Authors: Jonathan Khalifa Fatima Tensaouti JeanAlbert Lotterie Isabelle Catalaa Leonor Chaltiel Alexandra BenouaichAmiel Carlos GomezRoca Georges Noël Gilles Truc Patrice Péran Isabelle Berry MariePierre Sunyach Marie Charissoux Corinne Johnson Elizabeth CohenJonathan Moyal Anne Laprie
Publish Date: 2016/08/08
Volume: 130, Issue: 1, Pages: 181-192
Abstract
To assess the value of T2 dynamicsusceptibility contrast MRI DSCMRI and diffusionweighted imaging DWI to predict the glioblastoma relapse sites after chemoradiation From a cohort of 44 patients primarily treated with radiotherapy 60 Gy and concomitant temozolomide for glioblastoma who were included in the reference arm of a prospective clinical trial NCT01507506 15 patients relapsed and their imaging data were analyzed All patients underwent anatomical MRI DSCMRI and DWI before radiotherapy and every 2 months thereafter until relapse Voxels within the sites of relapse were correlated with their perfusion and/or diffusion abnormality PDA pretreatment status after rigid coregistration The relative cerebral blood volume rCBV and apparent diffusion coefficient ADC were used as biomarkers Several PDA areas were thresholded hyperperfused voxels using a 175 fixed rCBV threshold HPt hypoperfused hPg and hyperperfused HPg voxels using a histogrambased Gaussian method diffusionrestricted voxels DRg and HPg voxels with diffusion restriction HPgDRg Two sets of voxels 2459483 and 2073880 were analyzed according to these thresholding methods Positive predictive values PPV of PDA voxels were low between 95 and 319 The best PPV was obtained with HPgDRg voxels within the FLAIR hyperintensity as 183 of voxels without initial PDA were within relapse sites versus 319 with initial PDA p 00001 This prospective study suggests that DSC and/or DWIMRI do not predict the glioblastoma relapse sites However further investigations with new methodological approaches are needed to better understand the role of these modalities in the prediction of glioblastoma relapse sites
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