Dataset Information

Delineation of recurrent glioblastoma by whole brain spectroscopic magnetic resonance imaging.

ABSTRACT:

Background

Glioblastoma (GBM) cellularity correlates with whole brain spectroscopic MRI (sMRI) generated relative choline to N-Acetyl-Aspartate ratio (rChoNAA) mapping. In recurrent GBM (rGBM), tumor volume (TV) delineation is challenging and rChoNAA maps may assist with re-RT targeting.

Methods

Fourteen rGBM patients underwent sMRI in a prospective study. Whole brain sMRI was performed to generate rChoNAA maps. TVs were delineated by the union of rChoNAA ratio over 2 (rChoNAA > 2) on sMRI and T1PC. rChoNAA > 2 volumes were compared with multiparametric MRI sequences including T1PC, T2/FLAIR, diffusion-restriction on apparent diffusion coefficient (ADC) maps, and perfusion relative cerebral blood volume (rCBV).

Results

rChoNAA > 2 (mean 27.6 cc, range 6.6-79.1 cc) was different from other imaging modalities (P ≤ 0.05). Mean T1PC volumes were 10.7 cc (range 1.2-31.4 cc). The mean non-overlapping volume of rChoNAA > 2 and T1PC was 29.2 cm³. rChoNAA > 2 was 287% larger (range 23% smaller-873% larger) than T1PC. T2/FLAIR volumes (mean 111.7 cc, range 19.0-232.7 cc) were much larger than other modalities. rCBV volumes (mean 6.2 cc, range 0.2-19.1 cc) and ADC volumes were tiny (mean 0.8 cc, range 0-3.7 cc). Eight in-field failures were observed. Three patients failed outside T1PC but within rChoNAA > 2. No grade 3 toxicities attributable to re-RT were observed. Median progression-free and overall survival for re-RT patients were 6.5 and 7.1 months, respectively.

Conclusions

Treatment of rGBM may be optimized by sMRI, and failure patterns suggest benefit for dose-escalation within sMRI-delineated volumes. Dose-escalation and radiologic-pathologic studies are underway to confirm the utility of sMRI in rGBM.

SUBMITTER: Bell JB

PROVIDER: S-EPMC9948314 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Delineation of recurrent glioblastoma by whole brain spectroscopic magnetic resonance imaging.

Bell Jonathan B JB Jin William W Goryawala Mohammed Z MZ Azzam Gregory A GA Abramowitz Matthew C MC Diwanji Tejan T Ivan Michael E ME Del Pilar Guillermo Prieto Eibl Maria M de la Fuente Macarena I MI Mellon Eric A EA

Radiation oncology (London, England) 20230222 1

<h4>Background</h4>Glioblastoma (GBM) cellularity correlates with whole brain spectroscopic MRI (sMRI) generated relative choline to N-Acetyl-Aspartate ratio (rChoNAA) mapping. In recurrent GBM (rGBM), tumor volume (TV) delineation is challenging and rChoNAA maps may assist with re-RT targeting.<h4>Methods</h4>Fourteen rGBM patients underwent sMRI in a prospective study. Whole brain sMRI was performed to generate rChoNAA maps. TVs were delineated by the union of rChoNAA ratio over 2 (rChoNAA > 2 ...[more]

PMID: 36814267

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Dataset Information

Delineation of recurrent glioblastoma by whole brain spectroscopic magnetic resonance imaging.

Background

Methods

Results

Conclusions

Publications

Delineation of recurrent glioblastoma by whole brain spectroscopic magnetic resonance imaging.

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