
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding authors are MSK authors: Atin Saha, Onur Yildirim -- Source: Wos

https://synapse.mskcc.org/synapse/works/has_related_data_chk/216537