Document Detail


Differentiation of recurrent glioblastoma multiforme from radiation necrosis after external beam radiation therapy with dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging.
MedLine Citation:
PMID:  19789240     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate whether cerebral blood volume (CBV), peak height (PH), and percentage of signal intensity recovery (PSR) measurements derived from the results of T2-weighted dynamic susceptibility-weighted contrast material-enhanced (DSC) magnetic resonance (MR) imaging performed after external beam radiation therapy (EBRT) can be used to distinguish recurrent glioblastoma multiforme (GBM) from radiation necrosis. MATERIALS AND METHODS: Fifty-seven patients were enrolled in this HIPAA-compliant institutional review board-approved retrospective study after they received a diagnosis of GBM, underwent EBRT, and were examined with DSC MR imaging, which revealed progressive contrast enhancement within the radiation field. A definitive diagnosis was established at subsequent surgical resection or clinicoradiologic follow-up. Regions of interest were retrospectively drawn around the entire contrast-enhanced region. This created T2-weighted signal intensity-time curves that produced three cerebral hemodynamic MR imaging measurements: CBV, PH, and PSR. Welch t tests were used to compare measurements between groups. RESULTS: Mean, maximum, and minimum relative PH and relative CBV were significantly higher (P < .01) in patients with recurrent GBM than in patients with radiation necrosis. Mean, maximum, and minimum relative PSR values were significantly lower (P < .05) in patients with recurrent GBM than in patients with radiation necrosis. CONCLUSION: These findings suggest that DSC perfusion MR imaging may be used to differentiate recurrent GBM from EBRT-induced radiation necrosis.
Authors:
Ramon F Barajas; Jamie S Chang; Mark R Segal; Andrew T Parsa; Michael W McDermott; Mitchel S Berger; Soonmee Cha
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-09-29
Journal Detail:
Title:  Radiology     Volume:  253     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-29     Completed Date:  2009-12-01     Revised Date:  2010-11-02    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  486-96     Citation Subset:  AIM; IM    
Copyright Information:
(c) RSNA, 2009.
Affiliation:
Department of Radiology, Neuroradiology Section, University of California, San Francisco, CA 94143, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Volume
Brain / radiation effects*
Brain Neoplasms / diagnosis*,  radiotherapy*
Cerebrovascular Circulation
Contrast Media*
Diagnosis, Differential
Female
Glioblastoma / diagnosis*,  radiotherapy*
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Angiography*
Male
Middle Aged
Necrosis
Neoplasm Recurrence, Local / diagnosis*
Radiation Injuries / diagnosis*
Radiotherapy Dosage
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
NS045013/NS/NINDS NIH HHS; TL1 RR024129-01/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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