Institut za onkologiju i radiologiju Srbije / Institute for Oncology and Radiology of Serbia
Published May 10, 2017 | Version v.1
Journal article Open

Differentiation between progression and pseudoprogression by arterial spin labeling MRI in patients with glioblastoma multiforme

Authors/Creators

  • 1. Clinical Center of Serbia, Radiology and MRI Center, Belgrade
  • 2. Department of Radiation Oncology and Diagnostics, Institute for Oncology and Radiology of Serbia, Belgrade
  • 3. Medical Faculty, University of Belgrade
  • 4. Medical Faculty, University of Belgrade; University Clinical Hospital Center Zemun
  • 5. Medical Faculty, University of Belgrade; Institute for Medical Statistics and Informatics, Belgrade, Serbia
  • 6. Clinical Center of Serbia, Radiology and MRI Center; Medical Faculty, University of Belgrade

Description

PURPOSE: To compare arterial spin labeling (ASL) perfusion technique with the clinically established dynamic susceptibility contrast-enhanced (DSC) perfusion weighted-imaging (PWI), and to determine its value in routine MRI evaluation of disease progression in patients with glioblastoma multiforme (GBM).

METHODS: A prospective intraindividual study was performed in 31 patients with histologically proven GBM who had clinical and/or radiological deterioration after treatment, including surgery, radiotherapy and therapy with temozolomide. Conventional brain protocol with ASL and DSC techniques was performed on 3T MRI unit. Cerebral blood flow (CBF) and cerebral blood volume (CBV) maps were analyzed by means of regions of interest (ROI). Each ROI average value was normalized to the contralateral normal brain parenchyma ROI value. Neuroradiologists analyzed CBF and CBV maps separately, and classified patients into progression or pseudoprogression group. Radiological diagnosis was confirmed by clinical-radiological follow-up for at least three months after patient deterioration.

RESULTS: High linear correlation existed between DSC-PWI and ASL in the tumor ROI (r=0.733; p<0.001). 92% of ASL CBF maps were informative. ASL detected all lesions as well as DSC MRI. Both techniques provided perfusion values closely correlated.

CONCLUSION: ASL allows distinction between GBM progression and pseudoprogression, and it can be used as reliable alternative to DSC-PWI.

Notes

Đ¢his study has shown that ASL may be integrated in the routine MRI protocol as an alternative to DSC PWI, in the differentiation of GBM pseudoprogression and progression.

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Additional details

Related works

Is identical to
28952228 (PMID)
Is part of
1107-0625 (ISSN)
2241-6293 (ISSN)