| Differentiating treatment-induced necrosis from recurrent/progressive brain tumor using nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion. | |
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MedLine Citation:
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PMID: 21803763 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Differentiating treatment-induced necrosis (TIN) from recurrent/progressive tumor (RPT) in brain tumor patients using conventional morphologic imaging features is a very challenging task. Functional imaging techniques also offer moderate success due to the complexity of the tissue microenvironment and the inherent limitation of the various modalities and techniques. The purpose of this retrospective study was to assess the utility of nonmodel-based semiquantitative indices derived from dynamic contrast-enhanced T1-weighted MR perfusion (DCET1MRP) in differentiating TIN from RPT. Twenty-nine patients with previously treated brain tumors who showed recurrent or progressive enhancing lesion on follow-up MRI underwent DCET1MRP. Another 8 patients with treatment-naive high-grade gliomas who also underwent DCET1MRP were included as the control group. Semiquantitative indices derived from DCET1MRP included maximum slope of enhancement in initial vascular phase (MSIVP), normalized MSIVP (nMSIVP), normalized slope of delayed equilibrium phase (nSDEP), and initial area under the time-intensity curve (IAUC) at 60 and 120 s (IAUC(60) and IAUC(120)) obtained from the enhancement curve. There was a statistically significant difference between the 2 groups (P < .01), with the RPT group showing higher MSIVP (15.78 vs 8.06), nMSIVP (0.046 vs 0.028), nIAUC(60) (33.07 vs 6.44), and nIAUC(120) (80.14 vs 65.55) compared with the TIN group. nSDEP was significantly lower in the RPT group (7.20 × 10(-5) vs 15.35 × 10(-5)) compared with the TIN group. Analysis of the receiver-operating-characteristic curve showed nMSIVP to be the best single predictor of RPT, with very high (95%) sensitivity and high (78%) specificity. Thus, nonmodel-based semiquantitative indices derived from DCET1MRP that are relatively easy to derive and do not require a complex model-based approach may aid in differentiating RPT from TIN and can be used as robust noninvasive imaging biomarkers. |
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Authors:
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Jayant Narang; Rajan Jain; Ali Syed Arbab; Tom Mikkelsen; Lisa Scarpace; Mark L Rosenblum; David Hearshen; Abbas Babajani-Feremi |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2011-07-29 |
Journal Detail:
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Title: Neuro-oncology Volume: 13 ISSN: 1523-5866 ISO Abbreviation: Neuro-oncology Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-08-19 Completed Date: 2011-12-08 Revised Date: 2012-09-28 |
Medline Journal Info:
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Nlm Unique ID: 100887420 Medline TA: Neuro Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 1037-46 Citation Subset: IM |
Affiliation:
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Division of Neuroradiology, Department of Radiology, Henry Ford Health System, Detroit, MI 48202, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Brain Neoplasms / pathology, radiography*, radiotherapy* Cohort Studies Diffusion Magnetic Resonance Imaging* Female Follow-Up Studies Glioma / pathology, radiography*, radiotherapy* Humans Male Middle Aged Necrosis Neoplasm Recurrence, Local / pathology, radiography*, radiotherapy* Radiation Injuries / radiography* Retrospective Studies Survival Rate Treatment Outcome Young Adult |
| Comments/Corrections | |
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