INTRODUCTION: Glioblastomas multiformes (GBM) remain incurable in most cases. Their invasion into normal brain makes current therapies ineffective. Post-mortem studies suggest about a 25% of GBMs invade less than 1 cm from the tumour bulk and 20% invade more than 3 cm. AIM OF STUDY: The study aims to use DTI to assess tumour extension and determine how previously reported patterns relate to the progression-free survival (PFS). MATERIALS AND METHODS: Twenty-five patients with GBM treated according to the EORTC/NCIC protocol were retrospectively analysed. Patients were imaged post-operatively at 1.5 T. The sequences were composed of standard anatomical and a standard DTI sequence. As described earlier p and q maps were constructed. For each of the p and q maps, regions of interest were drawn around the visible abnormality. Patients were assigned a diffuse, localised or minimally invasive pattern. Progression was defined according to the RANO criteria (4) and PFS determined in days. Kaplan-Meier plots of survival for the three groups were plotted as were the proportion of patients who had not progressed at 24 months. RESULTS: The median PFS for the diffuse group was 278 days, for the localised group 605 days and 820 days for the minimally invasive group. Three-fourth of the minimally invasive group were progression-free at 24 months (LOG RANK 9.25; p = 0.010). CONCLUSION: It is possible to identify three invasive phenotypes in GBMs using Diffusion tensor imaging , and these three phenotypes have different progression free survival. A minimal phenotype (20% of patients) predicts a greater delay to progression.
INTRODUCTION:Glioblastomas multiformes (GBM) remain incurable in most cases. Their invasion into normal brain makes current therapies ineffective. Post-mortem studies suggest about a 25% of GBMs invade less than 1 cm from the tumour bulk and 20% invade more than 3 cm. AIM OF STUDY: The study aims to use DTI to assess tumour extension and determine how previously reported patterns relate to the progression-free survival (PFS). MATERIALS AND METHODS: Twenty-five patients with GBM treated according to the EORTC/NCIC protocol were retrospectively analysed. Patients were imaged post-operatively at 1.5 T. The sequences were composed of standard anatomical and a standard DTI sequence. As described earlier p and q maps were constructed. For each of the p and q maps, regions of interest were drawn around the visible abnormality. Patients were assigned a diffuse, localised or minimally invasive pattern. Progression was defined according to the RANO criteria (4) and PFS determined in days. Kaplan-Meier plots of survival for the three groups were plotted as were the proportion of patients who had not progressed at 24 months. RESULTS: The median PFS for the diffuse group was 278 days, for the localised group 605 days and 820 days for the minimally invasive group. Three-fourth of the minimally invasive group were progression-free at 24 months (LOG RANK 9.25; p = 0.010). CONCLUSION: It is possible to identify three invasive phenotypes in GBMs using Diffusion tensor imaging , and these three phenotypes have different progression free survival. A minimal phenotype (20% of patients) predicts a greater delay to progression.
Authors: Eric Aliotta; Prem P Batchala; David Schiff; Beatriz M Lopes; Jason T Druzgal; Sugoto Mukherjee; Sohil H Patel Journal: J Neurooncol Date: 2019-09-17 Impact factor: 4.130
Authors: L S Hu; H Yoon; J M Eschbacher; L C Baxter; A C Dueck; A Nespodzany; K A Smith; P Nakaji; Y Xu; L Wang; J P Karis; A J Hawkins-Daarud; K W Singleton; P R Jackson; B J Anderies; B R Bendok; R S Zimmerman; C Quarles; A B Porter-Umphrey; M M Mrugala; A Sharma; J M Hoxworth; M G Sattur; N Sanai; P E Koulemberis; C Krishna; J R Mitchell; T Wu; N L Tran; K R Swanson; J Li Journal: AJNR Am J Neuroradiol Date: 2019-02-28 Impact factor: 3.825
Authors: Stephen J Price; Adam M H Young; William J Scotton; Jared Ching; Laila A Mohsen; Natalie R Boonzaier; Victoria C Lupson; John R Griffiths; Mary A McLean; Timothy J Larkin Journal: J Magn Reson Imaging Date: 2015-07-03 Impact factor: 4.813
Authors: Jiun-Lin Yan; Chao Li; Natalie R Boonzaier; Daniel M Fountain; Timothy J Larkin; Tomasz Matys; Anouk van der Hoorn; Stephen J Price Journal: Ther Adv Neurol Disord Date: 2019-05-14 Impact factor: 6.570