The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma

Author:

Rejimon Abinand C.12ORCID,Ramesh Karthik K.12,Trivedi Anuradha G.12ORCID,Huang Vicki12ORCID,Schreibmann Eduard1,Weinberg Brent D.34ORCID,Kleinberg Lawrence R.5ORCID,Shu Hui-Kuo G.14,Shim Hyunsuk1234,Olson Jeffrey J.46ORCID

Affiliation:

1. Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA

2. Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA

3. Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA

4. Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA

5. Department of Radiation Oncology, Johns Hopkins University, Baltimore, MD 21218, USA

6. Department of Neurosurgery, Emory University, Atlanta, GA 30322, USA

Abstract

Current diagnostic and therapeutic approaches for gliomas have limitations hindering survival outcomes. We propose spectroscopic magnetic resonance imaging as an adjunct to standard MRI to bridge these gaps. Spectroscopic MRI is a volumetric MRI technique capable of identifying tumor infiltration based on its elevated choline (Cho) and decreased N-acetylaspartate (NAA). We present the clinical translatability of spectroscopic imaging with a Cho/NAA ≥ 5x threshold for delineating a biopsy target in a patient diagnosed with non-enhancing glioma. Then, we describe the relationship between the undertreated tumor detected with metabolite imaging and overall survival (OS) from a pilot study of newly diagnosed GBM patients treated with belinostat and chemoradiation. Each cohort (control and belinostat) were split into subgroups using the median difference between pre-radiotherapy Cho/NAA ≥ 2x and the treated T1-weighted contrast-enhanced (T1w-CE) volume. We used the Kaplan–Meier estimator to calculate median OS for each subgroup. The median OS was 14.4 months when the difference between Cho/NAA ≥ 2x and T1w-CE volumes was higher than the median compared with 34.3 months when this difference was lower than the median. The T1w-CE volumes were similar in both subgroups. We find that patients who had lower volumes of undertreated tumors detected via spectroscopy had better survival outcomes.

Funder

NIH

Publisher

MDPI AG

Reference42 articles.

1. Role of stereotactic biopsy in the diagnosis and management of brain tumors;Krieger;Semin. Surg. Oncol.,1998

2. How often are nonenhancing supratentorial gliomas malignant? A population study;Scott;Neurology,2002

3. Unreliability of contemporary neurodiagnostic imaging in evaluating suspected adult supratentorial (low-grade) astrocytoma;Kondziolka;J. Neurosurg.,1993

4. Preliminary evaluation of fluid-attenuated inversion-recovery MR in the diagnosis of intracranial tumors;Tsuchiya;AJNR Am. J. Neuroradiol.,1996

5. Advances in MRI assessment of gliomas and response to anti-VEGF therapy;Pope;Curr. Neurol. Neurosci. Rep.,2011

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3